Cette étude a été faite pour analyser les aspects cliniques et thérapeutiques des anomalies de la jonction pyélo-urétérale. Etude transversale et descriptive portant sur 35 cas d'anomalies de la jonction pyélo-urétérale (AJPU) colligés au service d'Urologie du CHU du Point G durant une période de 4 ans (Janvier 2010 au Décembre 2014). Les données ont été recueillies sur les fiches d'enquête, les dossiers médicaux et les registres du bloc. Les données sociodémographique, clinique et thérapeutique ont été saisies sur Microsoft Word 2007 et analysées sur Excel 2007 et SPSS 18.0. 35 cas d'AJPU ont été colligés en 4 ans. La moyenne d’âge était de 29,3 ans. La douleur lombaire était le motif de consultation le plus fréquent soit 40%. 20% des patients ont été en consultation pour la première fois 10 ans d’évolution symptomatique. Une destruction rénale avait été observée dans 28,6%. Le couple Echographie + UIV a permis d’établir le diagnostic chez 37,1%. La complication lithiasique était présente chez 17,1% des patients. 51,4% des patients ont reçu une pyéloplastie à ciel ouvert selon Anderson KUSS. L'anomalie de la jonction pyélo-urétérale dans notre étude a été caractérisée par un retard de consultation avec des complications redoutables. La chirurgie à ciel ouvert a été le gold standard avec des résultats satisfaisants. L'endopyéloplastie, la cure de la jonction coelioscopique sont des chirurgies mini invasives non disponible chez nous mais à encourager et à intégrer dans l'arsenal thérapeutique.
Introduction: Renal colic is a medico-surgical emergency in which complicated forms could progress to renal failure and nonfunctional kidney. The objective of our study is to describe the epidemiological, diagnostic and therapeutic aspects of renal colic at the urology department of the NGRH. Methods: This was a prospective study involving 101 patients followed up for renal colic. The study spanned from July 2015 to July 2016 at the urology department of the NGRH. Results: A total of 101 patients suffering from renal colic were enrolled in the study giving a prevalence of 5.1%. The mean age was 38.89 years with a standard deviation of 14.5 years and a sex ratio of 1:3. Flank or lumbar pain of crushing type (45.5%), constant and of severe intensity (61.4%) were the most frequent clinical characteristics. The plain abdominal radiography (Kidney-Ureter-Bladder) coupled with ultrasonography had a 100% sensitivity for the etiological diagnosis of renal colic. Urinary lithiasis was the most frequent cause with 73.3%. Uroculture revealed a urinary tract infection in 44 patients (43.6%). The most frequent germ isolated on the culture was Escherichia coli (27.7%). Renal function was abnormal in 34 patients (33.7%). Medical treatment was composed of analgesics, NSAIDs and antispasmodic representing 93.1%. Percutaneous nephrostomy was performed in 6.9%. Pyelolithotomy was the most frequently performed surgical procedure and was done in 11 patients that are 39.3%. Fifty seven patients (56.4%) got healed without sequelae; 6 cases (5.
We present a rare case of emphysematous cystitis associated with an emphysematous pyelonephritis in a diabetic Arab man who was admitted in a confusional state. A 60-year-old man was admitted to the emergency department with confusion and hypogastric mass. The Clinical examination found comatose patient with a mass in the tympanic hypogastric percussion. The pelvic computed tomography (CT) demonstrated intramural gas in the urinarytract, which suggested a diagnosis of emphysematous cystitis and emphysematous pyelitis. The treatment was based on an antibiotics associated with a bladder drainage and diabetes stabilization. The evolution was uneventful. Every diabetic patient with a urinary tract infection who seems to be severely ill should have an abdominal X-ray as a minimal screening tool to detect emphysematous complications. The rarity and the association with an emphysematous pyelitis, which is rarely reported in the literature, are two remarkable characteristics described in this case report.
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