Pesticide poisoning is one of the most common diseases in the emergency department, characterized by rapid changes in condition, a high misdiagnosis rate, and a poor prognosis. Measures for early removal of poisons ar...Pesticide poisoning is one of the most common diseases in the emergency department, characterized by rapid changes in condition, a high misdiagnosis rate, and a poor prognosis. Measures for early removal of poisons are crucial, and gastric lavage is one of the important measures. Regarding the post-gastric lavage effect, abdominal CT scanning has an important application value in the assessment of the gastric lavage effect after pesticide poisoning.展开更多
This study aimed to estimate renal effective dose during abdominal CT scans in order to assess the renal risks of cancer and heredity per procedure in Moroccan hospitals. It’s consisted of examining a total of 120 pa...This study aimed to estimate renal effective dose during abdominal CT scans in order to assess the renal risks of cancer and heredity per procedure in Moroccan hospitals. It’s consisted of examining a total of 120 patients referred to three radiology departments for an abdominal CT scan at the rate of 40 per hospital. The data that collected for this diagnostic exam included scanner acquisition parameters, number of series, use of the contrast medium, and rotation time as well as slice thickness, the displayed CT dose index (CTDI<sub>vol)</sub> and the Dose Length Product (DLP). Renal dose, effective dose and biological risks were estimated using the International Commission on Radiological Protection (ICRP) conversion factor. The patients included in this study were an average age of the (46.49 ± 14.16) years and an average weight of (73.34 ± 7.58) kg. For the mean effective dose (<em>E</em>) and average kidney dose (<em>D<sub>K</sub></em>) received per patient during an abdominal CT scan, it were respectively of (6.67 ± 2.73) and (18.26 ± 7.74) mSv. The distribution of these values according to the hospital variable shows a difference in mean effective dose of the order of 0.26, 0.38 and 1.45 mSv and a difference in the mean renal dose of the order of 8.76, 4.94 and 0.48 mSv respectively for H1, H2 and H3. The induction cancer risk of abdominal and kidney per 10<sub>5</sub> procedures was respectively of 3 and 10. The kidney cancer risk by procedure is two to three times more likely than abdominal. For hereditary risk of abdominal and renal exposure per 10<sub>6</sub> procedures, it is 14 and 21 respectively. The renal stochastic effect by procedure is also two to three times more likely than that of the abdomen. Our values are relatively higher than those of published in some previous studies. Cancer risk and heredity estimation highlights the need to limit radiation dose. This first ever survey confirmed the need to improved training of health professionals involved in computed tomography on factors affecting image quality, doses and protocols optimization.展开更多
Introduction: Acute intestinal obstruction is a serious pathology, a surgical emergency for which medical imaging plays an important role in the management. We initiated this work in order to study the contribution of...Introduction: Acute intestinal obstruction is a serious pathology, a surgical emergency for which medical imaging plays an important role in the management. We initiated this work in order to study the contribution of imaging in the diagnosis of acute intestinal obstruction at the Point-G University Hospital. Patients and Methods: This was a prospective, descriptive and analytical study of 96 patients collected at the radiology and medical imaging department of CHU Point-G from January 2018 to January 2019. Results: The age of our patients varied from 11 to 86 years, with an average of 36 years old. There was a male predominance of 64.6% against 35.4% for women, i.e., a sex ratio of 1.82. Previous surgery was found in 61.5% of our patients. The pain was present in all patients. An unprepared abdominal X-ray was performed in 89.6% of patients. Hydroaerobic levels were found in 96.5% of patients. Abdominopelvic CT scans were performed on 12 patients, all of whom were diagnosed with occlusion. These positive diagnostic findings were consistent with intraoperative findings in 92% of cases. The causes were dominated by bridges in 46 patients and tumors in 9 patients. Signs of severity on CT were dominated by signs of distress of the upstream bile ducts in 8.3%. Exactly 8% of our patients spontaneously resumed transit, 91% received surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients (83.3%) and poor with death in 16 patients (16.7%). Conclusion: Acute intestinal obstruction remains a serious pathology for which the X-ray of the PSA is often the only radiological examination performed in an emergency. However, abdominopelvic CT seems to us to be widely indicated thanks to its contribution both to the positive diagnosis and to the diagnosis of severity and etiology. However, this imaging technique is widely underused in our practice because of its high cost and lack of availability.展开更多
