Injection Of Contrast Product Research Articles

THROMBOPHLEBITE POST-TRAUMATIQUE : A PROPOS DE TROIS CAS POST-TRAUMATIC THROMBOPHLEBITIS: ABOUT A THREE CLINICALS CASES

Abstract Introduction: Cranial post-traumatic cerebral thrombophlebitis is a rare form of cerebrovascular event. It is a diagnostic and therapeutic emergency, often underdiagnosed. Patients and observations: We report below a retrospective study on clinical records of three patients, with extremes ranging from 15 to 70 years, without pathological history, all struck by cars on public roads and hospitalized for the management of benign head injuries. Computed tomography scan (CT) without injection was performed in the three patients objectifying post-traumatic cranial lesions: extradural hematomas, intraparenchymal hematomas, pneumocephaly and contusions with doubt on CT confirmed by CT with injection of contrast product. Treatment with low molecular weight heparins (60 IU/Kg/12 h) with anti-vitamins K relay with strict clinical, biological and radiological monitoring, associated with motor physiotherapy for one case, allowed good clinical improvement. Conclusion: The diagnosis of post-traumatic cerebral vein thrombosis remains difficult to confirm by brain imaging and poses a management dilemma between effective anticoagulation and post-traumatic bleeding lesions.

BRAIN METASTASES FROM PRIMARY UTERINE CERVICAL CANCER: A CASE REPORT AND A LITERATURE REVIEW

Background :Brain metastasesfromprimarycervical cancer are very rare.Wepresentthis report, to describe a case of brainmetastasesfromprimaryuterine cervical cancer and to conduct a literaturereview about clinicalpresentation, treatment, and prognosis of thisdesease. Case Presentation :A 51-year-old woman, followed since 2017 for squamous cell carcinoma of the cervix for which she had underwent surgical treatment and received radiotherapy, being asymptomatic for 4 years after completion of treatment.She is brought to the Emergency Department in February 2021 forintracranial hypertension syndrome associated with behavioral troubles, symptoms that developed progressively during the last two months before her consultation.The clinical examination found a conscious patient without sensory or motor deficit and without damage to the cranial nerves. A cerebral Magnetic Resonance Imaging (MRI) revealed a left frontal tumor process 50 mm in diameter enhanced peripherally after injection of contrast product, necrotic and surrounded by significant cerebral edema determining a mass effect on the median structures with signs of engagement under falcoriel (figure 1). The patientunderwent asurgicalresectionofthetumor, themassbeingremoved en bloc. Histopathologicalandimmunohistologicalexaminationoftheresectedtumorrevealed a metastaticoriginfrom a primarycervicalsquamoscellcarcinoma. A postoperative brain scan revealed the persistence of a left frontal tumor process 14 mm in diameter with significant perilesional edema. The patient subsequently received total brain radiotherapy at a dose of 37.5 Gy (15 fractions of 2.5 Gy) then an additional dose on the tumor residue at a total dose of 10 Gy (4 fractions of 2.5 Gy). A control scan performed one month after the end of radiotherapy showed a regression in size of the lesion of the left frontal cerebral lesion and the perilesional oedema.Twelve months after the end of radiotherapy, a CT scan revealed progression of the secondary cerebral localization.Sixteen months after the end of radiotherapy, the patient was still alive and followed in oncology. Conclusion: Brain metastases from primary uterine cervical tumors are extremely rare and generally have a poor prognosis.Multimodal therapy such as surgery and radiotherapy, depending on the clinical status of individual patients,should be recommended in patients with brain metastasis to improve survival.

Intraventricular Hemorrhage, a Rare Complication of a Cerebral Tuberculoma: Study of a Case in the Neurology Department of the University Hospital of Conakry

Intraventricular haemorrhage (IVH) is an extremely rare and poorly described complication of central nervous system Tuberculosis (CNS-TB). In this study, we report the case of a 42-year-old man who presented with a weakness of the left hemibody with diffuse headache, altered consciousness associated with fever. No notion of contagion was noted. Brain computed tomography (CT) showed a hematoma in the occipital horns of the lateral ventricles with peri-lesional oedema of the right hemisphere; after injection of contrast product (CP), there were ring-shaped contrasts in the occipital horn of the lateral ventricle and the right thalamus. Angioscan showed no aneurysms or vascular anomalies. Chest X-ray showed micronodular opacities less than 1.5 cm in size in relation to miliary. Xpert MTB/RIF of sputum and cerebrospinal fluid (CSF) showed Mycobacterium tuberculosis (MT). The patient’s course was favourable under antihypertensive and antitubercular treatment. Conclusion: This case illustrates the diagnostic difficulties of CNS-TB due to the polymorphism of the clinical and radiological presentation of CNS-TB.

