We report a case of agenesis of the right inferior lobar branch of the pulmonary artery in the Medical Imaging Department of the Mali Hospital. The patient was a 61-year-old woman residing in Bamako and admitted to the Medical Imaging Department of the Mali Hospital. On admission, she had a history of pulmonary tuberculosis, which had been treated and cured since the age of 25, and had controlled hypertension. Clinical examination revealed a deterioration in general condition, chest pain, respiratory distress, a productive cough, decreased vocal vibrations on palpation, submatousness on percussion, and crackles in both lung fields on auscultation. A standing frontal chest X-ray revealed narrowing of the right intercostal spaces with slight collapse of the ipsilateral lower lobe, elevation of the ipsilateral diaphragmatic hemidome, and a verticalized right lower lobe vascular network. Echocardiography revealed mild dilation of the cardiac chambers. An ECG revealed left ventricular hypertrophy. Based on the echocardiography and ECG findings, a pulmonary CT angiogram was requested, which revealed agenesis of the right lower lobe branch of the pulmonary artery, left hypertrophic cardiomyopathy, hypoplasia of the right lower pulmonary vein, bilateral bronchopulmonary disease, mild hypoplasia of the right lower lobe, and mild dilation of the left arterial branch. Agenesis of the right lower lobe branch of the pulmonary artery is a rare congenital malformation. Pulmonary CT angiography plays a key role in diagnosis and ensures appropriate management.
Objective:To evaluate the short-term efficacy and safety of ultrasound-guided phenol PENG Block for the management of chronic pain of degenerative joint origin at Bouaké University Hospital. Methods:Prospective study conducted over six months (July-December 2024), including patients (>16 years old) suffering from painful degenerative joint diseases (EN > 6/10). Epidemiological, clinical and therapeutic variables were analysed. A statistical analysis using Student's t-test (p < 0.05) assessed pain reduction after phenol PENG Block. Results:Twenty-six patients were included (mean age: 43 years). The majority were women (73.1%), who were overweight (38.5%) or obese (23%). Coxarthrosis was the most common indication (42.4%). Phenol PENG block resulted in a significant reduction in pain, with a decrease in the average EN from 8 to 2 (p = 0.00). No complications were reported. Conclusion:Ultrasound optimises the accuracy and safety of PENG block, making its use essential. The development of cooperation strategies promotes better management of this technique.
Aim:Contributing to the improvement of chest trauma care. Objective:Identifying post-traumatic chest CT lesions. Materials and methods:Retrospective study conducted at the Bouaké Medical Imaging Centre from January 2019 to December 2021, i.e. over a period of three years. It involved 103 patients with chest trauma in Bouaké who underwent CT scans. Epidemiological and clinical parameters and CT scan findings were analysed. Results:The average age of patients was 33 years, with extremes of 2 and 89 years. Males predominated in 78% of cases, with a sex ratio of 3.57. In 76.3% of cases, the patients were victims of road traffic accidents (RTAs). Chest injuries were closed in the majority of cases (94%). Parietal lesions were observed in 87.4% of cases. Rib fractures accounted for 87.4%. These fractures were multiple in 70% of cases. Haemothorax, pulmonary contusion and pneumomediastinum accounted for 25.2%, 28% and 7.7% of chest injuries, respectively. Conclusion:Computed tomography is the appropriate examination for the management of chest trauma, especially in the context of multiple trauma. Rigorous technique and interpretation would ensure a comprehensive study, preventing potential injuries from being overlooked.
Rasmussen encephalitis is a chronic and progressive inflammatory encephalopathy, responsible for unilateral hemispheric damage causing focal epileptic seizures, hemiparesis and cognitive decline. It is an immune-mediated disease, with constant involvement of T lymphocytes. It generally progresses in three phases: a prodromal phase, an acute phase and a residual phase. The diagnostic criteria have been well established since the European consensus of 2005. Early injections of intravenous immunoglobulin and Natalizumab allowed a reduction in the frequency of seizures and cerebral inflammation. We report a case of Rasmussen encephalitis with a review of literature to shed light on this condition suffering from diagnostic delay or even diagnostic error.
Hernia through the Winslow's foramen is rare, with a nonspecific clinical presentation, and its diagnosis can be challenging. It is a form of obstruction due to internal hernia. Internal hernias are a common cause of obstruction, which can present clinically in an acute or progressive manner. This diagnosis should be prioritized in a patient without a history of surgical or inflammatory abdominal conditions. We report two cases of distal ileal hernia through the Winslow's hiatus This uncommon form of internal hernia is difficult to diagnose We highlight the clinical signs and the radiological assessment (abdominal X-ray without contrast) for diagnosing intestinal obstruction, but the computed tomography and the laparoscopy anticipate the location and condition of the loop and provide an overview of treatment.
