Bland-White-Garland syndrome or ALCAPA is an abnormality of birth of the left coronary artery from the pulmonary artery. It is a diagnostic and therapeutic emergency because it is a curable cause of hypokinetic dilate...Bland-White-Garland syndrome or ALCAPA is an abnormality of birth of the left coronary artery from the pulmonary artery. It is a diagnostic and therapeutic emergency because it is a curable cause of hypokinetic dilated heart disease in infants. We report through this clinical case, the fourth case of infantile ALCAPA diagnosed in Senegal in a 7-month-old infant. The symptomatology began around the age of 2 months, with a grumpy state associated with more marked crying and moaning during feedings and bowel movements. The mother reported hospitalization for a severe lung infection when she was 6 months old. The examination noted an infant in poor general condition, retarded growth and weight, and a 3/6th holosystolic murmur at the apex. Troponinemia was positive at 43.90 ng/L. The electrocardiogram showed Q waves on the lower side, a sub endocardial lesion on the upper side and a ST segment elevation in aVR. Doppler echocardiography showed dilated cardiomyopathy with a mean alteration of systolic function of the left ventricle at 37%, a mean mitral insufficiency and a strong suspicion of a birth anomaly of the left coronary artery. The CT scan confirmed the diagnosis of ALCAPA. Surgicalreimplantation of the left coronary artery at the aortic level was performed at 10 months of life with a favourable outcome at D50 postoperative.展开更多
BACKGROUND Tuberculosis is endemic in Senegal.While its extra-pulmonary localization is rare,esophageal tuberculosis,particularly the isolated form,is exceptional.We report here a case of isolated esophageal tuberculo...BACKGROUND Tuberculosis is endemic in Senegal.While its extra-pulmonary localization is rare,esophageal tuberculosis,particularly the isolated form,is exceptional.We report here a case of isolated esophageal tuberculosis in an immunocompetent patient.CASE SUMMARY A 58-year-old man underwent consultation for mechanical dysphagia that had developed over 3 mo with non-quantified weight loss,anorexia,and fever.Upper digestive endoscopy showed extensive ulcerated lesions,suggesting neoplasia.The diagnosis was confirmed by histopathology,which showed gigantocellular epithelioid granuloma surrounding a caseous necrosis.Thoracoabdominal computed tomography scan did not show another localization of the tuberculosis.The outcome was favorable with treatment.CONCLUSION Esophageal tuberculosis should be considered when dysphagia is associated with atypical ulcerated lesions of the esophageal mucosa,in an endemic area.展开更多
文摘Bland-White-Garland syndrome or ALCAPA is an abnormality of birth of the left coronary artery from the pulmonary artery. It is a diagnostic and therapeutic emergency because it is a curable cause of hypokinetic dilated heart disease in infants. We report through this clinical case, the fourth case of infantile ALCAPA diagnosed in Senegal in a 7-month-old infant. The symptomatology began around the age of 2 months, with a grumpy state associated with more marked crying and moaning during feedings and bowel movements. The mother reported hospitalization for a severe lung infection when she was 6 months old. The examination noted an infant in poor general condition, retarded growth and weight, and a 3/6th holosystolic murmur at the apex. Troponinemia was positive at 43.90 ng/L. The electrocardiogram showed Q waves on the lower side, a sub endocardial lesion on the upper side and a ST segment elevation in aVR. Doppler echocardiography showed dilated cardiomyopathy with a mean alteration of systolic function of the left ventricle at 37%, a mean mitral insufficiency and a strong suspicion of a birth anomaly of the left coronary artery. The CT scan confirmed the diagnosis of ALCAPA. Surgicalreimplantation of the left coronary artery at the aortic level was performed at 10 months of life with a favourable outcome at D50 postoperative.
文摘BACKGROUND Tuberculosis is endemic in Senegal.While its extra-pulmonary localization is rare,esophageal tuberculosis,particularly the isolated form,is exceptional.We report here a case of isolated esophageal tuberculosis in an immunocompetent patient.CASE SUMMARY A 58-year-old man underwent consultation for mechanical dysphagia that had developed over 3 mo with non-quantified weight loss,anorexia,and fever.Upper digestive endoscopy showed extensive ulcerated lesions,suggesting neoplasia.The diagnosis was confirmed by histopathology,which showed gigantocellular epithelioid granuloma surrounding a caseous necrosis.Thoracoabdominal computed tomography scan did not show another localization of the tuberculosis.The outcome was favorable with treatment.CONCLUSION Esophageal tuberculosis should be considered when dysphagia is associated with atypical ulcerated lesions of the esophageal mucosa,in an endemic area.
