Papillary Renal Cell Carcinoma Revealed by Renal Traumatism: A Case Report in Lomé

This study is a report on a case of papillary carcinoma of the kidney revealed by an abdominal contusion. The results of radiological investigations were discordant with the low intensity of the shock. The treatment consisted of radical nephrectomy because of the suspicion of a pre-existing malignancy. Histological analysis revealed a papillary carcinoma pT3N0M0. We focus on the need for performing diagnostic tests in order to avoid missing a pre-existing anomaly to the kidney trauma.

[Heterogeneous testicle on ultrasonography: consider tuberculosis after cancer in endemic zone]

The purpose of this report is to describe findings of clinical examination and imaging in a 27-year-old man admitted for nonpainful left testicular enlargement. Initial diagnosis was testicular cancer based on ultrasonography and association with pulmonary metastasis. This diagnosis was revised after histological study demonstrated testicular tuberculosis.

[Kidney ultrasound scan performed on the adult patient with HIV serology positive in the University Hospital of Tokoin and campus of Lome]

PURPOSES

To describe the elementary lesions, to list the kidney pathologies, to determine the kidney reach frequency and to establish an interrelationship enters the gravity of the kidney reach and the kidney's structure at the ultrasound scan.

PATIENT AND METHOD

It was about a prospective survey of ten (10) month, realized in the Departments of radiology of the Teaching Hospitals of Lomé (CHU Tokoin and Campus), concerning 281 patients aged of 18 to 71 years whose HIV serology is positive.

RESULTS

The radiological frequency of the HIV/AIDS infection noted during our period of survey was of 3.27% (281/8583). The modal age group was of 30-40 years (32.38%). The female representativeness was 56.92% against 43.08% of men. The drivers (23.13%) follow-ups of the tradesmen were the more touched. The bachelors were more exposed (38.43%). The kidney increased size in 31.85% of the cases. The majority of the patients (88.19%) was at the echographic advanced stage of the renal suffering of which 70.08% were at the III stage. The length of the kidneys was generally normal (74.38%), their width was normal in 53.38% of the cases and increased in 44.42% of the cases. As for the thickness, it was increased in general (71.88%). The kidney suffering (49.03%) was the most dominant pathology.

CONCLUSION

The wealth of the kidney pathology associated to the infection of the HIV/AIDS should bring the practitioners to integrate the ultrasound scan in the balance of this affection.

[The circumcision: why and how is it practiced in the newborn and the infant in the Lomé teaching hospital?]

OBJECTIVE

To identify the different indications, to analyze the conditions of realization of the circumcisions and to evaluate the results.

PATIENTS AND METHOD

It is about a prospective survey study done in the operative room of the Tokoin teaching hospital (Lomé) and on a period of 12 months (15th June 2007 to 15th June 2008). It was about newborns and infants circumcised in the operative block by a pediatric surgeon. One hundred and thirty-four newborns and infants were circumcised during the period of our study. The medan of age was of 5.86 months (range: 1 to 27 months).

RESULTS

One hundred and seven newborns and infants (79.85%) were circumcised for religious motive, 20 (14.92%) for hygiene motive, one (0.75%) for a lesion of the foreskin (burn of the foreskin by hot water), five (3.73%) for a phimosis and one (0.75%) for a paraphimosis. One hundred newborns and infants (74.63%) were circumcised under anesthesia by the fluothane associated to a caudal block, 29 (21.64%) were under local anesthesia (infiltration of anesthetic to the base of the penis) and five (3.73%) under general anesthesia by fluothane only. One hundred and two children (76.12%) were circumcised by the technique using the clamps and 32 (23.88%) by the technique using the Gomco clamp.

CONCLUSION

The circumcision is a surgical act whose indications are variable in our surroundings. It is mainly practiced for a religious motive.

