Cerebral Ischemia after Stenting of Coarctation of the Aorta.

Percutaneous stenting angioplasty of native coarctation of the aorta is considered a low-risk procedure with high success rate. The incidence of cerebral complications, especially ischemic complications, is very low. We report a case of a 15-year-old boy who underwent a percutaneous stenting angioplasty for a coarctation of the aorta and developed a cerebral infraction 4 hours after the procedure.

Cade oil poisoning: about a case.

Throughout Morocco, cade oil is used in folk medicine for many purposes, in particular for atopic dermatosis. It is also used as a wormer. Cade oil poisoning of newborns and infants thus often has an iatrogenic origin, resulting especially from the ingestion of a significant amount or from a prolonged and extensive cutaneous application. Thus, this oil, used for therapeutic purposes, is responsible for a non-negligible number of cases of poisoning, some fatal. We report a case of poisoning after cutaneous application of cade oil in a 2-month-old infant. The outcome was fatal. This report calls attention to the real possibility of this event and emphasizes the interest of preventing it by promoting information to families in Morocco.

[Snake bites in children at the Fez University Hospital in Morocco]. / L'envenimation ophidienne pédiatrique au centre hospitalier universitaire de Fès (Maroc).

AIMS: The objective of our study is to describe the epidemiological, clinical, biological, and therapeutic aspects of snake bites in children in northern Morocco. METHODS: This retrospective study reviewed files of all children admitted to the pediatric intensive care unit of the Hasssan II University Hospital in Fez from April 2011 through April 2013. It includes all children reported by themselves or their family to have been bitten by a snake and all those with traces of snake fangs. RESULTS: This study included 12 children, with a mean age of 9.6 ± 2.9 years. In each case, admission took place the day the envenomation occurred, a mean of 8.8 ± 5.6 hours after the bite. Locoregional signs and edema were seen in all cases, associated with bruising (58%) and blisters (25%). General events, including gastrointestinal, cardiovascular, neurologic, and hemorrhagic signs, affected 83% of the children. Hemostasis disorders occurred in 91% of patients, including profound thrombocytopenia (mean: 27.7 ± 30.7 G/L. All envenomations were grade 2 or grade 3. Analgesia was administered systematically; a fasciotomy was performed in 25% of cases and transfusion of blood products in 66%. Three children (25%) were intubated and two children died (16%). CONCLUSION: This series is characterized by the severity of the clinical presentations, with a predominance of locoregional complications and hemostasis disorders corresponding to snake-bite syndrome. We conclude that immunotherapy adapted to the local species must be made available to improve the prognosis of this envenomation.

Repair of isolated double-chambered right ventricle.

The finding of a double-chambered right ventricle (DCRV) is exceptionally rare as an isolated anomaly. It is a congenital cardiac anomaly in which the right ventricle is separated into two chambers, a proximal high-pressure chamber and a distal low-pressure chamber, by anomalous muscles or fibrous tissues in the right ventricular cavity. We report the case of a 6-year-old infant who was admitted for growth retardation. The patient was diagnosed with an isolated DCRV without any other associated congenital anomalies. The patient underwent a successful cardiac surgical procedure of enlargement repair; he was discharged in good clinical condition with a normal cardiac function.

[Postpartum pneumomediastinum associated with subcutaneous emphysema: a case report]. / Pneumomédiastin et emphysème sous-cutané du post-partum : une nouvelle observation.

This case report refers to a 21-year-old primigravida, who complained of dyspnoea and was noticed to have unusual swelling of the face and neck after home delivery. A diagnosis of subcutaneous emphysema was made and this was confirmed with the chest X-ray. Pneumomediastinum and hydropneumothorax were also detected. Uneventful recovery over three days followed conservative management.

[Fatal poisoning due to Indigofera]. / Intoxication mortelle à l'Indigofera.

Indigo, also known in Morocco as Nila, is a dye widely used in the coloring of Moroccan handicrafts. It is obtained from fermentation reactions on the leaves and branches of true indigo, Indigofera tinctoria, which is a widespread plant in tropical Africa and Asia. We report a case of fatal poisoning in a 3-year-old child after administration of indigo for therapeutic purposes. Death resulted from multiple organ failure. The toxicity of this compound is little known in the literature and deserves to be explored through toxicokinetic and toxicodynamic studies, in order to better determine the toxic constituents of the dye.

Left Ventricle Diverticulum with Partial Cantrell's Syndrome.

CANTRELL SYNDROME IS A VERY RARE CONGENITAL DISEASE ASSOCIATING FIVE FEATURES: a midline, upper abdominal wall disorder, lower sternal abnormality, anterior diaphragmatic defect, diaphragmatic pericardial abnormality, and congenital abnormalities of the heart. In this paper, we report a case of partial Cantrell's syndrome with left ventricular diverticulum, triatrial situs solitus, ventricular septal defect, dextrorotation of the heart, an anterior pericardial diaphragmatic defect, and a midline supraumbilical abdominal wall defect with umbilical hernia. The 5-month-old patient underwent a successful cardiac surgical procedure. A PTFE membrane was placed on the apex of the heart to facilitate reopening of the patient's chest. Postoperative course was uneventful. The patient was discharged with good clinical condition and with a normal cardiac function.

Trichobezoar with small bowel obstruction in children: two cases report.

A trichobezoar is a mass of cumulated hair within the gastrointestinal tract. Stomach is the common site of occurrence. Intestinal obstruction due to trichobezoar is extremely rare. The authors report two cases of a trichobezoar obstructing the terminal ileum in one and the jejunum in another.

