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.

Mal de Pott chez l'enfant : aspects épidémiologiques, cliniques et thérapeutiques en chirurgie pédiatrique à Cotonou

Introduction : Le mal de Pott est une forme grave de tuberculose extra-pulmonaire à cause du risque de lésions neurologiques. Patients et méthodes : Il s'est agi d'une étude rétrospective menée sur 10 ans (janvier 2006 à décembre 2015) dans le service de chirurgie pédiatrique du Centre National Hospitalier et Universitaire Hubert Koutoukou Maga (CNHU-HKM). Nous avons étudié ses caractéristiques épidémiologiques, cliniques et thérapeutiques chez des sujets âgés de 0 à 15 ans. Résultats : Il a été colligé 20 cas, soit 2 cas/an. L'âge moyen des enfants était de 5,5 ans avec des extrêmes de 9 mois et 15 ans. Ceux de moins de 5 ans étaient les plus atteints (14 cas). Le sex-ratio était de 3. Les douleurs rachidiennes (10 cas) et les tuméfactions du dos (8 cas) étaient les principaux motifs de consultation. La fièvre et la douleur provoquée à la palpation des épineuses vertébrales étaient les signes cliniques les plus résents chacun dans 16 cas/20. Des signes neurologiques étaient notés dans 8 cas. Les signes radiographiques étaient dominés par l'ostéolyse vertébrale et le pincement de l'interligne articulaire. Il a été identifié 1 cas d'image en fuseau. Les lésions siégeaient essentiellement sur le rachis lombaire (8 cas). Le traitement était spécifique et orthopédique. L'évolution était favorable chez 16 patients après un recul moyen de 86 mois. Conclusion : Le mal de Pott est une affection qui doit être vite diagnostiquée et traitée afin d'en éviter les complications qui sont redoutables

Urethral mucosal prolapse in young girls: a report of nine cases in Cotonou.

BACKGROUND: Urethral mucosal prolapse is rare. This condition may be confused with tumour or sexual abuse in girls. This study aims at reporting the pathology presentation and therapeutic options of urethral prolapse in girls. MATERIALS AND METHODS: A retrospective study was undertaken from January 2000 to December 2008. Authors analysed the clinical features and the treatment options. RESULTS: There were nine cases of urethral prolapse. The ages ranged from 2.5 to 10 years (mean age: 5.08 years). The main presentation was vaginal bleeding (five cases). Physical examination revealed a soft, non-tender mass that bleeds on touch (six cases), with a length ranging from 0.75 to 1 cm. Urine culture in four patients revealed urinary infection that yielded Escherichia coli in three cases and the Staphylococcus aureus in one case. Six patients had surgical treatment while three had medical treatment. In those who had surgery, one had acute urine retention and one had recurrence that was treated successfully without operation. All the nine girls are cured. CONCLUSION: Urethral prolapse is a disease of the prepubertal girls of low socio-economic group. Diagnosis is clinical. The treatment of choice is surgical.

Urethral mucosal prolapse in young girls: a report of nine cases in Cotonou

Background: Urethral mucosal prolapse is rare. This condition may be confused with tumour or sexual abuse in girls. This study aims at reporting the pathology presentation and therapeutic options of urethral prolapse in girls. Materials and Methods: A retrospective study was undertaken from January 2000 to December 2008. Authors analysed the clinical features and the treatment options. Results: There were nine cases of urethral prolapse. The ages ranged from 2.5 to 10 years (mean age: 5.08 years). The main presentation was vaginal bleeding (five cases). Physical examination revealed a soft; non-tender mass that bleeds on touch (six cases); with a length ranging from 0.75 to 1 cm. Urine culture in four patients revealed urinary infection that yielded Escherichia coli in three cases and the Staphylococcus aureus in one case. Six patients had surgical treatment while three had medical treatment. In those who had surgery; one had acute urine retention and one had recurrence that was treated successfully without operation. All the nine girls are cured. Conclusion: Urethral prolapse is a disease of the prepubertal girls of low socio-economic group. Diagnosis is clinical. The treatment of choice is surgical

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.

