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Benlghazi A, Benali S, Belouad M, Bouhtouri Y, Rachid AB, El Mangoub F, Elhassani MM, Kouach J. A surgical case report on primary umbilical endometriosis (Villar's nodule). SAGE Open Med Case Rep 2024; 12:2050313X241246861. [PMID: 38606030 PMCID: PMC11008341 DOI: 10.1177/2050313x241246861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 03/26/2024] [Indexed: 04/13/2024] Open
Abstract
Endometriosis is a disease characterized by the implantation of endometrial-like tissue outside the uterine cavity. Common symptoms include cyclical pain, dysmenorrhea, dyspareunia, and infertility. Although endometriosis can spread to various extrauterine locations including the ovaries, fallopian tubes, and peritoneal surfaces, umbilical endometriosis is a rare manifestation of the disease. We report an intriguing clinical case of primary umbilical endometriosis in a 36-year-old female patient admitted to our department due to the notable manifestation of a painful swelling at the umbilicus, accompanied by cyclic episodes of bleeding. Subsequent investigations, incorporating ultrasound and computed tomography, indicated the presence of umbilical endometriosis, a finding that was subsequently confirmed by pathological examination of a mass biopsy. Surgical resection of the umbilical mass was performed, and histopathological analysis definitively confirmed the diagnosis of endometriosis. This case report aims to discuss in depth the diagnosis and management of umbilical endometriosis.
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Affiliation(s)
- Abdelhamid Benlghazi
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Saad Benali
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Moad Belouad
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Yassine Bouhtouri
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Ait Bouhou Rachid
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Fatima El Mangoub
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Moulay Mehdi Elhassani
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
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Benlghazi A, Messaoudi H, Belouad M, Ait Bouhou R, Elhassani MM, Kouach J. Idiopathic granulomatous mastitis: A challenging case report and comprehensive review of the literature. Int J Surg Case Rep 2024; 118:109555. [PMID: 38581937 PMCID: PMC11004635 DOI: 10.1016/j.ijscr.2024.109555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/15/2024] [Accepted: 03/17/2024] [Indexed: 04/08/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Idiopathic granulomatous mastitis is an uncommon, long-lasting inflammatory condition of the female breast. It is characterized by the development of a painful breast mass that gradually increases in size. This condition is benign and its cause is unknown. It primarily affects women of childbearing age who have a history of pregnancy and breastfeeding. The main feature of idiopathic granulomatous mastitis is the presence of chronic inflammation in the breast. CASE PRESENTATION We report a 36-year-old woman with a history of pregnancy and breastfeeding presented with pain and swelling of the right breast. Physical examination revealed a mass with redness and retraction of the nipple. Imaging revealed localized density and hypoechoic areas with collection, suggesting granulomatous mastitis. A biopsy confirmed the diagnosis. The abscess was drained through a small incision performed under local anesthesia. Treatment with corticosteroids resulted in significant improvement, with complete resolution after one month. CLINICAL DISCUSSION A comprehensive evaluation of potential causes is necessary to confirm the diagnosis of idiopathic granulomatous mastitis. Histologically, it is distinguished by the predominant presence of neutrophils and the absence of caseous necrosis. Treatment remains controversial, with recent literature supporting the efficacy of conservative management with steroid and immunosuppressive therapy, leaving surgical excision for complicated and refractory cases. CONCLUSIONS Idiopathic granulomatous mastitis is an uncommon breast condition where the exact causes and recommended treatment approaches are not well-defined. It is important to consider this condition in women who are in their reproductive years.
