Anatomical variants of the celiac trunk.

AIM OF THE STUDY: Determine the anatomical variants of the celiac trunk and describe it in its modal form using a scanner. PATIENTS: In total, 200 patients were included in this study. MATERIAL AND METHODS: The study was carried out using a multi-detector scanner (SIEMENS Somatom Emotion Excel Edition, 16 bars). The two-dimensional and three-dimensional reconstructions by volume were made with the OSIRIX software. It was a retrospective study. The study had taken into account the result of the abdominal scanners injected carried out from December 15, 2018 to February 15, 2019 i.e. 14 months (1 year 2 months). RESULTS: A predominance of type I of UFLACKER is 93.50% with a rate of change from normal of 6.50%. A vertebral projection of the origin of the celiac trunk at the level of the T12-L1 intervertebral disc was observed in 52.80%. An existence of collateral branches in 7.5% of cases. Other terminal branches apart from the three classics were found in 8.5% of the cases. CONCLUSION: These variants deserve special attention in the case of a pre-therapeutic vascular assessment for the surgical or interventional management of tumors and trauma of the supra-meso-colic viscera or even for organ transplantation.

Multiple variations of collateral branches of the abdominal aorta associated with pyelic duplication: A case report.

PURPOSE: We describe a rare case of anatomical variation of the collaterals of the abdominal aorta associated with a duplication of the pyelic. MATERIAL AND METHOD: A 51-year-old patient in whom an abdominal CT scan was performed as part of the exploration of a cystic left renal mass objectified on ultrasound. RESULTS: A celiomesenteric trunk with two left renal arteries and a duplication of the left pyelon were found. CONCLUSION: The reported case is of interest in the rare association of these anatomical variants.

Autosomal dominant polycystic kidney disease in University Clinic of Nephrology and Haemodialysis of Cotonou: clinical and genetical findings.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease, but poorly studied in Africa. Its frequency in the University Clinic of Nephrology and Hemodialysis of Cotonou during the ten last years was 7 cases per year with a hospital prevalence estimated at 18 per 1000. The mean age of patients was 47.2 years extending from 29 to 70 years. Males were predominant with a sex ratio of 1.13. Family history was found in 47% of patients. The most common manifestations were lumbar pain (62%), high blood pressure (59%) urinary tract infections (53%), hematuria (46%), and abdominal masses (43%). Hepatic cysts were the most extra renal manifestations, found in 34% of cases. Renal failure was observed in 72% of patients of our series, six of them were under dialysis. Direct sequencing of polycystin 1 gene enabled us to identify some new mutations: 4 nonsense mutations (p.Q2824X exon 23, p.Q1651X exon 15, p.W1666X exon 15, p.R966W exon 12), a duplication (c_1761.1745 dup exon 9), a deletion (c.9397 + 1_9397 + 8del intron 26) and a deletion-insertion (c.7290_7291delins CTGCA exon 18).

[Seven cases of inverted nasosinusal papilloma treated at Cotonou]. / Sept cas de papillome inversé nasosinusien pris en charge à Cotonou.

OBJECTIVE: Sinonasal inverted papilloma is a rare benign tumor with a high recurrence rate and potential malignant transformation. The purpose of this study was to analyze the clinical and radiological aspects and to identify the suitable surgical approaches to be used in developing countries. METHODOLOGY: In 3 years, 7 cases have been analyzed in a retrospective study. Patients presented with unilateral nasal obstruction and epitasis, a whitish unilateral polypoid mass, sinonasal opacity with osteolysis on CT scan or on sinus X-ray. Using these data we adopted the Krouse staging which classifies the disease in four stages and accordingly the appropriate surgical approach was used. The diagnosis was confirmed by histological examination of the biopsied specimen. RESULTS: Average age 48.28 years, predominant sex male. Symptom: unilateral nasal obstruction 5, bilateral nasal obstruction 1, epistaxis 5. The average time-delay before consultation was 73 months. The combined endonasal endoscopic and vestibular was the most commonly used approach (4 cases). The results were satisfying. After a minimal follow up of 2 years, one case of recurrence was detected after 4 years. CONCLUSION: CT scan is an essential tool for the diagnosis and detecting the extension of sinonasal inverted papillomas. Better results were obtained with a surgical approach that combined a vestibular approach and an endonasal endoscopic approach in our region.

Bacterial cellulose-based composites for biomedical and cosmetic applications: Research progress and existing products.

Bacterial cellulose (BC) is a promising unique material for various biomedical and cosmetic applications due to its morphology, mechanical strength, high purity, high water uptake, non-toxicity, chemical controllability, and biocompatibility. Today, extensive investigation is into the manufacturing of BC-based composites with other components such as nanoparticles, synthetic polymers, natural polymers, carbon materials, and biomolecules, which will allow the development of a wide range of biomedical and cosmetic products. Moreover, the addition of different reinforcement substances into BC and the organized arrangement of BC nano-fibers have proven a promising improvement in their properties for biomedical applications. This review paper highlights the progress in synthesizing BC-based composites and their applications in biomedical fields, such as wound healing, drug delivery, tissue engineering, and cancer treatment. It emphasizes high-performance BC-based materials and cosmetic applications. Furthermore, it presents challenges yet to be defeated and future possibilities for BC-based composites for biomedical and cosmetic applications.

