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Saadi A, Bedoui MA, Mokadem S, Zaghbib S, Boussaffa H, Bellali M, Ayed H, Bouzouita A, Derouiche A, Allouche M, Chakroun M, Slama RB. Anatomy and anatomical variations of adrenal veins and its application to adrenal venous sampling. Surg Radiol Anat 2024; 46:543-550. [PMID: 38429406 DOI: 10.1007/s00276-024-03331-y] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 02/23/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE Our aim was to study the anatomy of the left and right main adrenal veins (LAV and RAV) and to identify their anatomical variations in order to see the practical application of these findings to adrenal venous sampling (AVS). METHODS Our work is based on dissection of 80 adrenal glands from fresh corpses in the forensic medicine department. We studied the number, the drainage, the direction and the level of termination of the main adrenal veins. RESULTS The average length of the LAV was 21 mm. It ended in 100% of cases at the upper edge of the left renal vein with a mean connection angle of 70° and after an anastomosis with the lower phrenic vein in 36 cases(90%). The average length of the RAV was 9 mm. It ended in 100% of cases at the level of the retro hepatic inferior vena cava (IVC) mainly on its posterior face in 21 cases (53%) and on its right lateral border in 18 cases (45%). The mean angle of the RAV in relation to the vertical axis of the IVC was 40°, with extremes ranging from 15° to 90°. CONCLUSIONS AVS seems to be easier on the left than on the right side because of the greater length of the adrenal vein (21 mm vs. 9 mm) and a greater angle of connection (70° with the left renal vein vs. 40° with the IVC), which explains the lower success rate of cannulation and the more frequent occurrence of blood sample contamination on the right side.
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Affiliation(s)
- Ahmed Saadi
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Mohamed Ali Bedoui
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia.
| | - Seif Mokadem
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Selim Zaghbib
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Hamza Boussaffa
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Mohamed Bellali
- University of Tunis El Manar, Faculty of Medecine of Tunis, Charles Nicolle Hospital, Department of Legal and forensic medicine , Tunis, Tunisia
| | - Haroun Ayed
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Abderrazek Bouzouita
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Amine Derouiche
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Mohamed Allouche
- University of Tunis El Manar, Faculty of Medecine of Tunis, Charles Nicolle Hospital, Department of Legal and forensic medicine , Tunis, Tunisia
| | - Marouene Chakroun
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Riadh Ben Slama
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
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Saadi A, Mokadem S, Bedoui MA, Zaghbib S, Hermi A, Bellali M, Boussaffa H, Ayed H, Bouzouita A, Allouche M, Chakroun M, Slama RB. A cadaveric anatomical study of the adrenals: vascular relationship. Endocrine 2024; 83:483-487. [PMID: 37932646 DOI: 10.1007/s12020-023-03585-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/23/2023] [Indexed: 11/08/2023]
Abstract
The adrenal gland is a retroperitoneal organ with intimate relationships with neighboring organs but also with the large retroperitoneal vessels. Our aim was to study the vascular relationships of the adrenal gland with the large abdominal vessels. Our work is an anatomical dissection of 80 fresh cadaveric adrenals. The subjects didn't have a history of retroperitoneal surgery. Dissection conditions were similar to those in the living. All measurements were made in situ. On the right side, the average distance between the adrenal gland and the renal vein (DR) was 13 mm (0-20). In one case, the adrenal gland laid directly on the right renal vein (DR = 0). The average length L, over which the right adrenal gland entered behind the inferior vena cava (IVC), was 8 mm (0-12). In 4 cases, the right adrenal was lateral to the IVC and in 6 cases the length L exceeded 10 mm. On the left side, the mean distance DL, separating the adrenal gland from the left renal vein was 8 mm with extremes ranging from 0 mm to 18 mm. In eleven cases, the adrenal gland laid directly on the left renal vein. The right adrenal gland has a close relationship with the IVC and is often located behind it. This close relationship helps to explain the increased incidence of IVC lesions during surgery. The left adrenal gland has an intimate relationship with the left renal vein and often lies on top of it. This explains the risk of injury to the left renal pedicle during left adrenal surgery.
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Affiliation(s)
- Ahmed Saadi
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Seif Mokadem
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Mohamed Ali Bedoui
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia.
