[Experience of a multidisciplinary team in the management of superficial venous malformations: 99 cases]. / Les malformations veineuses superficielles et leur prise en charge par un comite multidisciplinaire: 99 cas.

BACKGROUND: Vascular malformations are heterogenous angiodysplasias. AIM: The aim of this work is to study the epidemiological and clinical features of venous malformations (VM) as well as their multidisciplinary management. METHODS: It is a retrospective study of patients having simple VM, seen at the multidisciplinary consultation of angiodysplasias of our hospital, over a 10 year period. RESULTS: This study included 99 patients having VM. A female predominance was noticed. Average age was 18.5 years. VM had mainly cephalic location. All VM were treated with percutaneous sclerotherapy. Aesthetic results were excellent in the cases of small VM size. CONCLUSION: VM are most frequent in cephalic region and cause aesthetic and functional handicaps. Percutaneous sclerotherapy is the treatment of choice for such a venous malformations, especially for small VM. VM are anomalies which can have serious complications. Their management has to be multidisciplinary in order to better precise the diagnosis and to take the adequate therapeutic decision.

[Arteriovenous malformations: study about 54 patients]. / Malformations arterioveineuses: etude de 54 patients.

BACKGROUND: Arteriovenous malformation (AVM) are vascular anomalies that may threaten functional and vital prognosis. The aim of this study was to assess the managment of Arteriovenous malformation METHODS: It is a retrospective study about 54 patients, having AVM, collected over a 7-year period. RESULTS: Sex ratio MJF was 1.25; average age at the diagnosis was 25.4 years. Puberty, pregnancy and trauma, were the most important favoring factors for the development of AVM. Location was the head in 75% of the cases. Doppler ultrasound was the most indicated examination to confirm the diagnosis. In over than 70% of our patients, therapeutic abstention and follow-up were indicated. In the other cases, embolization, with or without surgery was the treatment. A patient died of massive haemorrhage. Treatment is necessary in complicated AVM. Follow-up (if abstention or after treatment) is mainly based on clinical and Doppler data. CONCLUSIONS: AVM are anomalies that may be serious and their management must be multidisciplinary, to allow better therapeutic indications.

[Post traumatic rupture in patients with uretero pelvic junction obstruction. Case report]. / Rupture post - traumatique d'un syndrome de la jonction pyelo -ureterale meconnu. A propos d'une observation.

Authors report a case of post traumatic pelvic rupture occurring in an unknown ureteropelvic junction (UPJ) obstruction. Ultrasonography showed pyelectasia and fluid effusion in the anterior perirenal space. CT scan confirmed the diagnosis of UPJ obstruction and showed the rupture of the anterior pelvic wall communicating with a perirenal urinoma. The patient underwent a retrograde stenting for decompression and surgical drainage of the urinoma. Pyeloplasty was performed 4 months after injury. A follow up intravenous pyelogram showed good flow through the repair and the patient remaines asymptomatic 2 years after treatment. Post traumatic rupture of UPJ obstruction is a rare event with few reported cases in literature. Diagnosis is suggested on imaging studies. CT scan shows the rupture site in the ureteropelvic tract and guides percutaneous drainage.

[Treating pain related to inoperable pancreatic cancer in tropical areas: the advantage of CT-guided celiac plexus block and splanchnic nerves neurolysis]. / Intérêt en milieu tropical de la neurolyse percutanée chimique du plexus solaire et des nerfs splanchniques sous contrôle scanographique au cours des tumeurs malignes évoluées du pancréas.

Many sub-Saharan African countries have recently acquired computed tomography scanners that make interventional radiology possible, especially for the treatment of cancer pain. We report the case of a patient with severe abdominal pain related to advanced pancreas cancer. After unsuccessful morphine treatment, he underwent CT-guided alcohol injection for neurolysis of the celiac plexus and splanchnic nerves. This report describes the technique and discusses its potential applications in tropical countries.

[The place of MRI in the hepatic tumors]. / Place de l'imagerie par resonance magnetique dans les tumeurs hepatiques.

MRI semeiology of hepatic tumors was assessed with a retrospective study of 132 patients explored between May 1998 and December 2001. MR examinations were acquired with a one Tesla operating system. All images were acquired by a T2-weighted fast spin echo MR and dynamic flash MR with Gadolinium. Hemangiomas demonstrate characteristic signs in most cases, as was described in the literature. However, adenoma, hepatocellular carcinoma and metastases have various and less specific features.

[Intramural small-bowel hematoma due to anticoagulant therapy: a radiologic study; with regard to two cases]. / Hématome intramural du grêle dû aux anticoagulants: une etude radiologique a propos de deux observations.