Situs inversus is an abnormal placement of the thoracic and/or abdominal organs that are inverted right/left from normal. It is a rare congenital malformation often discovered in childhood. In adults, it can lead to m...Situs inversus is an abnormal placement of the thoracic and/or abdominal organs that are inverted right/left from normal. It is a rare congenital malformation often discovered in childhood. In adults, it can lead to misdiagnosis. Clinical case: A 35-year-old female patient, seen in a hepatogastroenterology consultation for acute spontaneous pain in the right hypochondrium. She had no particular clinical history. A diagnosis of hepatopathy was suspected. Abdominal and pelvic CT scans showed the left liver, stomach and spleen in the right hypochondrium, but with the heart in place, suggesting incomplete situs inversus. The evolution in our patient was spontaneously resolved with analgesics and antispasmodics, which leads us to believe that the volvulus was probably partial and without other complications. Conclusion: In developing countries, antenatal diagnosis of situs inversus is rare and is usually made during a pathology that leads the patient to a medical consultation. CT is one of the key paraclinical examinations for its diagnosis as genetic tests are not widely available.展开更多
Aorto-enteric fistula(AEF)is a rare entity that accounts for high mortality. Early diagnosis is paramount to improving the survivals of patients with AEF but the diagnosis tends to be delayed in practice due to extrem...Aorto-enteric fistula(AEF)is a rare entity that accounts for high mortality. Early diagnosis is paramount to improving the survivals of patients with AEF but the diagnosis tends to be delayed in practice due to extremely variable clinical presentations. Contrasted computer tomography(CT),oesophagastroduodenoscopy(OGDS)or angiography should be prompted in a timely manner based on a high index of clinical suspicion. In this article,a case of primary AEF(PAEF)with herald gastroenteric tract haemorrhage is presented. In addition to the pathophysiology and managements,the pitfalls of the diagnostic studies are discussed,pinpointing the importance of high index of clinical suspicion.展开更多
文摘Pesticide poisoning is one of the most common diseases in the emergency department, characterized by rapid changes in condition, a high misdiagnosis rate, and a poor prognosis. Measures for early removal of poisons are crucial, and gastric lavage is one of the important measures. Regarding the post-gastric lavage effect, abdominal CT scanning has an important application value in the assessment of the gastric lavage effect after pesticide poisoning.
文摘This study aimed to estimate renal effective dose during abdominal CT scans in order to assess the renal risks of cancer and heredity per procedure in Moroccan hospitals. It’s consisted of examining a total of 120 patients referred to three radiology departments for an abdominal CT scan at the rate of 40 per hospital. The data that collected for this diagnostic exam included scanner acquisition parameters, number of series, use of the contrast medium, and rotation time as well as slice thickness, the displayed CT dose index (CTDI<sub>vol)</sub> and the Dose Length Product (DLP). Renal dose, effective dose and biological risks were estimated using the International Commission on Radiological Protection (ICRP) conversion factor. The patients included in this study were an average age of the (46.49 ± 14.16) years and an average weight of (73.34 ± 7.58) kg. For the mean effective dose (<em>E</em>) and average kidney dose (<em>D<sub>K</sub></em>) received per patient during an abdominal CT scan, it were respectively of (6.67 ± 2.73) and (18.26 ± 7.74) mSv. The distribution of these values according to the hospital variable shows a difference in mean effective dose of the order of 0.26, 0.38 and 1.45 mSv and a difference in the mean renal dose of the order of 8.76, 4.94 and 0.48 mSv respectively for H1, H2 and H3. The induction cancer risk of abdominal and kidney per 10<sub>5</sub> procedures was respectively of 3 and 10. The kidney cancer risk by procedure is two to three times more likely than abdominal. For hereditary risk of abdominal and renal exposure per 10<sub>6</sub> procedures, it is 14 and 21 respectively. The renal stochastic effect by procedure is also two to three times more likely than that of the abdomen. Our values are relatively higher than those of published in some previous studies. Cancer risk and heredity estimation highlights the need to limit radiation dose. This first ever survey confirmed the need to improved training of health professionals involved in computed tomography on factors affecting image quality, doses and protocols optimization.
