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3.
Tunis Med ; 86(2): 169-70, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18444536

RESUMO

BACKGROUND: Verneuil's disease or hidradenitis suppurativa is a chronic suppurative, and cicatricial inflammatory disease, mainly affecting apocrine-bearing area of the skin. Squamous cell carcinoma is an uncommon but a frightening complication of hidradenitis suppurativa. AIM: To report a new case of squamous cell carcinoma arising in Verneuil's disease. CASE REPORT: We reported a case of 60 year old man with a 30 years history of hidradenitis suppurativa in which squamous cell carcinoma arise. A wide surgical excision removing the tumour and leaving a large defect was performed. The patient had a well recovery, wounds healed well by primary intention. No recurrence observed at 18 months of follow up. CONCLUSION: Squamous cell carcinoma is an uncommon complication of hidradenitis suppurativa. Surgical excision represents also the treatment of choice.


Assuntos
Neoplasias do Ânus/complicações , Carcinoma de Células Escamosas/complicações , Hidradenite Supurativa/complicações , Neoplasias Cutâneas/complicações , Neoplasias do Ânus/cirurgia , Carcinoma de Células Escamosas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/cirurgia
5.
Tunis Med ; 84(6): 374-6, 2006 Jun.
Artigo em Francês | MEDLINE | ID: mdl-17042212

RESUMO

Renal vein thrombosis is a rare pathology difficult to diagnose. It has quite various clinical expressions and biological consequences. The diagnosis is based upon radiologic explorations. This entity may have various causes. Detecting this condition may lead to restoration of renal function compromised by renal vein thrombosis. The treatment of renal vein thrombosis is mainly medical and based on anticoagulants. The role of fibrinolytic treatment is controversial. Surgery is exceptional. We report two cases of idiopathic thrombosis of the renal vein in adult patient. Also, we have done a review of the literature on this clinical syndrome and its diagnostic and therapeutic aspects.


Assuntos
Veias Renais , Trombose Venosa , Anticoagulantes/administração & dosagem , Anticoagulantes/uso terapêutico , Feminino , Fibrinolíticos/administração & dosagem , Fibrinolíticos/uso terapêutico , Seguimentos , Heparina/administração & dosagem , Heparina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Abdominal , Veias Renais/diagnóstico por imagem , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia Doppler , Urografia , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/tratamento farmacológico , Vitamina K/antagonistas & inibidores
6.
Tunis Med ; 82(8): 730-4, 2004 Aug.
Artigo em Francês | MEDLINE | ID: mdl-15532767

RESUMO

UNLABELLED: The aim of the study was to determine prognostic factors of post operative morbidity and mortality for patients aged 80 years and older. We compared two groups of patients aged 80 and over operated to determine predictive factors of morbidity and mortality: group of patients who presented post operative complication within 30 days after surgery and group of patients without any complication. Comparison of the two groups for global morbidity using univariate analysis showed only one prognostic factor: surgery of diabetic foot (p = 0.034). Predictive factors of mortality according to univariate analysis were: pre-operative shock (p = 0.001), abdominal wall pathology (p = 0.027), gastric or duodenal ulcer diseases (p = 0.011) and global morbidity (p = 0.006). After logistic regression, only pre-operative shock was an independent predictive factor of mortality (p = 0.0023). CONCLUSION: Risk for morbidity after surgery in the elderly 80 years and over is linked with type of surgery and not with soil. Likewise, risk for mortality is linked with advanced stage of disease that is presence of pre-operative shock and not with soil.


Assuntos
Procedimentos Cirúrgicos Operatórios/efeitos adversos , Procedimentos Cirúrgicos Operatórios/mortalidade , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Complicações Pós-Operatórias/epidemiologia , Prognóstico , Estudos Retrospectivos
7.
Tunis Med ; 82(2): 229-32, 2004 Feb.
Artigo em Francês | MEDLINE | ID: mdl-15185601

RESUMO

Among digestive clinical presentations of systemic lupus erythematosus, acute pancreatitis remains a serious affection with very poor prognosis. To date, pathogenesis is still unclear. We report two cases of fatal acute pancreatitis related to systemic lupus erythematosus.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Pancreatite/etiologia , Doença Aguda , Adulto , Humanos , Masculino , Pancreatite/patologia
8.
Tunis Med ; 82(1): 69-71, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15125362

RESUMO

Ectopic kidney is a rare pathology. It is usually misknown and often revealed by a complication. We report a case of a 30-year-old male patient who presented in emergency with a right thoraco-abdominal trauma and a benign head trauma. Injury evaluation revealed a right ectopic pelvic kidney with a grade IV laceration. Furthermore, there was a hepatic contusion in the sixth segment and a fracture of the ninth, tenth and eleventh right ribs. Therapeutic attitude consisted on a successful conservative and nonoperative treatment for both lesions. CT scan is of utmost importance in diagnosis. Management is the same as for normally positioned kidney.


