ABSTRACT
Massive purulent andacute pericarditis in children is a life-threatening disease associated with high mortality. It has been described tocomplicate usuallya bronchopulmonary infectionbut is currently uncommon in the era of antibiotics. Acute and massive purulent pericarditis has been rarely reported in children in association with human immunodeficiency virus (HIV) infection. This is a case of a10-year-old boy who presented with signs of sepsis and cardiac tamponade due to a massive staphylococcal purulent pericarditis complicating an unknown HIV infection.The child underwent pericardiectomy, intensive treatment, and survived this life-threatening disease.
Subject(s)
HIV Infections/complications , HIV , Liver Abscess/diagnosis , Pericardiocentesis/methods , Pericarditis/complications , Staphylococcal Infections/complications , Staphylococcus aureus/isolation & purification , Acute Disease , Anti-Bacterial Agents/therapeutic use , Child , Diagnosis, Differential , HIV Infections/diagnosis , Humans , Male , Pericarditis/microbiology , Pericarditis/therapy , Staphylococcal Infections/diagnosis , Staphylococcal Infections/surgery , Suppuration , Tomography, X-Ray ComputedABSTRACT
Le but de cette étude était de décrire les complications des avortements provoqués dans la clandestinité et imposant un traitement chirurgical. Il s'agit d'une étude rétrospective transversale portant sur les malades opérés dans les services de Chirurgie de l'Hôpital central et du Centre Hospitalier Universitaire de Yaoundé du 1er Janvier 2004 au 31 Décembre 2008. Les variables d'étude étaient l'âge, le statut matrimonial, les antécédents gynécologiques, les antécédents d'avortement antérieur, le mode, l'indication chirurgicale et l'état général des patientes; les lésions découvertes en peropératoire, leur traitement et l'évolution postopératoire. Cinquante une patientes ont été retenues pour cette étude menée pendant une durée de quatre ans, soit une moyenne de 12,7 cas par an. L'âge des patientes variait entre 15 ans et 41 ans avec une moyenne de 30 ans; 33 patientes (64,7%) avaient un âge situé entre 15ans et 25 ans. 6 patientes (11,7%) étaient multipares et 4 patientes étaient primipares (7,8%). Treize patientes (25,42%) avaient déjà subi une interruption volontaire de grossesse sans complication. Quarante-neuf patientes (96%) étaient arrivées avec un tableau de péritonite ; 43 patientes (84,22%) étaient classées ASA III (American Association of Anesthesiologists). Les lésions chirurgicales étaient à type de perforations ou de déchirures utérines dans 20 cas (39,21%), annexielles dans 9cas (17,64%), digestives dans 16 cas (31,37%) et urinaires dans 4 cas. Le traitement a associé au traitement de la péritonite, les sutures utérines, digestives et vésicales ; les gestes d'exérèse comprenaient deux hystérectomies et cinq salpingectomies. Il a été réalisé des gestes de dérivation dont deux cystostomies et deux colostomies. La mortalité était de 15,6%. L'étude recommande une éducation des femmes en matière de contraception et de planning familial, et surtout une politique sociale permettant de réduire le nombre des avortements clandestins
Subject(s)
Abortion, Criminal/adverse effects , Cameroon , Case Reports , Intraoperative Complications , Postoperative ComplicationsABSTRACT
Anaesthesia for removal of pheochromocytomas requires preoperative preparation of patients so as to normalize blood pressure. During operation, hypovolemia linked with the sudden fall of circulating catecholamines as well as hypertension during handling of the tumor are to be managed. A case of a 11 year child with pheochromocytoma is reported. Once the diagnosis had been established, various attempts to normalize blood pressure failed. Despite a precarious condition, the operation could be performed. During surgery, hypertension occurred and three hypotensive drugs failed to correct it. It ceased after removal of the tumor. The postoperative course was uneventful. The authors discuss the role of the type of catecholamines and their concentration in the failure of antihypertensive medication.
Subject(s)
Adrenal Gland Neoplasms/surgery , Antihypertensive Agents/therapeutic use , Hypertension/drug therapy , Pheochromocytoma/surgery , Adrenal Gland Neoplasms/complications , Child , Humans , Hypertension/etiology , Intraoperative Complications , Male , Pheochromocytoma/complicationsABSTRACT
The authors report on a study carried out at the Centre Hospitalier universitaire (University Hospital) of Yaounde (Cameroon). Such a study aimed at to check interest of systematic malaria chemoprophylaxis during the peri-operative phase in general surgery. 61 patients were divided in two groups by random allocation with and without quinine chemoprophylaxis. All of them were monitored clinically and parasitologically during the peri-operative phase. Results show that in both groups, only patients already positive before surgical intervention presented clinical malaria signs, biologically confirmed; malaria attack was more frequent and more severe in the group without quinine. No malaria attack was observed in patients of both groups in which thick smear was negative in pre-operative phase. The authors suggest that any patient during the pre-operative phase, be tested to find out Plasmodium falciparum. If the test is positive, so chemoprophylaxis with quinine be prescribed. But such a medication is valuable only in urban endemic zone.
