Mono-ventricular hydrocephalus is a rare condition in adults. Most of the time, this condition is acquired and is secondary to an anatomical or functional obstruction of the foramen of Monro. Exceptionally, mono-ventricular hydrocephalus is the result of a congenital atresia of the foramen of Monro. We reported here the case of a 31-year-old received in consultation with chronic headaches, morning jet vomiting whose paraclinical assessment made it possible to diagnose monoventricular hydocephaly by atresia of the foramen of monro.
The patient was cured of his symptoms after septomy endoscopic under stereotac condition. Etiological, clinico-radiolocal and and therapeutical aspects are discussed in the light of the literature.
Adenomas of the middle ear are even rarer. Although considered benign tumors, they carry a risk of recurrence and malignant transformation. We present a 37-year-old patient with a hypoacusis of the left ear with purulent otorrhea on a non-marginal tympanic perforation as symptomatology. The audiogram showed transmission deafness, and the scanner found a fleshy attic mass with a preserved ossicular chain. The patient underwent an antro-atticotomy with mass excision, the anatomopathological result of which was in favor of an adenoma of the middle ear. The patient has shown no recurrence for almost 2 years. In conclusion, middle ear adenomas are rare neoplasms and have no specific symptoms or clinical presentation. Total exploration and extirpation is required for treatment, and microscopic and immunohistochemical examinations are mandatory for a definitive diagnosis.
The non-recurring lower laryngeal nerve is an extremely rare anatomical variation. It occurs only on the right (except in the case of situs inversus). Knowledge of this anatomical variation is essential for identifying and preserving the nerve during thyroid surgery. We present the case of a patient with a non-recurring lower laryngeal nerve discovered during a total thyroidectomy.
We present the case of a patient with a non-recurrent inferior laryngeal nerve discovered during a total thyroidectomy.
Objective: We evaluated the role of laparoscopic retroperitoneal pyelolithotomy in the management of large renal calculi.
Methods: A retrospective study including 45 cases (male, 27; female, 18) of solitary renal calculi of size more than 2.5cm were evaluated. There were 41 patients with single calculus, 4 patients with a staghorn calculus. Laparoscopic retroperitoneal pyelolithotomy was performed using balloon dissection with minor modifications.
Results: Stone clearance was achieved in all forty-five cases. The mean operative time was 90 min. Postoperative hospital stays averaged 5 days. Patients were ambulatory in 24 hours and returned to work in 7 days on average. The minor complications encountered were peritoneal rent, balloon rupture, and superficial wound infection. The postoperative analgesic requirement was average, the patients required 1 tablet of diclofenac sodium (50 mg of diclofenac) for an average duration of 2 days.
Conclusions: Laparoscopic retroperitoneal pyelolithotomy is a suitable minimally invasive method for the treatment of patients with staghorn and large renal calculi in centers without robotic facilities.
Introduction: Management of anorectal disorders has been always a challenge for colorectal surgeons. Recently, the use of diode laser in proctology has emerged as an alternative to the conventional surgical treatment. The laser beam causes shrinkage and degeneration that depend on the power and the duration of laser light application. It is also associated with minimal postoperative pain, bleeding, discharge and short hospital stay.
Patients and Methods: This prospective study was carried out on 76 patients with common anal surgical lesions categorized into 3 groups. Group 1 included 26 patients with hemorrhoids and underwent laser hemorrhoidoplasty, group 2 included 24 patients with chronic anal fissure and underwent closed laser lateral internal sphincterotomy whereas group 3 included 26 patients with perianal fistula and underwent either fitula laser closure (FILAC) or laser fistulotomy in the Gastrointestinal Surgery Unit, General Surgery Department, Tanta University Hospitals, during the study period (12 months, from February 2021 to February 2022 on 76 patients).
Results: Regarding group1, laser hemorrhoidoplasty (LHP) was associated with minimal postoperative pain using VAS score, minimal bleeding with no serious bleeding requiring intervention, short hospital stay and only one case of recurrence. There was significant relation between postoperative edema and grade 4 hemorrhoids. Regarding group 2, closed laser lateral internal sphincterotomy was associated with no complications except for postoperative itching in five cases and was treated by local soothing agents. As for group 3, success rate was 73.9% among cases who underwent fistula laser closure (FILAC) and overall success rate was 76.9%. There was significant relation between recurrence and posterior position of the fistulous track of the intersphincteric type and significance between wide caliber of the track (more than 7mm) and recurrence.
Conclusion: Diode laser is a safe minimally invasive procedure for treatment of hemorrhoids, chronic anal fissure and perianal fistula.