文摘Introduction: Acute intestinal obstruction is a serious pathology, a surgical emergency for which medical imaging plays an important role in the management. We initiated this work in order to study the contribution of imaging in the diagnosis of acute intestinal obstruction at the Point-G University Hospital. Patients and Methods: This was a prospective, descriptive and analytical study of 96 patients collected at the radiology and medical imaging department of CHU Point-G from January 2018 to January 2019. Results: The age of our patients varied from 11 to 86 years, with an average of 36 years old. There was a male predominance of 64.6% against 35.4% for women, i.e., a sex ratio of 1.82. Previous surgery was found in 61.5% of our patients. The pain was present in all patients. An unprepared abdominal X-ray was performed in 89.6% of patients. Hydroaerobic levels were found in 96.5% of patients. Abdominopelvic CT scans were performed on 12 patients, all of whom were diagnosed with occlusion. These positive diagnostic findings were consistent with intraoperative findings in 92% of cases. The causes were dominated by bridges in 46 patients and tumors in 9 patients. Signs of severity on CT were dominated by signs of distress of the upstream bile ducts in 8.3%. Exactly 8% of our patients spontaneously resumed transit, 91% received surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients (83.3%) and poor with death in 16 patients (16.7%). Conclusion: Acute intestinal obstruction remains a serious pathology for which the X-ray of the PSA is often the only radiological examination performed in an emergency. However, abdominopelvic CT seems to us to be widely indicated thanks to its contribution both to the positive diagnosis and to the diagnosis of severity and etiology. However, this imaging technique is widely underused in our practice because of its high cost and lack of availability.
文摘Situs inversus is an abnormal placement of the thoracic and/or abdominal organs that are inverted right/left from normal. It is a rare congenital malformation often discovered in childhood. In adults, it can lead to misdiagnosis. Clinical case: A 35-year-old female patient, seen in a hepatogastroenterology consultation for acute spontaneous pain in the right hypochondrium. She had no particular clinical history. A diagnosis of hepatopathy was suspected. Abdominal and pelvic CT scans showed the left liver, stomach and spleen in the right hypochondrium, but with the heart in place, suggesting incomplete situs inversus. The evolution in our patient was spontaneously resolved with analgesics and antispasmodics, which leads us to believe that the volvulus was probably partial and without other complications. Conclusion: In developing countries, antenatal diagnosis of situs inversus is rare and is usually made during a pathology that leads the patient to a medical consultation. CT is one of the key paraclinical examinations for its diagnosis as genetic tests are not widely available.
文摘Aorto-enteric fistula(AEF)is a rare entity that accounts for high mortality. Early diagnosis is paramount to improving the survivals of patients with AEF but the diagnosis tends to be delayed in practice due to extremely variable clinical presentations. Contrasted computer tomography(CT),oesophagastroduodenoscopy(OGDS)or angiography should be prompted in a timely manner based on a high index of clinical suspicion. In this article,a case of primary AEF(PAEF)with herald gastroenteric tract haemorrhage is presented. In addition to the pathophysiology and managements,the pitfalls of the diagnostic studies are discussed,pinpointing the importance of high index of clinical suspicion.