Aspects scanographiques de la pneumopathie à COVID-19 à Ouagadougou: Étude multicentrique à propos de 1017 cas

ObjectiveTo study the chest CT profile of SARS-CoV-2 pneumonia in patients in the city of Ouagadougou. Patients and methodsdescriptive cross-sectional study with retrospective collection of 1017 patients of both sexes. Included were patients aged 15 and over who had performed a chest CT scan without or with injection of contrast product, suspected or positive for COVID -19. The variables analyzed were: the history, the nature of the examination, the socio-demographic, clinical, CT data including the description of the tomodensitometric lesions and their characteristics, the extent of the parenchymal lesions according to the visual estimate of the French thoracic Imaging Society, complications, other lesions on the chest CT scan and CORADS classification. All parameters (age, sex on the one hand and clinical and CT findings on the other) were subjected to statistical analysis. ResultsThe mean age of the patients was 56.95 years, predominantly male (1.47). Dyspnea was the most frequent symptomatology, at 46.26% (n = 506). Diabetes was the most common comorbidity with 29.37% (n = 94). Frosted glass opacity accounted for 90.95% of elementary lesions which were predominantly in plaque in 44.35% (n = 451), bilateral in (82.79%) and peripheral subpleural in (81.51%). The lower lobes were the most affected and postero-basal involvement predominant with greater involvement in the right lung. The extent was severe in 28.42% (n = 289). Thirty-nine point twenty-three (39.23)% or 399 of cases presented with complications dominated by pleural effusion at 56.39% (n = 225) and pulmonary embolism at 34.08% (n = 136 ). The lesions were classified as CORADS type in 815 CT reports. CORADS 5 type lesions were found in 47% of patients. Five hundred and ninety-two (592) PCRs of our patients were undetermined, in 58.21%. The PCR was positive in 342 cases or 33.63%. The bi- and multivariate analysis noted: a statistically significant link between the age and the extent of the lesions, between the extent of the lesions and the clinical context, between the extent of the lesions and comorbidities such as diabetes, Hypertension and renal failure. There was also a link between the PCR result and basic lesions such as ground glass and crazy paving and between the occurrence of pulmonary embolism and the presence of hypertension. DiscussionThe scanographic profile corresponded to that described in the literature. Frosted glass was the most common elementary lesion. The impairment was severe to critical in patients over 65 with comorbidity. CT angiography was the most requested in front of signs such as dyspnea and desaturation ConclusionA study on CT specificities with precision on the onset of symptoms and the notion of vaccination would complement these results.

CLINICO- MRI PROFILE OF LUMBAR DISC HERNIATION ON SCIATIC LUMBAR PAIN IN BI-RIVER HOSPITAL SETTINGS (CASES OF KINSHASA AND BRAZZAVILLE)

I. Objective: to highlight the clinico-MRI prole of lumbar disc herniation on sciatic lumboradiculgia in bi- river hospital settings (cases of Kinshasa and Brazzaville). This was aII. Materials and methods: retrospective, documentary and multicenter study of 302 patients who performed lumbar MRI examinations in 18 months in hospitals in Kinshasa and Brazzaville. The mean age of patients was 53.4 years. The most represented age groupIII. Results: was 50 to 59 years old. The female sex was predominant (55.4%) with a ratio of 0.79. The majority of patients (68.2%) came from Kinshasa. Lumboradiculalgia was the most predominant indication with (49.3%), followed by low back pain (48%). The majority of MRI examinations (91.4%) were performed without injection of contrast product. T1 and T2 weightings were performed in 100% of patients. Diseased disc degeneration was found at (41.7%) and lumbar disc herniation at (27.2%). The MRI examination was normal in (47%) of the patients. Based on potentially clinically positive relevance, only 48.7% of our MRI diagnoses were clinically positive. Age (p=0.000), lumboradiculalgia (p=0.000) and specialist physician prescription (0.039) had a statistically signicant relationship with clinically positive diagnosis. HDL is a pathological reality in the hospitals ofIV. Conclusion: Kinshasa and Brazzaville. The MRI prole found mainly corroborates the observations of the literature. Lumbar disc herniation and degenerative disc disease remain the most frequently encountered pathologies on magnetic resonance imaging in hospitals in Kinshasa and Brazzaville. They are at the origin of the lumbar spinal syndrome and affect the young population. The posterolateral disc herniation remains the most frequently encountered subtype with predominance of damage to the oors: L4-L5 and L5-S1.

