Pub Date : 2024-01-05DOI: 10.36347/sjmcr.2024.v12i01.005
Y. S. Benabdallah
Renal ectopia is a positional defect during development, consistently accompanied by malrotation, always involving abnormal vascularization with one or more ectopic arteries and a ureter of appropriate length for the location of the kidney. It is distinct from renal ptosis. Several types of ectopias are distinguished: on one hand, simple ectopias occurring in the vertical direction (intrathoracic kidney, low-lying kidney) or in the transverse direction (crossed ectopia), and on the other hand, ectopias with symphyses. Pathological pelvic ectopic kidney is rare. It is often revealed by pain, infectious complications, urinary lithiasis, or sometimes fortuitous discovery. We report the case of a 60-year-old patient with a history of hip prostheses, incidentally discovering, through a diagnostic assessment for nephritic colic due to contralateral ureteral lithiasis, a left ectopic kidney in the pelvic area on a CT scan. Based on this case and literature data, we will discuss the etiopathogenic, clinical, radiological, and therapeutic aspects of this malformation.
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Pub Date : 2024-01-03DOI: 10.36347/sjmcr.2024.v12i01.001
M. Samali, A. Elkoundi, A. Meskine, M. R. Andaloussi, M. Bensghir, H. Balkhi
Rheumatoid arthritis (RA) is a chronic disease that progresses in relapses and remissions. The disease affects preferentially the small joints but an extension to the cervical spine poses a particular problem for anaesthesia because of the risk of difficult and/or dangerous intubation due to the aggravation of neurological lesions linked to the occurrence of subluxation of the axis on the atlas. Treatments such as Non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids should be considered perioperatively, as it is important not to discontinue them, knowing that they increase the risk of sepsis as do other treatments (methotrexate) which have an immunosuppressive effect. The pre-anaesthetic evaluation of patients must also look for systemic damage (pericarditis, chronic interstitial lung disease) likely to interfere with the anaesthetic management. The latter must favour, as far as possible, loco-regional anaesthesia. Intubation through a fibrocope is the least traumatic technique. Taking care of the discomfort of the installation on a table, which is particularly harmful to these patients, and programming a multimodal analgesia as well as the continuation of treatment of RA.
{"title":"Anesthesic Management of a Patient Presenting a Rheumatoid Arthritis","authors":"M. Samali, A. Elkoundi, A. Meskine, M. R. Andaloussi, M. Bensghir, H. Balkhi","doi":"10.36347/sjmcr.2024.v12i01.001","DOIUrl":"https://doi.org/10.36347/sjmcr.2024.v12i01.001","url":null,"abstract":"Rheumatoid arthritis (RA) is a chronic disease that progresses in relapses and remissions. The disease affects preferentially the small joints but an extension to the cervical spine poses a particular problem for anaesthesia because of the risk of difficult and/or dangerous intubation due to the aggravation of neurological lesions linked to the occurrence of subluxation of the axis on the atlas. Treatments such as Non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids should be considered perioperatively, as it is important not to discontinue them, knowing that they increase the risk of sepsis as do other treatments (methotrexate) which have an immunosuppressive effect. The pre-anaesthetic evaluation of patients must also look for systemic damage (pericarditis, chronic interstitial lung disease) likely to interfere with the anaesthetic management. The latter must favour, as far as possible, loco-regional anaesthesia. Intubation through a fibrocope is the least traumatic technique. Taking care of the discomfort of the installation on a table, which is particularly harmful to these patients, and programming a multimodal analgesia as well as the continuation of treatment of RA.","PeriodicalId":509943,"journal":{"name":"Scholars Journal of Medical Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139536340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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