[Clinical and therapeutic aspects of pyelo-ureteral junction abnormalities at the University Hospital of Point G]. / Aspects cliniques et thérapeutiques des anomalies de la jonction pyélo-urétérale au CHU du point G.

This study is meant to analyze the clinical and therapeutic aspects of abnormalities ureteropelvic junction. Cross-sectional and descriptive study on 35 cases of abnormalities of the AUPJ collected the Urology Department of the University Hospital of Point G for a period of 4 years (January 2010 to December 2014). Data were collected on the survey forms, medical records and records of the block. The socio-demographic, clinical and therapeutic data were entered into Microsoft Word 2007 and Excel 2007 and analyzed on SPSS 18.0. Between January 2010 and December 2014, 35 cases of AUPJ were collected. The average age was 29.3 years. The back pain was the most frequent reason for consultation or 40%. 20% of patients were consulting for the first time 10 years symptomatic evolution. Kidney destruction was observed in 28.6%. The association Ultrasound + IVU has established the diagnosis in 37.1%. A urinary tract infection was found in 60%. The gallstone complication was present in 17.1% of patients. 51.4% of patients received open pyeloplasty by Anderson Kuss. The anomaly of the ureteropelvic junction in our study was marked by a consultation with delay formidable complications. The open surgery has been the gold standard with satisfactory results. The endopyéloplasty, the treatment of laparoscopic minimally invasive joint surgeries are not available to us but to encourage and incorporate in the therapeutic arsenal.

Emphysematous cystitis and emphysematous pyelitis: a clinically misleading association.

We present a rare case of emphysematous cystitis associated with an emphysematous pyelonephritis in a diabetic Arab man who was admitted in a confusional state. A 60-year-old man was admitted to the emergency department with confusion and hypogastric mass. The Clinical examination found comatose patient with a mass in the tympanic hypogastric percussion. The pelvic computed tomography (CT) demonstrated intramural gas in the urinary tract, which suggested a diagnosis of emphysematous cystitis and emphysematous pyelitis. The treatment was based on an antibiotics associated with a bladder drainage and diabetes stabilization. The evolution was uneventful. Every diabetic patient with a urinary tract infection who seems to be severely ill should have an abdominal X-ray as a minimal screening tool to detect emphysematous complications. The rarity and the association with an emphysematous pyelitis, which is rarely reported in the literature, are two remarkable characteristics described in this case report.