Biomedical subjects
Publications and source records attributed to A Slaoui.
Several myocardial lesions can be induced by thoracic blunt trauma. It varies from myocardial lesions to heart rupture. We report a case of right atrial rupture due to unusual blunt trauma: a hoof kick. We describe a successful management of this case. We suggest that a diagnosis of cardiac chamber rupture should be considered in all cases of blunt thoracic trauma.
Few cases of postoperative hypoglycaemia complicating the removal of a phaeochromocytoma have been reported in the literature. We reported one case of hypoglycaemia secondary to the removal of right phaeochromocytoma in a 30-year-old patient. Seven hours after the excision of the tumour, the patient developed a severe hypoglycaemia at 1.67 mmol x l(-1) revealed by seizures completely resolving in 24 h. The hypoglycaemia in this context resulted probably from the massive secretion of insulin by the beta cells of Langerhans islands due to the suppression of alpha-adrenergic inhibition. The prevention of this complication requires the repeated measurement of the capillary glycaemia in the postoperative period. An important supply of carbohydrate may be necessary to maintain a normoglycaemia.
We report a case of right atrial rupture due to blunt trauma by a hoof kick to the anterior chest wall. We describe our successful management of this case. We suggest that a diagnosis of cardiac chamber rupture should be considered in all cases of blunt thoracic trauma.
We report two cases of type III rupture of the left ventricle posterior wall, situated midway between the mitral annulus and the posterior papillary muscle and occurring in immediate continuations of a mitral valvular replacement. The first case has occurred at the moment of the canulas removal in a 28 years old patient operated for mitral stenosis. The tear was repaired with horizontal mattress sutures through felt strips on the external surface of the heart. The immediate post operative course was marked by bleeding recurrence and cardiac failure which has led to death. In the second case, a 68 years old man was operated for degenerative mitral insufficiency. The rupture has occurred just before closing the chest. The repair was realized successfully by using an intra-ventricular patch. The chordae tendinae removal constitutes a factor predisposing to the left ventricle posterior wall rupture. The repair has to use an intra-ventricular patch. The prevention is based on the preservation of the continuity between the mitral annulus and papillary muscles by preserving the sub-valvular apparatus or by using synthetic chordae.
Muscle paralysis due to potassium depletion are unusual. We report the case of a patient who developed quadriplegia and language disorders due to potassium depletion, following large intestinal resection. Potassium supplementation was given intravenously at a rate of 0.25 mmol.kg-1.h-1 during the first 48 h. This allowed complete total and rapid recovery from the paralysis.
In this study, a case of emphysematous pyelonephritis has been reported in a 70-year old diabetic male with a non-functional contralateral kidney. In spite of appropriate medical treatment and surgical drainage, the outcome was negative. The case in question concerned a rare form of the disease, i.e., emphysematous pyelonephritis, a severe and necrotizing infection which is characterized by the presence of intraparenchymal gas produced by anaerobic bacteria, and the rapid development of acute sepsis or septic shock. Medical treatment alone is seldom sufficient, and surgical intervention, in most instances consisting of radical nephrectomy rather than surgical drainage, is advocated due to the extent of the necrotic lesions.
We report five cases of phaeochromocytoma in patients admitted for myocardial infarction, severe cardiac failure, with shock, stroke and ischaemic gangrene of a lower limb respectively. The pathophysiology of these events is discussed. Early surgery prevents visceral damage from massive release of catecholamines.
The authors report a case of multiple myxoma of the right ventricle treated surgically. One of the myxomas infiltrated the right ventricular ourflow tract, the main pulmonary artery and its branches. This case underlines the difficulty of radical resection of infiltrating cardiac myxomas.
Left atrial myxomas are a rare stroke etiology (0.4%). They frequently present general symptoms such as fever, weight loss and an inflammatory syndrome, but the pseudolupic syndrome with cutaneous features and vasomotor symptoms is rarely described. We report the case of a 38-year old man who presented in March 1995 a stroke caused by a left atrial myxoma. There was also pseudolupic clinical and biological manifestations which disappeared after ablation of the myxoma. Cerebral angiography showed a small carotid aspect which evoked carotid dissection or carotid siphon occlusion. The authors discuss neurologic and pseudolupic manifestations of left atrial myxomas, and their physiopathologic mechanism.
Multiple recurrences of cardiac myxomas are rare and high-light the problem of re-operation. We report a case of double recurrence of left atrial myxoma and analyse the causes of recurrence. In our case, the first myxoma was inserted in the left inter-atrial septum, and the first recurrent tumor was inserted near the pulmonary vein, forming adhesion with the inter-atrial septum. The second recurrent tumor was inserted in the inter-atrial septum. The first operation resected the tumor, including part of the inter-atrial septum, and the sides of the septum were sutured. The two following operations used a patch for the septoplasty. This case is sporadic and not included in the high risk myxoma recurrence syndrome. Incomplete tumor resection is incriminated in one third of recurrences but seems unlikely in our case.
We performed a retrospective analysis of morbidity and mortality in 100 cases of ulcerative colitis treated at the surgical care unit of the Ibn Sina hospital over a 10 year period from 1984 to 1994. One major complication, usually infection, was observed in 40% of the cases. Overall mortality was 22%, a rate higher than the larger published series. The main factor incriminated in our study ; besides surgical circumstances, was the delay in care, including in the intensive care unit. It must be concluded that medical and surgical management must be initiated as soon as a flare up is diagnosed.
OBJECTIVES: We retrospectively examined our clinical data on hydatic cysts of the liver collected over the last 10 years in order to determine a classification which could be used to guide future therapeutic decisions. METHODS: From 1982 to 1992, hydatic cysts of the liver were surgically removed in 378 patients (mean age 38 +/- 12 years). Echography had been performed in all patients. Other preoperative investigations included computerized tomodensitometry (n = 57) and arteriography of the caeliomesenteric arteries (n = 12). Histological examination of surgical specimens included research for parasite inclusions within the pericyst and the hepatic parenchyma. RESULTS: Single cysts were found in 65.7% of the cases, double cysts in 20% and multiple cysts in 12.5%. Histology revealed parasites in the pericyst in 129 cases (34%) and a fistula from the cyst to the bile duct was observed in 47 cases (12.5%). A classification was obtained based on 5 criteria: localization and number of cysts, cyst content, morphology of the pericyst and biliary-cyst fistula. CONCLUSION: The excellent correlation between this classification and prognosis provides a valuable tool for the management of hepatic hydatic cysts.
The authors describe new technic of non-auxiliary orthotopic transplantation of segmental liver harvested from living dogs. 32 dogs were utilized. In the donor dogs, the left medial and lateral lobes were mibilized. The left portal branch, left hepatic artery, left biliary branch and the left hepatic vein were dissected free. The segmental liver graft was perfused and cooled in-situ through the left portal vein. The recipient dogs underwent two steps total hepatectomy: First the segments I, II, III, IV and V were resected. The segments VI and VII were maintained as well as the right portal vein and the retro-hepatic inferior vena cava order to keep the splanchnic and caval flux and to avoid the spleno-cavo-jugular by-pass. The segmental liver graft was then transplanted in an orthotopic position. Termino-lateral hepatico-caval anastomosis and left porto-portal anastomosis as well as arterial and biliary reconstruction were executed. All the donors survived more than 30 days. Nine recipient dogs died during the first three post-operative days from hemorrhage (3 dogs), fibrinolysis (2 dogs), primary non function of the graft (2 dogs) and hepatic artery thrombosis (1 dog). Seven recipients survived more than 30 days.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.