22 research outputs found
TURP syndrome: à propos d’un cas
No full textNous rapportons le cas d'un patient de 78 ans, sans antécédents pathologiques notables, qui a bénéficié d'une résection transuréterale d'une hypertrophie bénigne de prostate de 50g sous rachianesthésie. Ce patient a présenté, 90 minutes après le début de l'intervention, des nausées vomissements, brouillard visuel et bradycardie en rapport avec un TURP syndrome. L'ionogramme a objectivé une natrémie à 118meq/l, d'où sa mise sous sérum salé hypertonique à 3% avec bonne évolution. Cette observation décrit une forme typique mais modérée du TURP syndrome dont la prise en charge était facilitée par l'état d'éveil du patient permis grâce à la rachianesthésie.Mots clés: Résection transuréterale de la prostate, TURP syndrome, rachianesthésie, hyponatrémieEnglish Title: TURP syndrome: about a caseEnglish AbstractWe report the case of a 78-year old patient, with no particular past medical history, who underwent transurethral resection of the prostate (50 g) under spinal anesthesia for benign hypertrophy. 90 minutes after the beginning of the procedure, the patient had nausea, vomiting, visual fog and bradycardia, suggesting TURP syndrome. Ionogramme objectified a serum sodium level of 118meq/L, hence the patient was treated with 3% hypertonic saline solution, with good evolution. This study describes a common but moderate occurrence of TURP syndrome whose management was facilitated by patient’s alertness during spinal anesthesia.Keywords: Transurethral resection of the prostate, TURP syndrome,spinal anesthesia, hyponatremi
Pancréatite surinfectée révélé par un abcès du psoas
No full textLes pancréatites aigues grave peuvent se compliquer de pseudo kystes qui peuvent conduire à la formation de fistules, ces fistules peuvent être dirigées vers différentes régions avec différentes manifestations cliniques. Ces manifestations extra pancréatiques de la pancréatite aigue constituent, par leurs particularités cliniques, biologiques et radiologiques, un réel apport au diagnostic positif. Le pronostic est celui de la pancréatite et dépend du site de la fistulisation. Le traitement par laparotomie a longtemps été le «Gold Standard», ces dernières années ont vu le développement de moyens moins invasifs et donc offrants un minimum de morbi-mortalité (Chirurgie mini invasive, drainage percutané). Nous rapportons l'observation d'un patient ayant séjourné dans notre structure
Un syndrome malin des neuroleptiques compliqué d’hémorragie méningée et révélant une vascularite cérébrale
No full textLe syndrome malin des neuroleptiques est une complication du traitement par les neuroleptiques. Son incidence est estimée à 0,02% dans la population générale. Le traitement reste symptomatique et repose essentiellement sur l'arrêt immédiat du traitement antérieur. Nous rapportons l'observation clinique d'une patiente de 26 ans, schizophrénique sous Chlorpromazine, se présentant aux urgences pour la prise en charge d'un syndrome malin des neuroleptiques compliqué d'une hémorragie méningée et révélant une vascularite cérébrale
Transurethral resection of prostate syndrome: report of a case
No full textWe report a case of transurethral resection of prostate (TURP) syndrome. A 78-year-old man with prostatic hypertrophy was scheduled for transurethral resection of the prostate under spinal anesthesia. 30 minutes after the end of the surgery, the patient presented signs of TURP syndrome with bradycardia, arterial hypotension, cyanosis, hypoxemia and coma. The electrolytes analysis revealed an acute hyponatremia (sodium concentration 125 mmol/L). Medical treatment consisted of hypertonic saline solution 3%, volume expansion, intubation and ventilation. The presented case describes a typical TURP syndrome, which was diagnosed and treated early. The patient was discharged from hospital without any complications.Pan African Medical Journal 2013; 14:1
Volvulus du grêle sur mésentère commun incomplet une redoutable complication rare chez l’adulte: à propos de 1 cas
No full textFactors Associated with Mortality in Severe Acute Cholangitis in a Moroccan Intensive Care Unit: A Retrospective Analysis of 140 Cases
No full textBackground. Severe acute cholangitis is a life-threatening biliary infection, leading to organ dysfunction, septic shock, and naturally death. Mortality has dropped significantly in the past years through improving resuscitation and biliary drainage techniques. The aim of our study is to analyze our daily practice and the factors associated with mortality. Methods. A retrospective study including severe acute cholangitis patients admitted to our unit from January 2009 to December 2018. Variables analyzed (univariate then multivariate analysis) were age, sex, history, origin, evolution time, bilirubin, etiology, organ dysfunction, qSOFA, SOFA, TOKYO, biliary drainage timing and technique, shock, antibiotherapy, and resuscitation. Results. 140 patients were included in this study. Average age was 61. Sex ratio M/F was 0.59. Lithiasis etiology was dominant (69%). SOFA average score upon admission was 8. Ceftriaxone + metronidazole was the empirical antibiotic used in 87%. Average time to biliary drainage was 1.58±0.89 days. Endoscopic unblocking was the technique used in 76%. Mean duration of ICU stay was 6 days. Mortality rate was 28%. Statistically significant factors for mortality (p<0.05) were history of taking anticoagulant treatment, use of catecholamines and mechanical ventilation during ICU stay, and delay in consultation and administration of antibiotic therapy. Conclusions. Early recognition, antibiotics, resuscitation, and minimally invasive biliary drainage have improved patient outcomes although there is still progress to be made. Moreover, as multiple organ failure is often associated with mortality in severe acute cholangitis, predictive risk factors of organ failure should be more investigated
Intracardiac Thrombosis and Multiple Arterial Thromboembolism with Acute Limb Ischemia: A Rare Complication of Carbon Monoxide Intoxication
No full textAbstractCarbon monoxide (CO) poisoning is a very common reason for emergency ward admission, with symptoms varying from a simple headache and dizziness to severe neurological and cardiac impairment. We report here a rare clinical presentation of CO intoxication manifested by a severe cardiac impairment with intracardiac thrombus formation, acute limb ischemia, renal infarction, and carotid artery thrombosis. There have been initial reports of thromboembolic events in acute CO poisoning with intracardiac thrombosis being sparsely reported. Contrary to venous thromboembolism, arterial thromboembolism in CO poisoning seems to be extremely rare. To the best of our knowledge, this is the first report in recent literature of a combined intracardiac thrombosis and multiple arterial thromboembolism induced by CO poisoning.</jats:p
Asthenic peritonitis by stercoral perforation
No full textLa perforation stercorale est une entité assez rare et très peu décrite dans la littérature surtout francophone. C’est une complication à la constipation chronique et survient préférentiellement chez les personnes âgées et alitées. Le tableau clinique est non spécifique et l’évolution est défavorable dans 30 à 45 % des cas vue l’association des comorbidités au sepsis intra-abdominal ou systémique. Nous rapportons le cas d’une perforation stercorale asthénique chez un sujet de 80 ans avec une évolution favorable.Stercoral perforation is an uncommon entity and has been very rarely described in the literature (especially French literature). It is a complication of chronic constipation and usually occurs in the elderly and bedridden patients. The clinical examination is nonspecific and outcome is unfavorable in 30-45% of cases due to the association of comorbidities with intra-abdominal or systemic sepsis. We report a case of asthenic stercoral perforation in an 80-year patient with a favorable outcome
