RESUMO
Traumatic false aneurysm of superficial temporal artery is infrequent. About 21 cases were published during these last fifty-three years (1932-1985) in medical literature. The authors report a case of traumatic false aneurysm in a 50 y. o. woman, having had a frontal trauma one month before. They discuss the physiopathologic mechanism of this rare lesion. False aneurysm is always secondary to an arterial wall rupture. This rupture may be complete in arterial wound or partial with disruption of intima and media in simple contusion. It depends not only on the nature and the intensity of the trauma but also on the particular topography of the artery which is prone to such a complication.
Assuntos
Aneurisma/etiologia , Artérias Temporais/lesões , Aneurisma/diagnóstico , Aneurisma/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Ruptura , Artérias Temporais/patologiaRESUMO
The authors report a case of mesenteric venous infarction in a pregnant woman. After having studied the clinical characteristics of this accident, they discuss the role of pregnancy in its accuracy and also the therapy that has to be adopted.
Assuntos
Colo/irrigação sanguínea , Infarto/patologia , Intestino Delgado/irrigação sanguínea , Oclusão Vascular Mesentérica/patologia , Veias Mesentéricas/patologia , Complicações Cardiovasculares na Gravidez/patologia , Adulto , Duodeno/irrigação sanguínea , Feminino , Humanos , GravidezRESUMO
The authors report one case of a intraperitoneal rupture of an hydatic cyst. The diagnosis of rupture was performed pre-operatively by tomodensitometry which has demonstrated the rupture and an intraperitoneal epanchement.
Assuntos
Equinococose Hepática/diagnóstico por imagem , Cavidade Peritoneal , Tomografia Computadorizada por Raios X/métodos , Idoso , Equinococose Hepática/cirurgia , Humanos , Masculino , Ruptura EspontâneaRESUMO
Advanced care decision in emergency medicine is difficult for the elderly. How to be fair, avoiding an unreasonable obstinacy? Based on the case of very old person, we show how an optimal management can be decided in accordance with the spirit of the law.
Assuntos
Serviços Médicos de Emergência/legislação & jurisprudência , Legislação Médica , Suspensão de Tratamento/legislação & jurisprudência , Idoso de 80 Anos ou mais , Serviços Médicos de Emergência/ética , França , Humanos , Masculino , Cuidados Paliativos/ética , Cuidados Paliativos/legislação & jurisprudência , Suspensão de Tratamento/éticaRESUMO
This case-report focused on the occurrence of a crisis of malignant hyperthermia on a young biker (21 y.o.) victim of a severe traffic accident. This observation gives some key points: the delayed occurrence of the crisis after 4 hours of surgery, the multi-factorial events that triggered the crisis; the choice to perform a quick diagnosis through gene analysis in comparison to the standard tests of caffeine on a muscular biopsy. These different points are discussed with a proposal of algorithm in the situation.
Assuntos
Predisposição Genética para Doença/genética , Hipertermia Maligna/diagnóstico , Hipertermia Maligna/tratamento farmacológico , Acidentes de Trânsito , Algoritmos , Ciclismo/lesões , Biópsia , Cafeína , Estimulantes do Sistema Nervoso Central , Humanos , Masculino , Hipertermia Maligna/terapia , Traumatismo Múltiplo/terapia , Respiração Artificial , Rabdomiólise/etiologia , Rabdomiólise/terapia , Adulto JovemAssuntos
Adrenérgicos/uso terapêutico , Raquianestesia/efeitos adversos , Efedrina/uso terapêutico , Hipotensão/prevenção & controle , Vasoconstritores/uso terapêutico , Idoso , Interpretação Estatística de Dados , Hemodinâmica , Humanos , Soluções Isotônicas/administração & dosagem , Pessoa de Meia-Idade , Perfusão , Estudos Prospectivos , Solução de RingerAssuntos
Gastrite Hipertrófica/patologia , Gastrite/patologia , Granuloma/patologia , Adulto , Feminino , Mucosa Gástrica/patologia , Gastrite/complicações , Gastrite/etiologia , Gastrite Hipertrófica/complicações , Gastrite Hipertrófica/etiologia , Granuloma/complicações , Granuloma/etiologia , Humanos , Estômago/patologiaAssuntos
Enterocolite Pseudomembranosa , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Colectomia , Enterocolite Pseudomembranosa/diagnóstico , Enterocolite Pseudomembranosa/patologia , Enterocolite Pseudomembranosa/cirurgia , Seguimentos , Humanos , Ileostomia , Masculino , Prognóstico , Fatores de TempoRESUMO
The authors report a case of cystic lymphangiomatosis of the spleen. Study of this case and a review of the literature confirm the rarity of this site and problems of differential diagnosis with hydatid disease. Treatment remains surgical and the prognosis is good.
Assuntos
Linfangioma Cístico , Neoplasias Esplênicas , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Linfangioma Cístico/diagnóstico , Linfangioma Cístico/cirurgia , Prognóstico , Neoplasias Esplênicas/diagnóstico , Neoplasias Esplênicas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Two new cases of Menetrier's disease with gastric adenocarcinoma in two men aged 62 and 81 years, respectively, are reported. In both cases, the diagnosis was established by histologic examination of the operative specimen. Emphasis is placed on diagnostic difficulties and on the risk of malignant transformation of Menetrier's disease, which should be viewed as a precancerous gastric lesion.
Assuntos
Adenocarcinoma/complicações , Gastrite Hipertrófica/complicações , Neoplasias Gástricas/complicações , Adenocarcinoma/patologia , Idoso , Idoso de 80 Anos ou mais , Transformação Celular Neoplásica/patologia , Diagnóstico Diferencial , Gastrite Hipertrófica/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/patologia , Neoplasias Gástricas/patologiaRESUMO
Several studies of the association between HLA and type 1 diabetes have been carried out revealing differences between ethnic groups. Our study, as part of the studies that should be performed about this association in the rest of the word, aims at elucidating the HLA DRB1, DQB1 polymorphism in Tunisian type 1 diabetes. This study includes 43 unrelated type 1 diabetes patients, and their mean age at onset is less than 15 years. Analysis of the frequency of alleles and haplotypes in these subjects, compared to a reference group (n = 101) led to the following results. 1) The Tunisian insulin-dependent diabetics present similarities as well as differences with other ethnic groups (Caucasians, North Africans). 2) The haplotype DRB1*04 DQ*0302 and DRB1*03 DQB1*0201 is positively associated to type 1 diabetes. 3) The heterozygotic genotype DRB1*04 DQB1*0302 / DRB1*03 DQB1*0201 is strongly associated to type 1 diabetes. 4) The haplotypes DRB1*01501 DQB1*0602 and DRB1*11 DQB1*0301 proved to be protective. In addition, the study of the subtypes DRB1*04 showed that alleles DRB1*0405 predispose to type 1 diabetes, whereas the allele DRB1*0403, which is in linkage disequilibrium with the DQB1*0402 in the Tunisian population, has a protective effect.