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Endometriosis is a rare entity, related after operation on the uterus or uterine tubes or a laparotomy procedures or other extrapelvic procedures, when seeding of endometrial fragments were shed into the peritoneal cavity. We report the case of a menopaused woman with a subcutaneous incisional scar mass that appeared 22 years after a caesarean section. The diagnosis was made by histological examination.
The authors report 5 cases of sarcoidosis developed on scars. Sarcoidosis may be isolated (1 case); it may precede (1 case) or accompany systemic sarcoidosis, or occur during a relapse (3 cases). Dermatologists who observe cicatricial changes always suspect sarcoidosis. It is therefore important that physicians should examine the scars of their patients with suspected sarcoidosis, since biopsy of these scars is easily performed, confirms the diagnosis and avoids more invasive explorations.
A patient with a complex congenital abnormality required the implantation of an interatrial septum patch through a right lateral atriotomy. Nine years later he developed two different morphologies of an incessant uncommon atrial flutter refractory to antiarrhythmic drug treatment. The electrophysiological study localized a site on the right atrium lateral wall where local activation time was 75 ms earlier than the onset of the P wave, transient entrainment with concealed fusion was obtained, the first postpacing interval after transient entrainment was 5 ms longer than tachycardia cycle length and the stimulus to P wave interval was 50 ms. At this site, radiofrequency delivery terminated the atrial flutter in less than 1 second. No further induction or recurrences of any morphology of the atrial flutter were observed after a four month follow up. These findings suggest the existence of a narrow conduction isthmus amenable to interruption by focal delivery of radiofrequency. The isthmus was most probably located between the atriotomy and the crista terminalis, posterior to the former and anterior to the latter.
Post-burn flexion contractures of the hands are evaluated in this retrospective study concerning eighty-six hands of seventy-nine children in the pediatric surgery unit of the University hospital of Dakar from 1971 to 1995. A peak frequency was found among 2-months-old males. Fire (flames or embers) is the most frequent etiology (49.5%). The initial treatment of these burns is more often inadequate because it is performed in dispensaries (small clinics) or at home and then causes severe sequelae. Among the methods of treatment, excision with graft gives the best results in short flexion contractures. Isolated Z plasty can be used successfully. Our follow-up is short (6 months) but the results are relatively good. Among the factors influencing the results, the seriousness of the lesions, the type of surgical treatment, immobilization and physiotherapy are the most significant.
Renal scarring is the main long term complication of acute pyelonephritis in children. The prevalence rate is hazardous since data from the literature are confusing with respect to reflux nephropathy, chronic pyelonephritis and renal hypoplasia. The pathology of such lesions consists in focal interstitial fibrosis. When the first pyelonephritic attack occurs during infancy, renal growth may be compromised. The current approach of renal scar assessment is based on dimercaptosuccinic acid (DMSA) scan. Bilateral extensive lesions may be responsible for altered glomerular filtration rate (GFR) and/or arterial hypertension. The management of overt scarring is conservative and careful prevention must be based on early and aggressive treatment of acute pyelonephritis.
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Eleven patients successfully treated with the argon or krypton laser for macular subretinal neovascularization were followed up in order to determine the extent of long-term enlargement of the chorioretinal scars. The mean follow-up time was 51.5 months and the mean increase in choroidal scar size 46.5%. In 10 patients the scars enlarged more toward the fovea than toward the periphery (51% as opposed to 43%). The rate of enlargement per month decreased with time after treatment. Only one patient exhibited decreased visual acuity during the follow-up period, due to invasion of the foveola by the scar.
A 33-year-old male patient showed increasing frequency of seizures 12 years after a blunt head injury. From findings of x-ray computed tomography, the lesion was thought to be a benign glioma. Removal of the lesion was performed with the guidance of electrocorticography. Histological diagnosis was gliotic scar with calcification. Diffuse iron particles were detected in layers II-V of the cortex by hematoxylin and Berlin-Blue stain. These findings suggest progressing traumatic epilepsy which may be explained by the mechanism of Willmore's model.
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The Authors report a case of umbilical endometriosis in a 46-year-old patient. The woman came in for observation describing acute pain in the vicinity of the umbilical scar. The pain was occasional at first and then became steady and increased at the time of menstruation. Medical examination revealed a left paraumbilical nodule, measuring 1 cm in diameter. The patient underwent surgical treatment: the nodule was excised and the subsequent histological examination was diagnostic for umbilical endometriosis. The surgical excision was effective: at follow-up 3 months later, there was no recurrence and the patient was in good general condition.
The endometriosis in the scar caused by episiotomy after delivery of twins has been shown, and the coalesced placentas have been peeled off. The first menstrual hemorrage began four weeks following the childbirth, and the first disorders in the scar appeared three months after child birth. A small number of such cases have been reported so far, probably because the endometrium in the second half of pregnancy has a slight ability of implantation, and the brisk fall in the sexual hormone production in the puerperium is not favourable for the growth of the probable implant.
The present report refers to a case of "primitive" endometriosis of the umbilical scar in a 50-years-old woman who complained of the appearance at the umbilicus of two nodules measuring 7 and 2 mm in diameter. These nodules, which were brownish in colour, were responsible for prickly pain and itching unrelated to the menstrual cycle. Both nodules were excised after a preoperative non-specific diagnosis of granuloma. Pathology findings revealed "cutaneous endometriosis". The authors believe that the appearance of a nodular swelling at the umbilicus of a woman of child-bearing age should lead to a suspicion of endometriosis among the possible diagnoses.
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