Femoral bifurcation associated with tibial aplasia: about 3 cases.

Femoral bifurcation associated with tibial aplasia of the limb is a very rare pathology. Its radical treatment is a disarticulation of the knee, followed by fitting of a prosthesis. In Benin the reluctance of parents to allow their children to undergo amputation and the access to equipment for the amputated child are a major technical and financial hindrance. Here we report three cases.

[Vein of Galen aneurysmal malformation in a Neonate: a case report]. / Diagnostic Postnatal d'une Malformation Anevrismale de la Veine de Galien a Propos d'un cas.

The aneurysm of the Galen vein is a rare and complex congenital intracerabral vascular malformation. We report a case suspected by the obstetric ultrasound in the third trimester and confirmed by the transfontanellar Doppler ultrasound and brain CT-Scan in the asymptomatic 11-day old baby born at term.

L'anévrysme de la veine de Galien est une malformation vasculaire congénitale intra cérébrale rare et complexe. Nous rapportons un cas suspecté à l'échographie obstétricale du 3èmetrimestre, confirmé par l'échographie doppler transfontanellaire et la tomodensitométrie cérébrale chez un nouveau-né à J11 de vie, né à terme et asymptomatique.

[Hip paraosteoarthropathy after sciatica nerve injury by quinine intramuscular injection]. / Paraostéoarthropathie de la hanche sur lésion du nerf sciatique par injection intramusculaire de quinine.

INTRODUCTION: Often occurring in central nerve injuries, paraosteoarthropathic conditions are revealed by a stiffness or ankylosis of the joint. Their occurring during peripheral nerve injuries is rare. OBJECTIVE: To report a case of hip paraosteoarthropathy features after sciatica nerve injury by quinine intramuscular injection. MATERIALS AND METHOD: We report a case of a 24-year-old patient presenting with pain, oedema of the left buttock, limitation of bending of the left hip, and antalgic limping associated with a small step because of axonal left sciatic nerve injury. Initial pelvis X-ray and laboratory findings were normal. Reviewed 4 months later with important stiffness of the left hip, a second X-ray showed an atypical paraosteoarthropathy (POA). Chemotherapy and physiotherapy alleviated neurological muscle weakness but did not have any effect on the hip functionality. Surgical excision was the only treatment that improved the amplitude of movements. Evolution 7 years later showed the disappearance of the peripheral nerve-injury signs and the conservation of the movement amplitude obtained after excision, without a return to normal. CONCLUSION-DISCUSSION: Factors pointing to this POA were initial oedema, immobilization because of pain, and trauma by quinine intramuscular injection. The interest is the exceptional occurrence of POA on a peripheral nerve injury (sciatica nerve injury by quinine injection) outside the context of length resuscitation and that sciatica nerve injury is frequent in tropical countries but anachronistic in a developed one.

[Osseus age of the black children of Benin. A population study of 600 children aged from 9 to 18 years and living in Cotonou]. / Age osseux du noir béninois. A propos de 600 enfants âgés de 9 à 18 ans et résidant à Cotonou.

PURPOSE: The purpose of this work is to study the skeleton maturation in the black population of Benin by means of Tanner Whitehouse method (TW2) in comparison with the populations of the developed countries. MATERIAL AND METHODS: The study was transversal and analytic. It included 297 boys and 303 girls aged from 9 to 18 years. This was conducted from October 2002 to May 2003 in Cotonou City, the economic capital of Benin. The corrected minimum size of the sample was 384 x 1.19. The sampling technique was chancy, multiphasic, stratified and in clusters. Every one of the 13 districts of Cotonou was considered as a stratum. The interpreter of the anteroposterior radiograph of the left wrist and hand was selected after an intra and extra observer test. The data treatment and analysis were performed by the logiciels Epi info and SPSS. The statistical tests used were Khi 2 test and Kappa index. RESULTS: The sample was mainly composed of pupils: 84.16% among the boys, 77.23% among the girls. 91.01% of the parents of the children had a middle standard of living. The skeleton maturation score increased with age in all TW2 methods. With the TW2 20 bone and RUS methods, the mature score was reached at percentile 50 among the boys at 18.5 years and among the girls at 17 years. It was precociously reached at percentile 97 respectively at 14 and 14.3 years among the boys and 12.7 years among the girls. With the Carpal bone method, the age of mature score at percentile 50 was 18.2years among the boys and 17.2 years among the girls. The early maturation was obtained at percentile 97 among the boys and the girls respectively at 13.2 and 12.5 years. DISCUSSION: The skeleton maturation score of the girls in Benin is I to 1.5 years higher than the one of the boys. With the TW2 bone and the RUS methods, the maturation shows a delay of 0.5 to 2.5 years at the percentile 50 and of 1.5 to 2 years at the percentile 97 in relation to the Belgian, British, Chinese, Korean, Japanese, and North American standards. These delays seem to be mainly due to the less favourable socioeconomic conditions in Benin. In the other hand, the more considerable delay of 1 to 4 years with the Carpal bone method remains to be elucidated. CONCLUSION: The osseous age stemming from this work is representative of the middle social stratums of the city backgrounds. It would gain to be completed by a similar work concerning the country backgrounds of Benin.

