Recurrent right atrial tumor? evoking a leiomyomatosis. A case report.
Background: Idiopathic Intracranial Hypertension (IIH) is due to an increased intracranial pressure with no secondary cause of intracranial hypertension and normal Cerebrospinal fluid (CSF) composition. IIH’s prevalence is high among obese women of childbearing age and subsequently coincides with pregnancy. Symptoms vary among patients and commonly present headaches and visual impairment. If untreated, it may steer persistent headaches and lasting visual impairment such as diplopia and scotoma or even blindness. Case Report: We hereby present the uncommon case of an epidural anesthesia for cesarean section in a patient with idiopathic intracranial hypertension and Lumbo-peritoneal shunt that presented to our obstetrics department in labor. First, epidural labor anesthesia (ELA) with a catheter placed above the LP shunt scar was the chosen course of action. However, ELA was converted to an epidural surgical anesthesia (ESA) for acute fetal distress secondary to a placental abruption. Conclusion: IIH usually occurs in pregnant women at any trimester. If undiagnosed or poorly managed, it can lead to drastic complications. As uncommon as it may be, all medical practitioners should be familiar with this pathology even though its diagnostic and treatment are exacting. While the optimal anesthetic management is still controversial, epidural anesthesia proved to be very effective.
Aims: The chondromyxoid tumor is a benign primary bone tumor of cartilaginous differentiation whose location is atypical and rarely described in the literature. Case Report: A 10 year old child, who consulted the emergency room of the children's hospital of Rabat for a hard and painful swelling of the right iliac fossa, rapidly increasing in volume. Biological tests were normal. The radiography showed a mixed lytic and condensing lesion, heterogeneous, of the right iliac wing, prompting an magnetic resonance imaging (MRI). Discussion: Chondromyxoid fibroma usually affects young subjects and manifests clinically as pain and swelling. Pathological fractures are common. On standard radiography, in long bones, there is an eccentric geographic gap, blowing out the cortex. On flat bones such as the iliac bone, the tumor is often polycyclic and mixed, combining condensation and bone lysis. Intratumoral microcalcifications may be encountered. MRI is the key examination to evoke the diagnosis of chondromyxoid fibroma. Conclusion: Imaging and in particular MRI plays multiple and fundamental roles in the management of chondromyxoid fibroma. MRI provides diagnostic guidance, particularly in the case of atypical localization.
SARS-CoV-2 was first identified at the end of 2019, in the Wuhan region (China), subsequently spreading worldwide with a major impact on health and economic system. A pneumothorax is a rare complication, affecting between 1–2% of SARS-CoV-2 cases. Pneumomediastinum is even rarer. Pneumothorax in the context of SARS-CoV-2 infection mainly occurs in patients with a severe form of the infection and requiring mechanical ventilation. This type of ventilation makes it possible to impose high positive expiratory pressures which can be complicated by pneumothorax when patients present with a lack of compliance secondary to fibrosis. Nevertheless, cases under conventional ventilation including without oxygen therapy are possible, suggesting that SARS-CoV-2 infection could be an independent risk factor for pneumothorax. Therefore, any worsening of the respiratory picture should evoke a pneumothorax. The management of pneumothorax secondary to SARS-CoV-2 pneumonia is usual. Placement of a chest drain could increase the risk of aerosol dissemination. We report the case of a pneumothorax occurring in a non-smoking patient hospitalized in intensive care for treatment of a serious SARS COV 2.
The use of spinal anesthesia in obstetrics is justified by the advantages it has over general anesthesia. It is a simple and easy technique. However, the possibility of serious complications or even death with this technique during cesareans leads to questions about its place. We report a case of totalization of spinal anesthesia during a cesarean section, that had a favorable evolution for both mother and child.
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