ABSTRACT
We report two observations of portal cavernoma diagnosed successively in Bamako and Dakar. The first is a 6-year-old male admitted to the service for ascites and abdominal pain. At admission the clinical parameters (weight, height, temperature, cranial perimeter and temperature) were within the norms for age. The clinical examination noted a moderate skin-mucosal pallor, asthenia. The biological assessment returned to moderate normochrome anemia with impaired pancreatic function while renal and hepatic functions were maintained. The abdominal scan performed after two low-contribution abdominal ultrasounds, objected signs in favor of a portal cavernoma with perisplenic and gastric varicose veins. The second is an 8-year-old male child born from an unborn marriage and from a followed pregnancy with premature delivery. His pathological history includes a notion of prematurity that required a stay in neonatology with umbilical catheterization and repeated abdominal pain. He had an acute abdominal episode in March 2015 justifying a surgical hospitalization for suspicion of appendicitis. At admission the clinical parameters (weight, height, temperature, cranial perimeter and temperature) were within the norms for age. The abdominal ultrasound prescribed for this was suggestive of portal cavernoma, later confirmed by abdominal computed tomography.
Nous rapportons deux observations de cavernome portal diagnostiqué successivement à Bamako et à Dakar. Le premier est un enfant de 6 ans de sexe masculin admis dans le service pour ascite et douleurs abdominales. L'examen clinique notait une pâleur cutanéo-muqueuse modérée, une asthénie. Le bilan biologique retrouvait une anémie modérée normochrome normocytaire avec une fonction pancréatique perturbée tandis que les fonctions rénales et hépatiques étaient conservées. Le scanner abdominal réalisé après deux échographies abdominales peu contributives, objectivait des signes en faveur d'un cavernome portal avec varice péri-splénique et gastrique. Le second est un enfant de 8 ans de sexe masculin né d'un mariage non consanguin et issu d'une grossesse suivie avec accouchement prématuré. Il est le 3e enfant de sa fratrie et scolarisé. On retrouve dans ses antécédents pathologiques une notion de prématurité ayant nécessitée un séjour en néonatologie avec cathétérisme ombilical et des douleurs abdominales à répétition. L'enfant a commencé à se plaindre de douleurs abdominales récurrentes vers l'âge de 6 ans. Douleurs de siège péri ombilical sans réveil nocturne dans un contexte de constipation chronique d'allure fonctionnelle. Il a fait un épisode abdominal aigu justifiant une hospitalisation en chirurgie pour suspicion d'appendicite. A l'admission les paramètres cliniques (poids, taille, température, périmètre crânien et température) étaient dans les normes pour l'âge. L'échographie abdominale prescrite à cet effet était évocatrice de cavernome porte, confirmé par la suite par la tomodensitométrie abdominale.
ABSTRACT
Four ecological zones of the Gambia River were sampled during four different hydrologic seasons for determination of microbial, nutrient, and physical parameters. A Greco-Latin Square experimental design was used to define the particular transect, station, depth, and tide/time-of-day of samples taken. Ranges of total bacterioplankton densities (10(6) cells/ml) were similar to those of tropical and temperate environments. Numbers of free bacteria were similar temporally, whereas attached bacteria numbers were greater during periods of high stream flows when suspended solids concentrations were higher. Free bacteria were usually twice as numerous in the freshwater zones than in the estuarine zones. Attached bacterial densities were approximately four times greater in the estuarine zones than in the freshwater zones. Uptake of(3)H-glucose on both a sample volume and per-cell basis increased from the early stages of the flood (6.95±SE 1.37 ng/liter/hour and 3.8 pg/hour/10(6) cells, respectively) and reached observed annual maximums during the dry season (21.01±SE 3.05 ng/ liter/hour and 13.0 pg/hour/10(6) cells, respectively). Spatially,(3)H-glucose uptake per sample volume and per cell was highest in the upper river zone and lowest in the lower estuary zone. The lower estuary zone consistently acted out of concert with the other river zones in terms of(3)H-glucose and(14)C-bicarbonate uptake. Analysis of variance (ANOVA) indicated that free and attached bacterioplankton densities were not homogeneous among transects, stations, depths, and tide/time-of-day at the different zones during the four hydrologic seasons. The results suggested that heterotrophy overshadowed autotrophy in the river and that the bacterial abundance, distribution, and glucose uptake activity in this tropical floodplain river were greatly influenced by the annual flood and the presence of extensive mangrove forests in the estuary.