[Apert's syndrome: a case report]. / Le syndrome d'Apert: à propos d'une observation.

Apert's syndrome is a type of acrocephalosyndactylia that is from part of the great group of craniofacial synostoses. It is characterized by craniofacial dysmorphia and syndactylia on hands and feet, which differentiates it from Crouzon's disease. It is a rare affection that is often transmitted through an autosome dominant mode, but sporadic cases exist. We report the case of a 15-year-old girl who presented characteristic clinical signs of Apert's syndrome with normal karyotype without parental consanguinity. The Ser 252 Trp mutation of the FGFR2 gene was found, confirming the molecular diagnosis. This study illustrates the severity of ocular and neurological problems of untreated Apert's syndrome. The presence of hemoglobinopathy (Hb AS) is also a mark of its originality.

[Case report of acute intoxication from intravenous injection of petroleum] . / A propos d'un cas d'intoxication aiguë par injection intraveineuse directe de pétrole.

A 18-year-old patient injected intravenously 2.5 mL of paraffin oil into the right upper limb. It caused a local thrombophlebitis with a slow evolution. A collapsus occurred on the sixth day. The authors obtained a clinical recovery of the limb after heparine and oral anticoagulation.

[Parathyroid cervical hematoma: a case report]. / Hématome cervical d'origine parathyroïdienne: à propos d'un cas.

Haemorrhagic cysts of the parathyroid gland are rare. Our case report concerns a presentation with a constrictive cervical haematoma, confirmed by ultrasound-guided aspiration. The haematoma, rapidly recurred, indicating exploration of the neck and haemostasis. Histological examination of excised tissue showed the haemorrhagic nature of the cyst.

Distal quadricepsplasty in children: 88 cases of retractile fibrosis following intramuscular injections treated in Benin.

INTRODUCTION: Retractile fibrosis of the quadriceps (RFQ) is a physical and social handicap in children, and often results from a past history of quadriceps intramuscular injection. The aim of this study was to evaluate the therapeutic results of RFQ treated by distal quadricepsplasty using a modified Thompson-Payr procedure (DQPMTP). HYPOTHESIS: Functional recovery will be good with DQPMTP. PATIENTS AND METHODS: This is a descriptive retrospective 10-year study from 2002 to 2011, including 74 children (88 knees) less than 15 years old, admitted for RFQ and treated in Benin. The types of RFQ were: knee flexion loss of motion 16 cases (18.2%), lag of extension 54 cases (61.4%) and associated genu recurvatum, 18 cases (20.5%). Wasting of the thigh was found in all cases. An associated distal femoral osteotomy was performed to correct a bone deformity in 18 cases (20.5%). RESULTS: There were 16 cases (18.2%) of poorly looking postoperative scars and 2 cases (2.3%) of fracture during physical therapy. Mean flexion ROM after surgery was 77.7°. Mean flexion increased from 77.7° to 108.5° following postoperative rehabilitation or a mean gain of 30.7°. The quadriceps muscle testing scores were at least 3/5. Results of DQPMTP were good in 80.7% of cases, as shown by mean active knee flexion of 108.5° with normal active extension. The results were satisfactory in 17 cases (19.3%). DISCUSSION: DQPMTP has the advantage of cutting a minimum of blood vessels, thus limiting the risk of hematoma. Laterally placed incisions create less tension reducing the risk of skin necrosis. The clinical and radiological results of this series confirm those in the literature. Treatment of RFQ by DQPMTP provides satisfactory functional rehabilitation in patients, which confirms our hypothesis. LEVEL OF EVIDENCE: Level IV, retrospective study without comparison.

[Cemento-ossifing fibroma: two cases]. / Le fibrome cémento-ossifiant: deux cas.

INTRODUCTION: Cemento-ossifying fibroma is a rare benign tumor which can affect both jaw bones, particularly the mandible. CASE REPORTS: We report two cases of cemento-ossifying fibroma which illustrate the radiological and anatomic features of these tumors. Differential diagnosis between cementifying fibroma and ossifying fibroma was particularly difficult. The cementifying fibroma was treated by surgical resection followed by immediate reconstruction with an iliac bone graft. The ossifying fibroma was treated by enucleation-resection. DISCUSSION: The clinical, radiological and histological features of cementifying and ossifying fibroma allow distinction. Surgical treatment is achieved by enucleation resection for small-sized ossifying fibromas and mono-bloc resection with bone reconstruction for large-sized cementifying and ossifying fibromas.