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Affiliation(s)
- Abdelhamid Benlghazi
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
| | - Hamza Messaoudi
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Moad Belouad
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Rachid Ait Bouhou
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Moulay Mehdi Elhassani
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology-Obstetrics, Mohammed V Military University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
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Benlghazi A, Benali S, Belouad M, Fakri A, El Mangoub F, Kouach J. Uncommon presentation of necrotizing fasciitis affecting the breast in a young breastfeeding patient: Case report. Int J Surg Case Rep 2024; 114:109147. [PMID: 38134617 PMCID: PMC10800673 DOI: 10.1016/j.ijscr.2023.109147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Necrotizing fasciitis is a highly dangerous infection that poses a life-threatening risk as it rapidly spreads and causes tissue necrosis in the subcutaneous tissues and fascia. Although rare, the breasts can be affected by this infection, which adds to the complexity of the condition. CASE PRESENTATION A 26-year-old woman who had been breastfeeding for two months presented with pain, swelling, and fever in her left breast. The left breast showed skin darkening and foul-smelling discharge. The diagnosis was septic shock due to necrotizing fasciitis. Prompt treatment included surgical debridement, broad-spectrum antibiotics, and supportive care. The patient's condition remained challenging, and the infection was caused by multi-resistant bacteria. CLINICAL DISCUSSION Necrotizing fasciitis is a highly severe and aggressive type of soft tissue infection. It can range from minor or mild infections of the soft tissues to severe cases involving septic shock. While it is uncommon, necrotizing fasciitis can also affect the breasts. The diagnosis of breast NF relies on a combination of clinical evaluation, culture results, laboratory findings, and imaging studies. Swift surgical interventions, along with appropriate antibiotic therapy and supportive management, are vital for the patient's survival and improved prognosis. CONCLUSIONS Breast necrotizing fasciitis is frequently misdiagnosed due to the presence of thick breast tissue, which creates challenges in identifying the infection between the skin and deep fascia. Swift and extensive surgical debridement, combined with the administration of broad-spectrum antibiotics, are crucial components for effectively managing and preventing the significant morbidity and mortality associated with this condition.
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Affiliation(s)
- Abdelhamid Benlghazi
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco.
| | - Saad Benali
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Moad Belouad
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Ahmed Fakri
- Department of anesthesia and intensive care unit, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Fatima El Mangoub
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
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Benlghazi A, Benali S, Belouad M, Ait Bouhou R, El Hassani MM, Kouach J. Malakoplakia mimicking malignant ovarian tumor: A case report and literature review. Int J Surg Case Rep 2023; 112:109012. [PMID: 37939569 PMCID: PMC10667935 DOI: 10.1016/j.ijscr.2023.109012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/10/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Malakoplakia is a rare inflammatory condition that generally occurs in immunocompromised individuals and is thought to be secondary to a bactericidal defect in macrophages. CASE PRESENTATION In this report, we present the case of a 50-year-old multiparous patient who presented with chronic pelvic pain. Ultrasonography revealed a suspicious left lateral-uterine mass. Laparoscopic exploration showed an inflammatory mass in the left adnexa adherent to the uterus, peritoneum, and meso-sigmoid. The patient underwent a total hysterectomy with bilateral salpingo-oophorectomy and peritoneal biopsy. Histological findings were consistent with a left adnexal location of malacopakia, and Bacteriological analysis revealed Escherichia coli infection sensitive to ciprofloxacin. At the 6-month follow-up, no recurrence was observed. The patient's condition improved following surgery and antibiotic treatment. CLINICAL DISCUSSION Genitourinary malakoplakia is more common in women and has no specific clinical, biological, or radiological features. Diagnosis is based on histological criteria, notably the presence of Michaelis-Gutmann bodies. Advances in our understanding of the pathophysiology of malakoplakia have made it possible to consider medical treatment options, mainly through the use of antibiotics. However, in cases where the organ is severely affected, surgical excision is recommended. CONCLUSIONS To summarize, adnexal malacoplakia is a highly uncommon disease that may be mistaken as a malignant tumor. The diagnosis is established through histological examination. The usual treatment is a combination of surgical excision followed by targeted antibiotic therapy, as the diagnosis is often not made until after surgery.
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Affiliation(s)
- Abdelhamid Benlghazi
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco.
