Gastric metaplasia of posterior urethral polyp: a case report

Congenital polyps of the posterior urethra are rare lesions, and have often been described in boys. The polyps are benign lesion usually lined by a transitional epithelium, but cases of squamous or intestinal metaplasia have been reported

Facteurs thérapeutiques affectant la cicatrisation au cours des gangrènes du périnée

Les gangrène du Fournier est une fasciite nécrosante rare et grave. Elle est grevée d'une lourde morbi-mortalité nécessitant une prise en charge médico-chirurgicale rapide et énergique. Le traitement initial repose sur la réanimation associée au débridement chirurgical. Secondairement le problème majeur reste la cicatrisation et les séquelles que gardent les patients. Plusieurs modalités thérapeutiques sont actuellement disponibles a fin d'améliorer et accélérer la cicatrisation. Notre étude rétrospective a colligé 20 cas. L'âge médian dans notre série était d 56 ans. Il y avait 16 hommes et 7 femmes. Une comorbidité était présente chez 15 patients. L'antibiothérapie a été entreprise dans tous les cas avec une durée médiane de 15 jours Le traitement chirurgical était entrepris dans tous les cas. Des révisions itératives étaient nécessaires chez tous les patients avec une médiane de 3 changements de pansements. Une colostomie était réalisée dans 6 cas. Une oxygénothérapie hyperbare était réalisée dans 4 cas. Une vaco-thérapie dans 1 cas. Un geste de recouvrement cutané était nécessaire dans 2 cas. La durée médiane de cicatrisation était de 15 jours avec l oxygénothérapie versus 24 jours en l absence de ce traitement. La durée médiane d'hospitalisation était de 20 jours. Quatre décès ont été dénombrés dans cette série. L obtention d'une cicatrisation sans séquelles est un chalenge dans la prise en charge thérapeutique. Malgré l'adjonction de nouvelles modalités thérapeutique ses résultats restent non satisfaisants. Cependant une approche multidisciplinaire associée à une oxygénothérapie et une vac-thérapie pourrait améliorer les résultats chez ces patients

A comparative assessment of antifungal activity of essential oils of five medicinal plants from Tunisia

The leaf essential oil yields of clementine, cypress, rosemary, tea, and thyme were 0.22, 0.87, 1.46, 1.20, and 0.72%, respectively, based on the dry weight of the plant material. The leaf essential oils of rosemary, tea, and thyme contained the highest levels of oxygenated monoterpenes (60.14-91.70%). Rosemary and tea leaf essential oils were rich in 1,8-cineole (49.98% and 57.55%, respectively), and they have potent antifungal activity against Alternaria alternata strain (MIC = 5000 μg/ml). Thyme was rich in carvacrol (78.54%) and had a MIC of 6000 μg/ml against A. alternata strain. Clementine leaf essential oil was characterized by the predominance of monoterpene hydrocarbons (88.65%), and it possessed a weak antifungal activity against A. alternata (MIC = 8000 μg/ml). Cypress leaf essential oil was characterized by the predominance of oxygenated sesquiterpenes (60.67%), having an antifungal activity of 8000 μg/ml

An acute urinary retention in an old man caused by a giant müllerian duct cyst: a case report

Müllerian duct cysts result from an abnormality in regression of the Müllerian system. They may occasionally give rise to symptoms. We report an unusual case of acute urinary retention in an old man caused by a giant Müllerian duct cyst

Mixed nutcracker syndrome with left renal vein duplication: A severe and exceptional presentation in an 18-year-old boy

The nutcracker syndrome (NCS) is rare and often misdiagnosed because it embraces an extended non-pathognomonic spectrum of symptoms that imply a difficult diagnosis. Ultimately it may be associated with substantial morbidity and even life-threatening events. Mixed NCS with renal vein duplication is an exceptional variety, have previously been reported to the best of our knowledge. We report a rare case of an 18-year-old boy who presented with a long history of abdominal, pelvic and left flank pain, fatigue and higher bilateral varicocele. Computed tomographic angiography, Doppler ultrasonography and venography were performed revealed left renal vein duplication with dilated retroaortic and preaortic branchs, entrapped respectively between the aorta and the vertebral column and in the aortico-mesenteric space, with extensive and complex varices of the deep pelvic venous plexus; promoting the mixed renal NCS. Auto transplantation of the left kidney was suggested, but refused by the patient; and only the varicocele was managed. The patient is still suffering from his severe initial symptoms. Diagnosis is difficult and should be considered in patients with inexplicable flank or abdominal pain. Our purpose is to raise clinician′s awareness for this condition so that they will be more likely to diagnose it. This will facilitate prompt diagnosis and treatment

Unexpected Small Urinary Bladder Pheochromocytoma: A Nonspecific Presentation

Objectives. Pheochromocytoma of the urinary bladder is an extremely rare tumor that typically presents with a hypertensive crisis during micturition. Preoperatively, it may be misdiagnosed due to nonspecific symptomatology, physical, and radiologic findings. Method. We report a case of unsuspected small pheochromocytoma which was incidentally found by CT scan and confirmed by the histological aspects after transurethral resection in a 63-year-old woman. Here, we have described the clinical presentation, physical findings, laboratory investigations, and treatment provided in our case. We have also included radiological images and histopathology slides with input from both radiologists and pathologists. Surgical management and postoperative follow-up are discussed, as are details of previous published data. Results. After undergoing surgical treatment (transurethral resection), our patient is asymptomatic, with complete resolution of her pathology. Conclusion. Diagnosis is difficult before histopathological examination and should be considered in patients with no risk factors for usual bladder tumor. Our purpose is to raise clinician's awareness for this condition so that they will be more likely to diagnose it. This will facilitate prompt diagnosis and treatment and especially prevent complications due to pheochromocytoma which may be severe

Modified medial nephropexy for treatment of the anterior nutcracker syndrome

We report the case of a 15-year-old male, presenting with recurrent gross hematuria complicated by acute anemia. Cystoscopy showed little bleeding from the left ureteral orifice. Diagnosis of left renal vein compression at the aortomesenteric space was established through color Doppler ultrasonography and computed tomographic angiography. Therapeutic attitude was interventionist in our case, performing successful management with modified medial nephropexy, with a retroperitoneal approch. To the best of our knowledge, we report the second case of left medial nephropexy for treatment of the anterior nutcracker syndrome. The first case of modified medial nephropexy was done by lowering the left renal vein from its initial position in the aortomesenteric angle through a restrict retroperitoneal approach

Bilateral renal infarction following atrial fibrillation and thromboembolism and presenting as acute abdominal pain: a case report

<p>Abstract</p> <p>Introduction</p> <p>Renal infarct is rare and often misdiagnosed because the symptoms are misleading. The mechanisms are various, mainly thrombotic and embolic.</p> <p>Case presentation</p> <p>In this review, we report the case of a 61-year-old Tunisian woman presented to the emergency unit with a 4-hour history of abdominal pain diffused at both flanks, ultrasounds was performed to remove a surgical emergency, showed a peri-renal fluid collection with heterogeneous parenchyma.</p> <p>We followed by a CT scan, which confirmed the diagnosis of renal infarct. The patient was treated by heparin at a curative dose, and the outcome was favorable.</p> <p>Conclusion</p> <p>Diagnosis is difficult and should be considered in patients with inexplicable flank or abdominal pain and with risk factors to this disease. Our purpose is to raise clinician’s awareness for this condition so that they will be more likely to diagnose it. This will facilitate prompt diagnosis and treatment.</p> <p>A review of the literature was performed and the case is discussed in the context of the current knowledge of this condition.</p