[3D reconstruction of anterior internal vertebral venous plexus of a human fetus: a feasibility study]. / Reconstruction tridimensionnelle des plexus veineux vertébraux internes et antérieurs d'un foetus humain: étude de faisabilité.

Anterior internal vertebral venous plexus have been studied extensively due to their clinical importance in diseases of the spine and obstruction of the inferior vena cava. The aim of this feasibility study was to reconstruct in 3D the lower thoracic area of the anterior epidural space of a 69 mm (crown-rump) human fetus from the Rouvière Collection, circa 1927. Forty slices (spaced by 40 microm) at the level of the tenth and eleventh thoracic vertebrae, and their lower adjacent intervertebral discs, were reconstructed in 3D using the commercial software SURFdriver. In a preliminary study, we had found that the structures of the epidural space are already formed at this stage of development, and that they are comparable to the adult stage (2002). Reconstruction of the microscopic slices in 3D allowed to better visualize spatially the structures of the venous plexus and their anatomical relationships. This technique could be used as a complement to the classically used histological studies.

[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.

Morphometry by computerized three-dimensional reconstruction of the hypogastric plexus of a human fetus.

The histological study of the plexus hypogastricus inferior (hypogastric plexus) of a human fetus does not permit the direct appreciation of its spatial configuration and its complicated relations. Developments in the field of computer science and three-dimensional (3D) reconstruction from serial histological sections have allowed a precise description of its morphometry and relations. The histological sections which were used came from the "Rouvière" collection of the Institute of Anatomy in Paris. A personal computer (IMAC) system of image analysis with reconstruction software was used. Serial pelvic histological sections were directly digitized from the slides. Image treatment and reconstruction were done with manual methods. The 3D reconstruction of the hypogastric plexus, the nerves, the pelvic skeleton and viscera were done. The hypogastric plexus and its topographic relations with the other organs were visualized and studied in three dimensions, and its morphometry was studied. The direct acquisition of the images from the slides allowed excellent high-quality digital images to be obtained. However, manual processing for the reconstruction was time-consuming. At first, the reconstruction of the various pelvic structures was done separately for each organ. Then the structures were visualized all together. Thus, the hypogastric plexus could be examined under various incidences with each organ. The virtual images obtained show new details of the topographic relations and improve knowledge of the precise innervation of the pelvic organs.

Les hernies ombilicales etranglees chez l'enfant au CNHU de Cotonou : a propos de 11 cas

L'etranglement herniaire ombilical est repute rarissime en Europe. Il n'en est pas de meme en Afrique noire et au Benin. Les auteurs ont analyse 111 cas de hernies ombilicales etranglees operees en 22 ans chez l'enfant. La moyenne annuelle est de 5 cas. Les hernies ombilicales etranglees chez l'enfant sont aussi nombreuses que les hernies anguinales etranglees. Les enfants de 9 mois a 5 ans ont ete les principales victimes; en particulier les nourrissons de 9 mois a 30 mois qui ont represente 54;96 pour cent des cas. Les hernies de petit volume ont ete les plus nombreuses. Les visceres etrangles (grele; epiploon) ont ete reseques dans 9 cas. La mortalite a ete de 1;80 pour cent. Les auteurs preconisent une intervention chirurgicale prophylactique dans les cas d'engouement herniaires ombilicaux

Mortalite a la Clinique Universitaire de Chirurgie Pediatrique du C.N.H.U. de Cotonou du 1er juillet 1989 au 31 decembre 1993

Une etude retrospective portant sur 3363 dossiers d'enfants admis a la Clinique Universitaire de Chirurgie Pediatrique du C.H.N.U. de Cotonou; du 1er juillet 1989 au 31 decembre 1993 a enregistre 161 deces donnant un taux de mortalite globale de 4;78 pour cent. 97;51 pour cent des deces concernaient des enfants hospitalises en urgence. Le deces etait survenu dans 42 pour cent des cas au cours des 24 heures suivant l'admission des enfants a l'hopital. 54;65 pour cent des patients decedes etaient des nouveau-nes ou des nourrissons. Les causes des deces venaient par ordre de frequence: des occlusions; des peritonites; des brulures; des traumatismes et des malformations autres que celles du tube digestif