| | - Saad Benali
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Moad Belouad
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Rachid Ait Bouhou
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Moulay Mehdi El Hassani
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
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Benlghazi A, Belouad M, Messaoudi H, Benali S, El Hassani MM, Kouach J. Abortifacient power of potassium permanganate rebirth of an archaic myth: Case report. Int J Surg Case Rep 2023; 111:108802. [PMID: 37725858 PMCID: PMC10518675 DOI: 10.1016/j.ijscr.2023.108802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/02/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Potassium permanganate has been historically used as an abortifacient, but it is now considered an outdated practice. Despite the lack of scientific evidence supporting its effectiveness as an abortifacient, some communities still hold misguided beliefs about its abortifacient properties. CASE PRESENTATION We report a case of a 38-year-old multiparous North African woman. Who experienced excessive vaginal bleeding after using potassium permanganate as an abortifacient. The examination revealed carbonized ulcerated lesions on the vaginal walls and cervix. Once the patient was stabilized, the medical team performed sutures on the vaginal lesions and inserted an intravaginal tampon to arrest the bleeding. The patient was discharged after 72 h. CLINICAL DISCUSSION In the last century, potassium permanganate was utilized as a method of abortion, but this practice has gradually fallen out of use. Regrettably, due to misinformation and a lack of comprehensive documentation, certain underdeveloped regions persist in employing this unsafe approach. The aim of this report is to inform obstetricians about the harmful effects of potassium permanganate, and the injuries it can cause. Given the scarcity and age of published reports on the subject, this document highlights the crucial importance of proper management to prevent these practices and ensure the safety of the women concerned. CONCLUSIONS The use of potassium permanganate in abortion presents serious risks, and despite its outdated nature, false beliefs about its abortifacient properties persist. Raising awareness among healthcare professionals and the general public is crucial in preventing the harmful effects of these erroneous beliefs.
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Affiliation(s)
- Abdelhamid Benlghazi
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco.
| | - Moad Belouad
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
| | - Hamza Messaoudi
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
| | - Saad Benali
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
| | - Moulay Mehdi El Hassani
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
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Benlghazi A, Belouad M, Bouhtouri Y, Benali S, El Hassani MM, Kouach J. Anterior vaginal cyst mimicking pelvic organ prolapse: Case report and literature review. Int J Surg Case Rep 2023; 111:108868. [PMID: 37788530 PMCID: PMC10550583 DOI: 10.1016/j.ijscr.2023.108868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/05/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Large Anterior vaginal cysts can manifest as symptomatic genital prolapse, posing a diagnostic challenge due to their uncommon clinical presentation. CASE PRESENTATION A 22-year-old primiparous woman with no previous medical history is admitted for delivery. Examination revealed a cystic mass on the anterior vaginal wall. Perineal ultrasound confirmed an independent cyst measuring 45x40x35 mm. The cyst was successfully aspirated, and the patient delivered without complications. At 12 months, the cyst reappeared, requiring vaginal surgical excision. Histological examination identified a Gartner cyst. During follow-up at 6 and 12 months, the patient remained asymptomatic. CLINICAL DISCUSSION Vaginal cysts typically present as small, solitary, and symptomless. However, they can grow in size, mimicking other conditions and often being misdiagnosed as cystoceles. Consequently, surgical excision of the vaginal cysts is the preferred treatment option, yielding positive anatomical outcomes and high patient satisfaction levels. CONCLUSIONS In this report, we describe a rare case of a Gartner cyst found on the anterior vaginal wall. The report also underscores the crucial role of imaging in accurately identifying the cyst's location, assessing its association with adjacent tissues, and guiding the surgeon in devising an effective operative plan.
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Affiliation(s)
- Abdelhamid Benlghazi
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco.
| | - Moad Belouad
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
| | - Yassine Bouhtouri
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
| | - Saad Benali
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
| | - Moulay Mehdi El Hassani
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
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Benlghazi A, Bouhtouri Y, Belouad M, Brarou H, Messaoudi H, Benali S, El Hassani MM, Kouach J. Bilateral serous retinal detachment in pre-eclampsia a rare but favorable complication: case report. Oxf Med Case Reports 2023; 2023:omad109. [PMID: 37881264 PMCID: PMC10597611 DOI: 10.1093/omcr/omad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/20/2023] [Accepted: 09/01/2023] [Indexed: 10/27/2023] Open
Abstract
Pre-eclampsia is a serious pregnancy-related condition that can cause damage to multiple organs, including the eyes. While pre-eclampsia is commonly associated with the narrowing of the retinal arteries, more severe complications such as cortical blindness, optic neuropathy, and serous retinal detachment (SRD) can occur in rare cases. This case report describes a 26-year-old primiparous woman who presented with headaches, bilateral visual fog, and tinnitus and was diagnosed with pre-eclampsia based on elevated blood pressure and proteinuria. Despite receiving antihypertensive treatment, the patient's visual symptoms worsened, prompting an emergency cesarean section. An ophthalmological examination revealed bilateral macular SRD. SRD in pre-eclampsia is a rare complication that can occur even in the immediate post-partum period, with a favorable prognosis. It should be noted that any pre-eclamptic patient presenting with visual symptoms in the third trimester or post-partum should be considered for serous retinal detachment.