[Crossed renal ectopia: a case report]

The authors report a case of a crossed renal ectopia with fusion discovered in an outpatient admitted for abdominal pain to recall embryologic, epidemiology and diagnosis aspects using a literature review.

[Acute scrotum in children]

AIMS

To evaluate the frequency, to identify the aetiologies of the acute scrotum and to describe their treatment in children.

MATERIAL AND METHOD

Fifty seven children treated for acute scrotum in the paediatric surgery department of the Tokoin teaching hospital (Lomé) between January 2003 to December 2007 were studied.

RESULTS

The frequency of acute scrotum was 5.80%. The average age was of 4.75 years (range: 7 days to 15 years). The aetiologies were: incarcerated inguino scrotal hernia (49.12%); spermatic cord torsion (29.83%); epididymo-orchitis (17.54%) and testicular trauma (3.51%). The delay of treatment was superior of 72 hours in 49.12%. The pain and the increase of the volume of the scrotum were present in all the patients. The emergency operation was performed in the spermatic cord torsion and the testicular trauma. The medical treatment was performed in the epididymo-orchitis cases. The patients presenting an incarcerated inguino-scrotal hernia benefited from a surgical cure in a delay of eight days after the acute episode. The operative continuations were in any cases simple.

CONCLUSION

The diagnosis and the treatment must be precocious in the acute scrotum in order to avoid possible complications.

[Epidemiologic and etiologic features of urinary infections in children at the pediatrics service of the CHU-Campus de Lome (Togo)]

From 1st January 1989 to 31th December 1997, 175 infants (108 females and 67 males) were hospitalised and treated at the pediatric service of CHU-Campus for urinary tract infection; this study follows the observation of the increasing of urinary tract infection in several centers of health in Togo; the aim of this study was to have a list the contributing factors, to understand the mechanism of such infection in order to reduce its frequency and the high percent of the mortality; the diagnosis of urinary tract infection was given by the result of the cytobacteriological exam of the urine which shows the pathological germ; others forms of the investigation, as abdominal echography were used also to look for the etiology of the urinary tract infection; but, the deficit of the of the medical imagery or the old material of the laboratories limited the searching of urinary tract infection etiology; cured infants were declared on the basis of absence of pathological germ in the result of the cytobacteriological exam control of the urine; the prevalence of the urinary tract infection was 8.29% with an incidence of 7.84% at the pediatric service of CHU-Campus; clinics symptoms were atypic and polymorphic; but the fever was the first clinical sign in the newly born and the urological signs were clear only from two to thirty months; 141 children (80.57%) were cured and 34 presented the complications with 3.43% of mortality; preventive measures on the urinary tract infection in infancy were proposed for the children parents and the practical physicians; these measures included information, education and communication (IEC) on the urinary tract infection, the symptomatology and the cytobacteriological exam of the urine.

[Venereal vegetations of the urogenital tract and their urological complications. Apropos of 257 cases]

A retrospective study was conducted during 8 years to determine the epidemiological features of condyloma and its complications in patients attending urology consultations in Lomé teaching hospital. During this period, 257 cases (218 males, 38 females) of condyloma were diagnosed. The condyloma represented the fifth cause of consultation in urology, after genito-urinary infection (n = 1214), prostatic dysuria (n = 1095), vesicovaginal fistula (n = 849), lower tractus urinary lithiasis (n = 500). The average age of the patients was 28 years (range: 14-57). In 51 cases the condyloma were associated with others sexually transmitted diseases: 25 cases of gonococcal infection, 11 cases of chancroid, 9 cases of vaginal candidiasis, and 6 cases of genital trichomoniasis. We noted 41 cases of urological complications: 19 cases of urinary infection, 13 cases of retention of urine, 7 cases of urinary forked jet, and 2 cases of urethrorrhagia. The results of this study shows that, the condyloma is commun sexually transmitted disease seen in urology clinic. Its classically benign course in patients males, were predominant, in this sex, by the urinary infection and urological mechanical accidents.