[Clinical aspects and management of scrotal calcinosis]. / Aspects cliniques anatomopathologiques et prise en charge de la calcinose scrotale.

INTRODUCTION: Scrotal calcinosis is a benign idiopathic cutaneous calcinosis characterized by the presence of calcified nodules of the scrotal skin. The aim of the study is to report the clinical, histological and therapeutic aspects. PATIENTS AND METHODS: This was a prospective descriptive study from 2014 to 2020 in the department of urology. Patients were included, aged at least 15years, consulting for nodules of the scrotal skin whose clinical and paraclinical assessment concluded to scrotal calcinosis. The variables studied were clinical, paraclinical, therapeutic and evolutionary. Informed consent of the patients and anonymity in the use of scientific photographs were observed. RESULTS: In 6years, 8 cases of scrotal calcinosis were diagnosed and operated on, i.e. 1.3 per year. The average age of the patients was 36.2years. The average age of the lesions was 4.2years, the general condition was good (n=8). The unsightly appearance (n=5), pruritus (n=2), recommendation of the spouse (n=2), psychological trauma (n=5), and fear of cancerous degeneration (n=3) were the reasons for consultation. The lesions were scattered or in clusters. Serologies were positive: HIV (n=2), chlamydia (n=4) and syphilis (n=3). Treatment was surgical (n=8). Histological analysis concluded to scrotal calcinosis. The average hospital stay was 2days. The mean time to complete healing was 19.6days without recurrence. CONCLUSION: Scrotal calcinosis is a benign, rare idiopathic pathology. The treatment is surgical.

[Clinical, diagnostic and evolutionary profile of peritoneal tuberculosis at the national reference general hospital of Ndjamena about 69 cases]. / Profil clinique, diagnostique et evolutif de la tuberculose peritoneale a l'hopital general de reference nationale de Ndjamena a propos de 69 cas.

INTRODUCTION: Peritoneal tuberculosis is not uncommon in Chad. Its diagnosis of certainty is difficult and is based on the analysis of ascites fluid and abdominal ultrasound. Our aim was to contribute to the study of the various clinical, diagnostic and progressive aspects of peritoneal tuberculosis in the internal medicine department of the HGRN. METHODOLOGY: This is a retrospective and prospective study spread over 39 months covering the period from January 2014 to March 2017 including all patients hospitalized for peritoneal tuberculosis in the internal medicine department of the HGRN. The diagnosis was made, on a bundle of anamnestic, clinical, ultrasound, cytological and evolutionary arguments. RESULTS: During the study period, 69 patients were included, or 9.77% of all hospital admissions. The average age was 42 years (range 18 to 83 years). The female sex represented 52.2% of the cases. The main reasons for hospitalization were ascites (87% of cases), associated with fever (92.5% of cases). The clinical signs were dominated by abdominal pain, deterioration of general condition and transit disorders. The ascites fluid was citrus yellow, rich in lymphocytes (81.6% of cases) and protein (94.2% of cases). Abdominal ultrasound, performed in all patients, demonstrated ascites with deep, mesenteric lymphadenopathy, portal in 62.3% of cases and compartmentalized in 37.7% of cases. Tuberculosis treatment was started in all patients and the outcome was favorable in 65.2% of cases. We deplored 20.3% mortality; all were patients who were severely immunosuppressed with HIV. CONCLUSION: Peritoneal involvement in tuberculosis is common in Chad. The diagnosis is not always easy, but the clinic associated with the exudative and lymphocytic characters of the ascites fluid as well as the abdominal ultrasound are elements which can direct towards a peritoneal localization of tuberculosis. The course is generally favorable under early treatment and well conducted.

INTRODUCTION: La tuberculose péritonéale n'est pas rare au Tchad. Son diagnostic de certitude est difficile et repose sur l'analyse liquide d'ascite et l'échographie abdominale. Notre but était de contribuer à l'étude des différents aspects cliniques, diagnostics et évolutifs de la tuberculose péritonéale dans le service d'hépato-gastro-entérologie de l'HGRN. MÉTHODE: C'etait une étude rétrospective et prospective étalée sur 39 mois couvrant la période de Janvier 2014 au Mars 2017 incluant tous les patients hospitalisés pour tuberculose péritonéale au service de médecine interne de l' HGRN. Le diagnostic était posé sur un faisceau d'arguments anamnestiques, cliniques, échographique, cytologiques et évolutifs. RÉSULTATS: Durant la période d'étude, 69 patients étaient inclus soit 9,77% de l'ensemble des hospitalisations du service. L'âge moyen etait de 42 ans (extrêmes d'âge allant de 18 à 83 ans). Le sexe féminin représentait 52,2%des cas. Les principaux motifs d'hospitalisation étaient l'ascite (87% des cas), associée à la fièvre (92,5% des cas). Les signes cliniques, étaient dominés par les douleurs abdominales, l'altération de l'état général et les troubles de transit. Le liquide d'ascite était jaune citrin riche en lymphocyte (81,6% des cas) et en protide (94,2% des cas). L'échographie abdominale, pratiquée chez tous les malades objectivait une ascite avec des adénopathies profondes, mésentériques, portales dans 62,3% des cas et cloisonnée dans 37,7% des cas. Un traitement antituberculeux etait instauré chez tous les patients et l'évolution etait favorable dans 65,2% des cas. Nous avions enregistré 20, 3% de mortalité, tous étaient des patients immunodéprimés sévères au VIH. CONCLUSION: L'atteinte péritonéale au cours de la tuberculose est courante au Tchad. Le diagnostic n'est pas toujours aisé mais le caractère exsudatif et lymphocytaire du liquide d'ascite ainsi que l'échographie abdominale sont des éléments qui peuvent orienter vers une localisation péritonéale de la tuberculose. L'évolution est généralement favorable sous traitement précoce et bien conduit.