[Neuroimaging findings in eclamptic patients still symptomatic after 24 hours: a descriptive study about 19 cases]. / Apport de l'imagerie neurologique chez les éclamptiques encore symptomatiques après 24 heures: étude descriptive à propos de 19 cas.

OBJECTIVE: To describe the neuroimaging findings in eclamptic patients still symptomatic after 24 hours. PATIENTS AND METHODS: All parturients consecutively admitted over a 12-month period for eclampsia and presenting with neurological disorders (coma, focal neurological abnormalities, and eye sight disturbance) underwent cerebral CT-scan and/or MRI. RESULTS: Nineteen women were studied, and all had abnormal neuroradiological findings. The CT-scan was normal in three cases. Cerebral oedema was the predominant lesion (14 cases). It was localized in the parietal or occipital area (12 cases), paraventricular area (1 case), or was diffuse (1 case). Diffusion weighted MRI was performed in four cases and showed cytotoxic cerebral oedema in one case. There were three cases of cerebral venous thrombosis and two cases of intracerebral haemorrhage. CONCLUSION: Various neuroradiological lesions can be observed in eclamptic patients. A localized cerebral oedema is the most frequent. Diffusion weighted MRI should be systematically done when neurological disorders persist.

[Pulmonary legionellosis at the earliest stage of hairy cell leukemia]. / Pneumopathie à Legionella pneumophila, inaugurale d'une leucémie à tricholeucocytes.

Legionella pneumonia is frequently reported in immunocompromised patients. The most important predisposing factor is a quantitative and qualitative defect of the monocytic-macrophagic system. We report a case of Legionella pneumophila in a 43-year-old man revealing hairy cell leukemia. The patient presented with community-acquired pneumonia resistant to common antibiotics. Serology provided the diagnosis and the patient improved with adequate treatment. Early diagnosis and appropriate treatment may reduce the mortality of this serious complication.

[Cecal volvulus: a case report in a child]. / Le volvulus du caecum chez l'enfant: à propos d'un cas.

Volvulus of the caecum is a rare entity in childhood. We report on a case of caecal volvulus in a 6-year-old child, admitted with clinical symptoms of gut occlusion and shock. Outcome was favourable after surgical treatment. The epidemiological, clinical, radiological aspects and therapy are discussed in light of data of the literature.

[Emphysematous pyelonephritis with favourable outcome after conservative treatment]. / Une pyélonéphrite emphysémateuse d'évolution favorable après traitement conservateur.

Emphysematous pyelonephritis is a necrotizing renal infection characterized by bacterial gas production in the renal and perirenal area. It is a rare infection diagnosed in diabetic patients in most cases. Emphysematous pyelonephritis is responsible for a high mortality rate. We report the case of a woman, unknown diabetic, who presented with emphysematous pyelonephritis. Early diagnosis performed by CT-scan allowed effective and conservative surgical treatment and final positive outcome.

[Intraspinal air, a rare complication of blunt chest trauma]. / Le pneumorachis, complication rare du traumatisme thoracique fermé.

Pneumorachis, defined as the presence of air within the spinal canal, has rarely been described, and is exceptionally due to thoracic trauma. We report the case of a 37-year-old patient who sustained a motor vehicle accident. The chest CT-scan showed a bilateral-hemothorax, a small right pneumothorax, rib fractures, and a fracture of the fourth thoracic vertebra associated with air in the spinal canal extending from T6 to L2. The fracture of T4 associated with the pleural lesion is probably responsible for the pneumorachis. Possible pathogenic mechanisms of this rare blunt chest complication are discussed.

[Acute rhabdomyolysis due to butane inhalation. Report of two cases]. / Rhabdomyolyse aiguë lors d'une intoxication au butane. A propos de deux cas.

Prolonged inhalation of gas butane induced mostly neurological and cardiovascular symptoms. We reported two very rare cases of acute rhabdomyolysis caused by accidental prolonged inhalation of butane. The early diagnosis and the symptomatic treatment were associated with favourable evolution in the two cases. The mechanism of this complication is discussed and compared with the literature.

[Hypoglycaemia after surgery on phaeochromocytoma]. / Hypoglycémie compliquant la chirurgie d'un phéochromocytome.

Few cases of postoperative hypoglycaemia complicating the removal of a phaeochromocytoma have been reported in the literature. We reported one case of hypoglycaemia secondary to the removal of right phaeochromocytoma in a 30-year-old patient. Seven hours after the excision of the tumour, the patient developed a severe hypoglycaemia at 1.67 mmol x l(-1) revealed by seizures completely resolving in 24 h. The hypoglycaemia in this context resulted probably from the massive secretion of insulin by the beta cells of Langerhans islands due to the suppression of alpha-adrenergic inhibition. The prevention of this complication requires the repeated measurement of the capillary glycaemia in the postoperative period. An important supply of carbohydrate may be necessary to maintain a normoglycaemia.

[Quadriplegia secondary to potassium depletion]. / Tétraplégie secondaire à une hypokaliémie de déplétion.

Muscle paralysis due to potassium depletion are unusual. We report the case of a patient who developed quadriplegia and language disorders due to potassium depletion, following large intestinal resection. Potassium supplementation was given intravenously at a rate of 0.25 mmol.kg-1.h-1 during the first 48 h. This allowed complete total and rapid recovery from the paralysis.

[Spontaneous cutaneous cysto-hepato-bronchial fistula caused by a hydatid cyst. Apropos of a case]. / Fistule cutanéo-kysto-hépato-bronchique spontanée d'origine hydatique. A propos d'un cas.

We report a case liver hydatid cyst which fistulized simultaneously and spontaneously to the skin and in the bronchia observed in a 70-years-old woman. Outcome was favorable after surgical intervention. It is an extremely rare and original case.