Assuntos
Traumatismos Abdominais/patologia , Coristoma/diagnóstico , Rim/lesões , Rim/patologia , Fígado/lesões , Traumatismos Abdominais/etiologia , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Pelve/patologia , Fraturas das Costelas/patologia , Tomografia Computadorizada por Raios X , Ferimentos e Lesões
9.
Tunis Med ; 81(7): 505-9, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-14534963

RESUMO

Neuroendocrine tumors (NET) of the digestive system are rare. They comprise only 1% of all the tumors of the gastrointestinal tract. The aim of this study is to report two cases of exceptional localization of non secretary neuroendocrine tumors. Their difficulty in diagnosis, treatment and controversy in chemotherapy merit their study in depth. These are two patients that were treated in the department of general surgery (Beau Séjour) in Charles Nicolle Hospital for non secretary (NET) of the pancreas and stomach. The first was presented as a painless epigastria mass with frequent diarrhea. The second was presented as a painful mass in the left hypochondriac area without any other symptoms. Biochemical evaluation confirmed their non secretary properties. Surgery remains the first line of treatment. It was possible for the gastric, but not for the pancreatic tumor. Both were very advanced and had metastasis. Histopathological evaluation and immunohistochemical study using the method of peroxydase antiperoxydase (PAP) complexes for some special monoclonal antibodies confirmed the diagnosis. Chemotherapy of both cases was mal tolerated and was discussed in details.


Assuntos
Tumores Neuroendócrinos , Neoplasias Pancreáticas , Neoplasias Gástricas , Adulto , Feminino , Seguimentos , Gastrectomia , Humanos , Imuno-Histoquímica , Excisão de Linfonodo , Pessoa de Meia-Idade , Metástase Neoplásica , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/cirurgia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/terapia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirurgia , Fatores de Tempo
10.
Tunis Med ; 81(5): 351-3, 2003 May.
Artigo em Francês | MEDLINE | ID: mdl-12934458

RESUMO

Bezoars are concretions of stagnant swallowed material in digestive tract. The most frequent are trichobezoars made of hair and phytobezoars composed of undigestible fruits and vegetables fibers. We report a case of a 24-year-old female patient who presented in emergency with an acute peritonitis due to a gastric perforation on bezoars. Gastrotomy, extraction of bezoars, gastric stitching and peritoneal lavage were performed. Post operative period was uneventful. A new careful interrogation into the patient's previous habits found glue-eating custom during the four last years.


Assuntos
Bezoares/complicações , Ruptura Gástrica/etiologia , Adulto , Bezoares/cirurgia , Feminino , Humanos , Lavagem Peritoneal , Peritonite/etiologia , Ruptura Espontânea , Estômago/cirurgia , Ruptura Gástrica/cirurgia
11.
Tunis Med ; 81(2): 145-8, 2003 Feb.
Artigo em Francês | MEDLINE | ID: mdl-12708183

RESUMO

Cytomegalovirus infection of the digestive tract is rare and particularly severe after transplantation. Colon is the most often affected part of the digestive tube. We present the case of acute cytomegalovirus colitis that occurred five months after a bone marrow transplantation. An emergency subtotal colectomy with sigmoidostomy and ileostomy was performed followed six weeks later by an ileorectal anastomosis. The pathologic specimen showed cytomegalovirus inclusion bodies proving the diagnosis.


Assuntos
Transplante de Medula Óssea , Colite/etiologia , Infecções por Citomegalovirus , Complicações Pós-Operatórias , Doença Aguda , Adolescente , Anastomose Cirúrgica , Colectomia , Colite/diagnóstico , Colite/microbiologia , Colite/cirurgia , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/diagnóstico , Emergências , Seguimentos , Humanos , Ileostomia , Íleo/cirurgia , Masculino , Reto/cirurgia , Fatores de Tempo
12.
Tunis Med ; 81(11): 885-8, 2003 Nov.
Artigo em Francês | MEDLINE | ID: mdl-14986545

RESUMO

Two cases of small bowel neurofibromatosis in patients with Von Recklinghausen's disease are reported. Diagnosis of small bowel neurofibromatosis was made on the occasion of a complication for the two cases. We insist on the difficulty of diagnosis as well as in presence or not of complications. Treatment of these most often benign tumours remains surgical based on a segmental small bowel resection.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Tratamento de Emergência , Enteropatias/patologia , Enteropatias/cirurgia , Neurofibromatose 1/complicações , Adulto , Humanos , Intestino Delgado/patologia , Intestino Delgado/cirurgia , Masculino , Pessoa de Meia-Idade
13.
Tunis Med ; 80(8): 485-8, 2002 Aug.
Artigo em Francês | MEDLINE | ID: mdl-12703129

RESUMO

The aim of this study was to identify the prognostic factors of intraoperative haemorrhage, perioperative blood transfusions and morbidity. We collected 120 splenectomies in Beau Séjour department of surgery, Charles' Nicolle Hospital, Tunis, Tunisia between 1979 and 1999. The descriptive analysis showed sex-ratio 0.82 with mean age (+/- standard deviation) 30.6 +/- 15 year. Idiopathic thrombopenic purpura was the principal disease indicating splenectomy. Morbidity was defined as occurrence of post operative peritoneal sepsis or bleeding. The mortality and morbidity rates were respectively 0.8% and 6.6%. The prognostic analysis didn't identify predictive factors of intraoperative haemorrhage, however it identified two independent predictive actors of specific morbidity: intraoperative haemorrhage (p = 0.03) and preoperative rate of haemoglobin (p = 0.0049).


Assuntos
Doenças Hematológicas/terapia , Complicações Pós-Operatórias , Esplenectomia , Adolescente , Adulto , Feminino , Hemorragia , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Planejamento de Assistência ao Paciente , Prognóstico , Estudos Retrospectivos , Sepse
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