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Affiliation(s)
- Abdelhamid Benlghazi
- Department of Gynecology and Obstetrics, Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Yassine Bouhtouri
- Department of Gynecology and Obstetrics, Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Moad Belouad
- Department of Gynecology and Obstetrics, Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Houda Brarou
- Department of Ophthalmology, Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Hamza Messaoudi
- Department of Gynecology and Obstetrics, Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Saad Benali
- Department of Gynecology and Obstetrics, Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Moulay Mehdi El Hassani
- Department of Gynecology and Obstetrics, Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology and Obstetrics, Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
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Benlghazi A, Belouad M, Messaoudi H, Benali S, Elhassani MM, Kouach J. Giant ovarian serous cyst and postmenopausal adnexal torsion: An unusual case report and literature review. Int J Surg Case Rep 2023; 110:108686. [PMID: 37634435 PMCID: PMC10509804 DOI: 10.1016/j.ijscr.2023.108686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/09/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Adnexal torsion is an uncommon but urgent surgical situation more frequently observed during the reproductive years and rarely in postmenopausal women. CASE PRESENTATION This case report describes a postmenopausal woman with a large left ovarian cyst measuring 18 × 20 × 22 cm who experienced adnexal torsion, which is a rare occurrence in this age group. To avoid the potential requirement for additional surgical procedures in case of cyst recurrence in the remaining ovary or the development of uterine diseases a total abdominal hysterectomy and bilateral salpingo-oophorectomy with cystectomy were performed. Histopathological analysis of the cyst confirmed that it was a benign serous cystadenoma of the ovary. CLINICAL DISCUSSION Adnexal torsion can happen at any age but is less likely to occur after menopause. Moreover, giant ovarian cysts (>10 cm) are uncommon, making adnexal torsion on these cysts a rare event. While laparotomy remains the gold standard surgical intervention, laparoscopy is beginning to play a role in management of giant cyst. CONCLUSIONS This report documenting a rare case of adnexal torsion in a postmenopausal woman following a serous giant cystadenoma emphasizes that this surgical emergency can occur at any age. In addition, the report highlights that the presence of an ovarian mass or cyst increases the risk of adnexal torsion, regardless of age.
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Affiliation(s)
- Abdelhamid Benlghazi
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco.
| | - Moad Belouad
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Hamza Messaoudi
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Saad Benali
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Mly Mehdi Elhassani
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
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Benlghazi A, Belouad M, Messaoudi H, Benali S, El Hassani MM, Kouach J. Spontaneous successful term delivery in a unicornuate uterus: A case report and literature review. Int J Surg Case Rep 2023; 110:108689. [PMID: 37611398 PMCID: PMC10470303 DOI: 10.1016/j.ijscr.2023.108689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Malformations of the uterus are generally rare and are due to defective fusion of Mullerian duct. These include the unicorn uterus, with or without a rudimentary horn. Pregnancy in a unicornuate uterus is a rare event and carries with it maternal-fetal risks. CASE PRESENTATION In this report, we present an exceptional case of a pregnancy reaching full term in a unicornuate uterus without an accessory horn, which was serendipitously discovered during an emergency cesarean section. Intraoperatively, the uterus exhibited a distinct cylindrical shape with a flattened left wall, with the absence of both the left fallopian tube and left ovary. No additional abnormalities within the abdominopelvic cavity were noted. Notably, the postoperative recovery was uneventful for both the mother and newborn, without any notable complications. CLINICAL DISCUSSION The presence of a unicornuate uterus is associated with adverse obstetric outcomes, including recurrent miscarriage, premature delivery, fetal malposition, intrauterine growth retardation, and uterine rupture. In addition, around 40 % of women with this malformation may experience infertility. Although the efficacy of preconception or early interventions, such as rudimentary uterine horn resection and prophylactic cervical cerclage has not been fully established in improving obstetric outcomes, their usefulness is suggested by current medical practice. CONCLUSION Women with a unicornuate uterus are known to be at increased risk of obstetrical complications, such as spontaneous abortion, premature delivery, post-partum hemorrhage, abnormal fetal presentation and cesarean delivery. It is important to consider women with this anomaly as being at high obstetrical risk.
