[Salmonella enteritidis splenic abscess complicating a Plasmodium falciparum malaria attack]. / Abcès splénique à Salmonella enteritidis compliquant un accès palustre à Plasmodium falciparum.

INTRODUCTION: Salmonella splenic abscesses are rare and usually occur on pre-existing lesions. OBSERVATION: A Moorish 16 year-old woman from Senegal presented with a S. enteritidis abscess without any factor other than an attack of P. falciparum malaria. Treatment associated quinine salts, antibiotherapy and splenectomy. COMMENTS: P. falciparum malaria attacks not only induce humoral and then cellular immunodepression but are also at the origin of infarction or splenic hematoma that may enhance bacterial infection and the development of abscesses. Splenectomy or percutaneous drainage associated with antibiotherapy is the usual treatment for splenic abscesses. Prognosis remains severe (13 to 16% mortality).

[Spiral volumetric CT angiography in the diagnosis of pulmonary embolism in Senegal]. / Apport de l'angioscannographie spiralée dans le diagnostic d'embolie pulmonaire au Sénégal.

Authors relate spiral CT scan in pulmonary embolism about four cases : such as the surgical aspect, peri partum cardiomyopathy, cardiovascular collapsus, chest pains. In all cases spiral volumetric CT angiography Scan confirmed the diagnosis. So spiral CT scan proves to be a precious diagnosis tool that facilitates of multicentric study of pulmonary embolism. However, its effectiveness in the detection of isolated and segmentary embolism requires a thorough evaluation.

[CT imaging and fourth branchial pouch fistula in adults]. / TDM et diagnostic des fistules de la quatrième poche branchiale chez l'adulte.

We report two cases of fourth branchial pouch in adult. This rare and little-known pathology is indeed responsible for suppurative thyroiditis and left lower cervical abscess recurring in spite of antibiotic treatment and incision-drainage. CT scan using, iv contrast, air as a agent contrast with Valsalva test, shows air in the thyroid and perithyroid soft tissue infection, proving communication between the pyriform fossa and the thyroid. Bubble of air behind the left thyroid alar in the sinus track is the best argument for diagnosis. Hypopharyngoscopy shows the mucous opening of the bottom at the pyriform sinus.

[Intracranial subdural hematoma during spinal anesthesia]. / Hematome sous-dural intracranien au decours d'une rachianesthesie.

Spinal anesthesia (SA) is frequently used in tropical zones. Intracranial subdural hematoma is an uncommon complication of SA. The purpose of this report was to describe a case of intracranial subdural hematoma observed during SA performed for cesarean section in a 22-year-old women in Senegal. After one month of persistent intense headache, diagnosis was confirmed by computerized tomography. The hematoma was successfully treated by drainage under general anesthesia. Intracranial subdural hematoma has been attributed to cerebrospinal fluid hypotension due to leakage through the dural puncture site. Diagnosis, which may be difficult in Africa, should be suspected in patients with persistent headaches after SA. Confirmation requires computerized tomography of the brain. Prevention of this complication depends on the use of fine beveled-tipped puncture needle which are rarely available in the African setting.

[Value and limits of tomodensitometry applied to the diagnosis of sacroiliitis in young adults: study of 200 cases]. / Valeur et limites de la tomodensitométrie appliquée au diagnostic des sacro-iliites chez l'adulte jeune: etude de 200 dossiers.

Diagnosis of sacroiliitis may be difficult to establish in patients under 25 years of age since growth is not yet completed and joint damage is often still minor. A prospective study of 200 subjects with a median age of 22 years was carried out to compare the value of CT scan and conventional radiology. The study population included 32 healthy subjects and 168 consecutive patients with presumptive spondylarthropathy including 36 with bilateral sacroiliitis and 8 with unilateral sacroiliitis. Conventional roentgenograms and CT scans were performed in every patient. Blind reading of roentgenograms and CT scans was carried out by two pairs of observers with differing experience. CT scan provided no additional information when reading was done by experienced observers: rates of mistaken and doubtful results were similar with both investigations (10%); specificity of both tests was comparable (90%) but sensitivity was significantly greater for CT scan (91.2%) than for conventional roentgenograms (71.6%), reflecting improved detection of roentgenographically occult sacroiliitis. Less experienced observers obtained better results with CT scans, illustrating the ease of interpretation of CT scan images. Analysis of false-positive CT scans revealed that normal variations and, above all, features due to as yet uncompleted growth were the main sources of mistakes. These mistakes cancelled the advantage of increased sensitivity of CT scan studies and explained why CT scan failed to improve diagnosis.

[Giant cell tumors of the ribs. Apropos of a case]. / Tumerurs à cellules géantes des côtes. A propos d'une observation.

The authors report a case of grade I-II giant-cell tumour of the ribs extending to the thorax and the vertebral column. The tumour was treated by surgical resection followed by vertebral curettage in two stages and adjuvant regional radiotherapy. Giant-cell tumours of the ribs are exceptional and rarely found in the literature. They raise a therapeutic problem (surgery is essential, but radiotherapy is controverted), and a prognostic problem (there is always a potential risk of recurrent malignancy).

[Giant cell tumor. Apropos of a costovertebral site]. / Tumeur à cellules géantes. A propos d'une localisation costo-vertébrale.

The authors report a case of giant cell tumor. This case was unusual by its location (rib and vertebra), its size and its important inner thorax extension. This tumor was studied with different imaging methods and particularly MRI. The sensitivity of MRI is confirmed by the surgery in complete agreement with MRI findings.