Aortic dissection-Pulmonary embolism association: A therapeutic dilemma.

Aortic dissection is a rare but serious condition. Its association with pulmonary embolism is exceptional and produces a real therapeutic dilemma. We are discussing the case of a 67-year-old male patient who presented with paraplegia with infectious syndrome. The chest X-ray performed to screen for an infectious site led to the suspicion of an aortic aneurysm and the CT angiography showed Stanford type B aortic dissection associated with bilateral proximal pulmonary embolism. The treatment was symptomatic and resulted in the patient's death 48 hours after diagnosis. Management of this pathological association is not standardized between establishing anticoagulant therapy and therapeutic abstention. This management depends on the teams and has a very cautious prognosis.

[Myoma, fortuitous discovery or metrorrhagia: Which is more revealing?] / Myome, découverte fortuite ou métrorragie: qui dit mieux?

INTRODUCTION: myoma is commonly diagnosed in our hospital. It can be accidentally discovered or discovered due to metrorrhagia. The purpose of this study is to evaluate the association between the size of myomas and the circumstances under which they are detected and between the location of myomas and the occurrence of bleeding. METHODS: we conducted a cross-sectional study including women aged 18 or older undergoing ultrasound at the University Teaching Hospital Bogodogo and who were diagnosed with at least one uterine myoma over a period of 6 years from January 2012 to December 2018. Binary logistic regression was used to assess metrorrhagia while multinomial logistic regression was used to assess circumstances under which they were detected and size. RESULTS: we assessed 1049 women, among whom 2294 had myomas diagnosed on ultrasound. Each woman had two myomas. The average age of patients was 37 years. Women with myomas larger than 50 mm accounted for 29.7% (n=311). There was a strong association between interstitial, subserosal and submucosal myomas and the occurrence of metrorrhagias (p<0.001). A size less than 50 mm was significantly associated with fortuitous discovery (p=0.016) but not with revealing metrorrhagia (p=0.084). Women who had submucosal myomas (OR=3.13; CI95%= [1.45-6.76]), interstitial and submucosal myomas (OR=2.24; CI95%= [1.05-4.78] as well as interstitial, subserosal and submucosal myomas (OR=3.57; CI95%= [1.88-6.76]) were at higher risk of developing metrorrhagia. Myomas measuring less than 50 mm had twice the odds of revealing fortuitously (RRR=1.80; CI95%= [1.25-2.62]) or by metrorrhagia (RRR=1.75; CI95%= [1.04-2.95]. CONCLUSION: metrorrhagia is more common in women with myomas in specific locations.

[Status of obstetrical echography at the imaging service of the University Hospital Center of Bogodogo from January 1st, 2016 to December 31st, 2018]. / État des lieux des échographies obstétricales au service d'imagerie du Centre Hospitalier Universitaire Bogodogo du 1er janvier 2016 au 31 décembre 2018.

Obstetric ultrasound performed according to standards from its prescription to the report is a guarantee of quality. The aim of our study was to take stock of obstetrical ultrasounds in order to make rational the ultrasound follow-ups of pregnancy. This was a descriptive cross-sectional study with retrospective data collection through the reports of obstetrical ultrasounds performed from the 1st January 2016 to 31st December 2018. Of the 13,487 ultrasounds in the study period, 2,355 were obstetric ultrasounds, constituting 1746% of the ultrasound activity. The mean gestational age was 27.54 years (± 6.19). The CHU Bogodogo was the requesting structure for 86.88%. Paramedics were prescribers in 66.47%. Third trimester ultrasounds made up 57.06%. Gestational age in 12.99% was greater than 37 weeks while in 66.37% gestational age was greater than 24 weeks. Prenatal follow-up was indicated in 54.48%. Pregnancies were progressive in 97.49%. Twin pregnancies represent 2.72% and ultrasound pathological pregnancies 11.80%. Obstetric Doppler was performed in 2.12% with pre-eclampsia as the main indication (52%). There was 1.18% malformation with nervous system involvement in 60.71%. Through this inventory, the training of prescribers of obstetric ultrasound appears essential. The establishment of an observatory of obstetric ultrasound practices would be an asset for the quality of these medical examinations.