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Affiliation(s)
- Abdelhamid Benlghazi
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco.
| | - Moad Belouad
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Hamza Messaoudi
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Saad Benali
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | | | - Jaouad Kouach
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
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Benlghazi A, Belouad M, Hallak M, Benali S, Aitbouhou R, Kouach J. Vaginal bleeding as a rare presentation of metastatic renal cell carcinoma: Case report and literature review. Int J Surg Case Rep 2023; 110:108657. [PMID: 37579631 PMCID: PMC10429265 DOI: 10.1016/j.ijscr.2023.108657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/16/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Renal cell carcinoma (RCC) is a relatively uncommon malignancy, comprising only 3 % of adult cancers, but it is responsible for 85 % of primary renal tumors. When RCC metastasizes, the most common sites are the lungs, liver, bones, and brain. Although it is rare, RCC can also metastasize to the vagina. About 18-33 % of RCC cases are diagnosed with metastasis at the time of initial diagnosis. CASE PRESENTATION A 48-year-old woman presented with postcoital bleeding and dyspareunia. At the physical examination, a polypoid mass was discovered on the right lateral wall of the upper third of her vagina and CT scan showed a right renal. Biopsies revealed clear cell renal carcinoma with metastasis to the vagina. The patient was diagnosed with stage IV (T3cN2 M1) renal cancer and underwent systemic therapy with Everolimus. However, subsequent imaging showed tumor progression, and the patient opted to halt treatment and was subsequently lost to follow-up. CLINICAL DISCUSSION In the past decade, there have been fewer than ten reported cases of RCC metastasizing to the vagina. Diagnosing vaginal clear cell carcinoma is challenging due to overlapping morphology with clear cell renal cell carcinoma, requiring immunohistochemistry. Treatment of vaginal cancers is challenging due to their rarity, and there is a lack of consensus on the optimal approach due to limited prospective studies. CONCLUSIONS Although the occurrence of RCC metastasis to the vagina is very uncommon, it is important to consider the possibility of metastatic RCC in cases of vaginal bleeding or lesions.
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Affiliation(s)
- Abdelhamid Benlghazi
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco.
| | - Moad Belouad
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Mohammed Hallak
- Department of Nephrology, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Saad Benali
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Rachid Aitbouhou
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco
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Benlghazi A, Belouad M, Messaoudi H, Benali S, Aitbouhou R, Fatima EM, Elhassani MM, Kouach J. Primary clear cell adenocarcinoma of the vagina not associated with diethylstilbestrol metastasizing to the lung: a case report. Oxf Med Case Reports 2023; 2023:omad080. [PMID: 37637365 PMCID: PMC10451112 DOI: 10.1093/omcr/omad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/27/2023] [Accepted: 07/02/2023] [Indexed: 08/29/2023] Open
Abstract
Primary clear cell carcinoma of the vagina (PCCAV) is a rare form of vaginal cancer that typically affects young women with a history of prenatal exposure to DES. However, data on non-DES PCCAV cases are limited. This report describes a case of PCCAV in a 47-year-old patient who presented with post-coital bleeding and was diagnosed with clear cell adenocarcinoma via biopsy and MRI. The patient had no history of DES exposure and further testing showed no signs of metastasis, leading to surgery and chemotherapy. Four years later, the patient presented with dyspnea, and a chest CT scan revealed a lung nodule, later confirmed to be a metastasis of clear cell adenocarcinoma from the vaginal cancer. The patient passed away a month later due to complications from COVID-19.