We report two cases of spontaneous small bowel hematoma in two patients receiving long-term anticoagulant therapy. Plain abdominal film, ultrasound, CT-scan and oral barium examination were performed. Abdominal ultrasonography and CT-scan are in most cases relevant for the correct diagnosis of intra-mural small bowel hematoma. The diagnosis was based on the acknowledgment by the patient of anticoagulant drug consumption. Early diagnosis is crucial because most patients are treated nonoperatively with good outcome.

[Cervico-facial lymphatic malformations in adults]. / Les malformations lymphatiques cevico-faciales de l'adulte.

Lymphatic malformations are due to an abnormality in lymphatic development only rarely present in adults. Their prognosis is better than those of infants. We report 6 cases of lymphatic malformations of head and neck in adults reviewed from 1990 to 2001. The treatment was surgical in 5 cases. Surgical excision is the treatment of choice and reccurences are rare.

[Left paraduodenal internal hernia. A new case report]. / Hernie interne paraduodenale gauche. A propos d'une nouvelle observation.

OBJECTIVE: Remind the clinical and radiological features of the internal left para duodenal hernia. MATERIALS AND METHOD: We report the case of a left para duodenal hernia in a 30 years old woman who suffers of an acute abdominal pain explored by ultra sonography, barium upper gastro intestinal radiography, computed tomography and MRI. RESULTS: CT shows a well limited intra abdominal mass composed of small bowel wrapped in a bag of peritoneum, and moving to the left the mesenteric axis CONCLUSION: Left internal para duodenal hernia is a rare phenomenon and is frequently non diagnosed. Spiral computed tomography allows us now, to make the diagnostic with a good sensitivity in the majority of cases.

[Vertebroplasty success in a case of aggressive hemangioma]. / Succes de la vertebroplastie dans un cas d'hemangiome vertebral agressif.

Vertebral hemangioma is a vascular tumor most oftenly asymptomatic and of casual radiological discovery. More rarely, it can be aggressive, causing neurological complications and therefore requiring a convenient and sustained therapy where vertebroplasty is of essential importance. In this context, we report a case of an aggressive vertebral angioma of L4 which was responsible for lumbocruralgy. She underwent verterbroplasty and then had a very good outcome. In this way we deal with the the different technics of vertebroplasty, their advantages compared to other therapeutic medical, and or surgical methods, as well as their complications.

[Mammography screening of breast cancer in Tunisia. Results of first experience]. / Depistage mammographique du cancer du sein en Tunisie. Resultats d'une premiere experience.

This article reports the results of a mammography screening program of breast cancer, realized in the department of Radiology, Charles Nicolle hospital. A free screening mammography with two incidences was offered to women aged from 40 to 70 years old. 2200 mammographies were realized from May 1995 till July 1997. Women having a positive test benefited of a diagnostic explorations in the same unity. The positive test rate was 24%. Predictive positive value was 31%. This program allowed to detect 10 subclinical cancers, corresponding to a rate of detection of 4.5 cancers for 1000 women. This program is a first experience which demonstrated the feasibility of the mammography screening to wide scale and allowed the medical and paramedical team to acquire an experience.

[Splenic abscess: from diagnosis to treatment]. / Les abcès de la rate: du diagnostic au traitement.

Splenic abscess are a rare and severe pathology causing difficulty in diagnosis and treatment. The Clinical presentation usually associated with abdominal pain in the left upper quadrant, fever and splenomegaly. Diagnosis will be confirmed by morphologic examination such as ultra sonography and computed tomography. Percutaneous drainage procedure made in first intention can be used either for curative purpose or to prepare patient for surgery. We report four cases of splenic abscess collected in our departement between 1997 and 2000 in which percutaneous drainage procedure was trial first. Two of them were successful and the others were completed by splenectomy.

[Bone mineral density in patients with Crohn's disease. Contribution of bone densitometry in 53 cases]. / La densite minerale osseuse au cours de la maladie de Crohn: apport de l'osteodensitometrie chez 53 patients.

Fifty-three patients with Crohn disease were included in a prospective study. Bone mineral density was measured at the femoral neck and lumbar spine by dual-energy X-ray absorptiometry. Ten variables were analyzed in search of an association with bone demineralization; Age, sex, nutritional state, smoking, duration of the disease, hormonal status, inflammatory syndrome, site of disease: ileal, colic or ileocolic, accumulated doses of corticoids and intestinal resection. A bone demineralization was observed in 58.5% of cases. The ileum location and the corticothérapie were predictives of bone demineralization. Crohn disease is a disease at high risk of bone demineralization. Predictors of the bone loss were smoking, long duration of the disease, ileal site and systematic corticotherapy.