Status of Lumbar Spinal mri Indications in the Diagnostic Management of Lumbar Spinal Pathologies in Hospitals in Kinshasa and Brazzaville about 302 Patients

Objective: Consist of making an inventory of the indications for lumbar spinal MRI in the diagnostic management of lumbar spinal pathologies in hospitals in Kinshasa and Brazzaville. About 302 patients. Materials and Methods: This was a retrospective, documentary and multicenter study on 302 patients who underwent lumbar spine MRI examinations in 18 months in hospitals in Kinshasa and Brazzaville. Results: The mean age of patients was 53.4 years. The most represented age group was 50 to 59 years old. The female sex was predominant (55.4%) with a ratio of 0.79. The majority of patients (68.2%) came from Kinshasa. Lumboradiculgia was the most represented indication (49.3%) followed by low back pain (48%). The majority of MRI examinations (91.4%) were performed without injection of contrast product. T1 and T2 weightings were performed in 100% of patients. Degenerative disc disease was found at (41.7%) and lumbar disc herniation at (27.2%). The MRI examination was normal in (47%) of the patients. Based on potentially clinically positive relevance, only 48.7% of our MRI diagnose were clinically positive. Age (p=0.000), lumboradiculgia (p=0.000) and specialist physician prescription (0.039) had a statistically significant relationship with clinically positive diagnosis. Conclusion: The use of lumbar spinal MRI examination was inappropriate in our study; this opinion mostly corroborates the observations of the literature. A codification of lumbar MRI indications in the radiological exploration of lumbar spinal disorders would avoid abusive and expensive prescriptions for a study population with low economic income.

MO344INCIDENCE AND RISK FACTORS FOR ACUTE POSTOPERATIVE RENAL FAILURE

Abstract Background and Aims Postoperative acute renal failure (AKI) is a particular form of acute failure with several triggers. Decreased renal blood flow and the resulting ischemia seem to be the most common cause of kidney damage. The objective was to study the incidence and risk factors associated with post-operative AKI. Method It was a retrospective, descriptive study spanning a 3-year period from January 1, 2017 to December 31, 2019. The patients in this series were admitted to the various surgical departments. Results Our study included 618 cases of AKI. The incidence of postoperative AKI was 8.73%. The average age of our patients was 40.4 +/- 12.3 years, a male predominance with a sex ratio of 1.2. The main history was diabetes found in 39%, hypertension in 27.5% and an injection of contrast product a few days before the intervention in 14.5%. General surgery topped the list in 49.5% of our patients, followed by trauma in 25%, gyneco-obstetrics in 14.5%, and 11% for the rest of the surgeries. The associated risk factors were: hypovolemic shock, diabetes, severe sepsis. Conclusion The occurrence of acute renal failure in the postoperative period results from factors related to the field and surgery. Hence the need for early identification of risk situations, in order to reduce the incidence of renal damage during the perioperative period.

Stone in Ectopic Pelvic Pancake Kidney: A Surgical Challenge

Clinical Image: A 40 years old without a specific history who presents hypogastric pain associated with urinary signs type dysuria, pollakiuria. Biologically renal impairment with creatinine at 45 mg/l/min, ECBU is negative. Radiologically, abdominal ultrasound objective absence of visualization of the two kidneys with a pelvic renal ectopia is the seat of multiple stones, supplemented by an abdominal CT without injection of contrast product which confirms the presence of a dilation. Kidney laminating the parenchyma on a pancake lithiasic pelvic kidney driving back the bladder in the anterior. After discussion with the patient, an exploratory umbilical laparotomy with possibly nephorolithotomy for the extraction of the stones was proposed but the patient refused the procedure. Pancake kidney is rare and usually asymptomatic. Surgical intervention may be needed at complicated cases. Careful preoperative scrutiny of imaging can guide surgical therapy. More research is needed to establish the standard management of these patients.

CT-guided transforaminal cervical and lumbar epidural injections

Transforaminal injections are widely used. Serious complications including strokes and paraplegia have been reported after transforaminal injections of corticosteroids, and the Afssaps (2011) has issued a warning about their use [1]. The needle must be positioned in the posterior aspect of foramen, and its correct placement validated by an injection of contrast product. It is preferable to choose cortivazol (Altim(®)) as the corticoid for injection. This procedure is simple, reproducible, and durably effective in 60 to 70% of cases. Complications and adverse effects are rare but potentially serious: allergies, blood pressure surge, vasovagal syncope, transient exacerbation of pain, infection, stroke, and paraplegia. The aim of this course is to stress the need for rigor -in the indication, the technical performance of the procedure, and the overall management of the patient.