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Affiliation(s)
- Abdelhamid Benlghazi
- Department of Gynecology and Obstetrics Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
| | - Moad Belouad
- Department of Gynecology and Obstetrics Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
| | - Hamza Messaoudi
- Department of Gynecology and Obstetrics Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
| | - Saad Benali
- Department of Gynecology and Obstetrics Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
| | - Rachid Aitbouhou
- Department of Gynecology and Obstetrics Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
| | - El Mangoub Fatima
- Department of Gynecology and Obstetrics Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
| | - Mly Mehdi Elhassani
- Department of Gynecology and Obstetrics Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology and Obstetrics Military Hospital Mohammed V Rabat, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
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12
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Benlghazi A, Belouad M, Benali S, B Habib MA, E Hassani MM, Kouach J. A huge uterine leiomyoma in a 15-year-old girl. Oxf Med Case Reports 2023; 2023:omad058. [PMID: 37377718 PMCID: PMC10292641 DOI: 10.1093/omcr/omad058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Affiliation(s)
- Abdelhamid Benlghazi
- Correspondence address. Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat 10000, Morocco. Tel: +212657963722; E-mail:
| | - Moad Belouad
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
| | - Saad Benali
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
| | - Moulay A B Habib
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
| | - Moulay M E Hassani
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V Rabat, Rabat, Morocco
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13
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Li G, Lamsisi M, Chenafi S, Moniod L, Benlghazi A, Ennaji MM, Chauleur C, Bourlet T. Urine-based detection of HPV for cervical cancer screening: Time for standardized tests. J Med Virol 2023; 95:e28737. [PMID: 37185853 DOI: 10.1002/jmv.28737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/02/2023] [Accepted: 04/06/2023] [Indexed: 05/17/2023]
Abstract
Cervical cancer is preventable because it has an established etiology, mainly attributed to a detectable pathogen, human papillomavirus (HPV). In 2018, the world health organization issued an unprecedented call for global action to eliminate cervical cancer by 2030. The adaptation of regular screening programs is fundamental to achieve the goal of cervical cancer elimination. However, it is still difficult to achieve satisfactory coverage rates of screening in developing countries as well as in developed countries because many women are reluctant to participate in gynecologic examination. HPV detection in urine is a convenient, widely acceptable by women and relatively affordable without the necessity for clinical visits to improve the coverage rates of cervical cancer screening. Unfortunately, the clinical implementation of urine-based tests for HPV detection has been hindered by the lack of standardized tests. Further optimization of protocols and standardization of urinary HPV detection are expected to be realized. With the advantages of urine sampling to overcome cost, personal, and cultural barriers, time has come for the standardized tests to facilitate a wide clinical implementation of urinary HPV detection that will significantly contribute to the WHO's goal, that is, to eliminate the cervical cancer globally.
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Affiliation(s)
- Guorong Li
- Department of Urology, North Hospital, CHU de Saint-Étienne, Saint-Étienne, France
| | - Maryame Lamsisi
- Team of Virology, Oncology and Medical Biotechnologies, Laboratory of Virology, Microbiology, Quality, and Biotechnologies/ETB, Faculty of Science and Techniques Mohammedia, Hassan II University of Casablanca, Mohammedia, Morocco
| | - Sara Chenafi
- Laboratoire des Agents Infectieux et d'Hygiène, North Hospital, CHU de Saint-Étienne, Saint-Étienne, France
| | - Louise Moniod
- Department of Gynecology and Obstetrics, North Hospital, CHU de Saint-Étienne, Saint-Étienne, France
| | - Abdelhamid Benlghazi
- Department of Gynecology and Obstetrics, Military Hospital of Instruction Mohamed V, Rabat, Morocco
| | - Moulay Mustapha Ennaji
- Team of Virology, Oncology and Medical Biotechnologies, Laboratory of Virology, Microbiology, Quality, and Biotechnologies/ETB, Faculty of Science and Techniques Mohammedia, Hassan II University of Casablanca, Mohammedia, Morocco
| | - Céline Chauleur
- Department of Gynecology and Obstetrics, North Hospital, CHU de Saint-Étienne, Saint-Étienne, France
| | - Thomas Bourlet
- Laboratoire des Agents Infectieux et d'Hygiène, North Hospital, CHU de Saint-Étienne, Saint-Étienne, France
- Centre International de Recherche en Infectiologie, GIMAP Team 15, Inserm, U1111, CNRS, University of Saint-Etienne, University of Lyon, Lyon, France
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14
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Belouad M, Benlghazi A, Belkouchi L, Bouhtouri Y, Benali S, Kouach J. Septic shock following operative hysteroscopy in a menopausal woman: A case report and review of the literature. Gynecol Minim Invasive Ther 2022; 12:55-57. [PMID: 37025447 PMCID: PMC10071870 DOI: 10.4103/gmit.gmit_33_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/14/2022] [Accepted: 05/05/2022] [Indexed: 11/05/2022] Open
Abstract
Minimally invasive gynecologic surgery such as hysteroscopy has a low risk of complications. Infections, however, are more common in the presence of risk factors such as smoking, history of pelvic inflammatory disease, and endometriosis. We report the case of a patient who underwent operative hysteroscopy without immediate complications and was admitted 2 days later to the emergency department in a severe state of septic shock. With multiple organ failures requiring admission to an intensive care unit, the patient died despite extensive antibiotic therapy and vasoactive drugs. Ascending infection can be a potentially fatal complication of hysteroscopy, even in the absence of known risk factors.
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Belouad M, Benlghazi A, Allaoui M, Benali S, Bouhtouri Y, Messaoudi H, Elhassani M, Habib AB, Kouach J. Kyste hydatique pelvien primitif, une localisation inhabituelle: à propos d'un cas. PAMJ-CM 2022. [DOI: 10.11604/pamj-cm.2022.9.5.33742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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16
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Benlghazi A, Benali S, Bouhtouri Y, Belouad M, Massoudi H, Kouach J. [SARS-CoV-2 infection in pregnant women; epidemiological, clinical, biological and evolutionary profile in 16 cases: the COVID-19 experience in the Moroccan Military Hospital in Benslimane]. Pan Afr Med J 2021; 38:384. [PMID: 34381528 PMCID: PMC8325444 DOI: 10.11604/pamj.2021.38.384.28695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/01/2021] [Indexed: 12/20/2022] Open
Abstract
The first cases of infection caused by new SARS-CoV-2 coronavirus were reported in China in December 2019. This disease is called COVID-19 and has been declared as a pandemic by the WHO three months after its outbreak (in March 2020). In most cases it results in non-severe infectious syndrome associated with different degrees of benign symptoms (fever, cough, myalgia, headache and potential digestive disorders). SARS-CoV-2 can cause severe lung diseased and, sometimes, it results in death. Data on its consequences during pregnancy are limited. Currently, data on SARS-CoV-2 infection are reassuring and don´t indicate a higher risk of infection or a superimposed risk of complications in pregnant women compared to the general population. A few exceptional cases of maternal mortality have been reported, but they occur, most often, in patients with other diseases, in particular pre-eclampsia. This retrospective study highlights the clinical, biological and evolutionary materno-fetal data collected in the COVID-19 Military Field Hospital of Benslimane, Morocco, over a period of 3 months, from 21st July to 21 October 2020.
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Affiliation(s)
- Abdelhamid Benlghazi
- Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction Mohamed V, Université Mohammed V Rabat, Rabat, Maroc
| | - Saad Benali
- Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction Mohamed V, Université Mohammed V Rabat, Rabat, Maroc
| | - Yassine Bouhtouri
- Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction Mohamed V, Université Mohammed V Rabat, Rabat, Maroc
| | - Moad Belouad
- Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction Mohamed V, Université Mohammed V Rabat, Rabat, Maroc
| | - Hamza Massoudi
- Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction Mohamed V, Université Mohammed V Rabat, Rabat, Maroc
| | - Jaouad Kouach
- Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction Mohamed V, Université Mohammed V Rabat, Rabat, Maroc
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17
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Messaoudi H, Guelzim K, Belouad M, Benlghazi A, Kouach J. [Huge ovarian tumor in a perimenopausal woman: a case report]. Pan Afr Med J 2021; 38:232. [PMID: 34046137 PMCID: PMC8140729 DOI: 10.11604/pamj.2021.38.232.28240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 02/24/2021] [Indexed: 11/11/2022] Open
Abstract
Huge ovarian tumor is usually diagnosed at an advanced stage, in particular in developing countries. It can cause surgical complications. Anatomopathological examination is essential to establish the diagnosis. The role of tumor marker CA125 in a perimenopausal woman with pelvic mass has been widely debated.
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Affiliation(s)
- Hamza Messaoudi
- Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction Mohammed V, Université Mohammed V Rabat, Rabat, Maroc
| | - Khalid Guelzim
- Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction Mohammed V, Université Mohammed V Rabat, Rabat, Maroc
| | - Moad Belouad
- Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction Mohammed V, Université Mohammed V Rabat, Rabat, Maroc
| | - Abdelhamid Benlghazi
- Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction Mohammed V, Université Mohammed V Rabat, Rabat, Maroc
| | - Jaoud Kouach
- Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction Mohammed V, Université Mohammed V Rabat, Rabat, Maroc
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