| | - Selim Zaghbib
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Amine Hermi
- University of Tunis El Manar Faculty of Medicine of Tunis, Anatomy department, Tunis, Tunisia
| | - Mohammed Bellali
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of legal and forensic medicine, Tunis, Tunisia
| | - Hamza Boussaffa
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Haroun Ayed
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Abderrazek Bouzouita
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Mohamed Allouche
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of legal and forensic medicine, Tunis, Tunisia
| | - Marouene Chakroun
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Riadh Ben Slama
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
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Bedoui MA, Saadi A, Zaghbib S, Mokadem S, Boussaffa H, Hermi A, Ayed H, Bouzouita A, Chakroun M, Ben Slama R. Risk factors for sepsis and mortality in patients with emphysematous pyelonephritis : a series of 68 cases (case series). Ann Med Surg (Lond) 2024; 86:240-244. [PMID: 38222707 PMCID: PMC10783401 DOI: 10.1097/ms9.0000000000001475] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/26/2023] [Indexed: 01/16/2024] Open
Abstract
Background Emphysematous pyelonephritis (EPN) is a rare and severe necrotizing infection of the kidney with a high rate of complications and mortality. Our aim was to investigate risk factors of urosepsis and mortality in case of EPN. Materials and methods Between January 2010 and December 2022 the charts of patients diagnosed with EPN were retrospectively reviewed. Patients medical records were collected and data including demographics, BMI, EPN type, the organism causing the infection and biochemical variables were registered. The authors performed an univariate and multivariate logistic regression analysis for sepsis, septic shock, and mortality. Statistical significance was defined as a P-value of <0.05. Results Our study included 68 patients (63% females, mean age 58.6 years old). Forty-eight patients (70.6%) had diabetes. Half of the patients (50%) presented with sepsis and 11 patients (16.2%) developed a septic shock. The following factors were associated with sepsis by univariate analysis: diabetes (P=0.01), higher blood sugar on admission (P=0.01), higher leukocytic count (P<0.001), higher lymphocytic count (P<0.001), and lower platelet to leukocytes ratio (P<0.001). Multivariate regression analysis revealed that the main risk factors of urosepsis were the leukocytic (OR: 85.7; 95% CI: 9.177-800.486; P<0.001) and lymphocytic count (OR: 6.65; 95% CI: 1.228-36.050; P=0.028). Neither of the variables was significantly associated with a higher risk of mortality. Conclusion Leukocytic and lymphocytic count on admission are independent simple predictors for sepsis in patients with EPN.
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Affiliation(s)
- Mohamed A. Bedoui
- Department of Urology, Faculty of Medicine of Tunis, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
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Mokadem S, Saadi A, Chebbi S, Hermi A, Moussa S, Chakroun M, Slama MRB. Isolated ureteral injury from multiple stab wounds: A case report. Trauma Case Rep 2023; 48:100956. [PMID: 37928715 PMCID: PMC10623344 DOI: 10.1016/j.tcr.2023.100956] [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] [Accepted: 10/17/2023] [Indexed: 11/07/2023] Open
Abstract
This is a case report about a 44-year-old woman who sustained multiple stab wounds, resulting in an isolated right ureteral injury. Despite a precise diagnosis from an urgent CT scan showing contrast material extravasation, the patient's stable vital signs allowed for a thorough surgical exploration, leading to an accurate diagnosis. Immediate surgical repair of the right ureter using an end-to-end anastomosis following precise surgical principles achieved complete restoration of the initial injuries. The case highlights the accuracy of CT scan assessment, the unreliability of hematuria in diagnosing ureteral injuries, and the need for a high index of suspicion during surgical exploration to avoid overlooking such cases.
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Affiliation(s)
- Seif Mokadem
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Ahmed Saadi
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Sami Chebbi
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Amine Hermi
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Sarra Moussa
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Radiology Department, Tunisia
| | - Marouene Chakroun
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Mohamed Riadh Ben Slama
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
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Saadi A, Chebbi S, Mokadem S, Kacem LBH, Chakroun M, Slama MRB. Retroperitoneal ganglioneuroma: A five-case series from a single Tunisian center. Int J Surg Case Rep 2023; 111:108840. [PMID: 37734125 PMCID: PMC10518479 DOI: 10.1016/j.ijscr.2023.108840] [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: 08/13/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Retroperitoneal ganglioneuroma is an infrequent, benign tumor originating from the sympathetic nervous system. The diagnosis predominantly relies on histological assessment, often as an incidental discovery. Surgical removal stands as the primary treatment modality, and the overall prognosis tends to be favorable. CASE PRESENTATION Objective: In order to comprehensively examine the diagnostic, therapeutic, and progressive aspects of retroperitoneal ganglioneuroma, this study aims to analyze five cases of retroperitoneal ganglioneuroma that were surgically managed between 1993 and 2013. PATIENTS AND METHODS We present a series of five cases involving retroperitoneal ganglioneuromas that underwent surgical intervention in the urology department of Charles Nicolle Teaching Hospital of Tunis between the years 1993 and 2013. The study cohort comprised three females and two males, with an average age of 36.4 years (ranging from 10 to 88 years). Among these cases, four instances showcased incidental tumor detection, while one case manifested with cruralgia due to nerve compression. Complete tumor excision was achieved in all cases, with a single instance necessitating concurrent nephrectomy. Accurate diagnosis was ascertained through meticulous histological examination. CLINICAL DISCUSSION Results: The case series encompassed three women and two men, with an average age of 36.4 years (ranging from 10 to 88 years). The majority of cases (four out of five) unveiled tumors incidentally, whereas one case presented with cruralgia. Surgical removal resulted in complete resection of all tumors, although nephrectomy was necessary in one instance. Postoperative complications were minimal, and effective anticoagulant treatment addressed one thrombotic event. While recurrence was noted in a solitary case, subsequent imaging confirmed its stability. The average follow-up duration extended to 23.2 months (ranging from 6 to 72 months). CONCLUSION Retroperitoneal ganglioneuroma, being a rare and benign neoplasm, mandates meticulous pathological assessment and precise imaging for precise localization. Unquestionably, complete surgical resection remains paramount to forestall recurrence and mitigate the likelihood of malignant transformation. Overall, the prognosis associated with retroperitoneal ganglioneuroma tends to be favorable.
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Affiliation(s)
- Ahmed Saadi
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Sami Chebbi
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia.
| | - Seif Mokadem
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Linda Bel Hadj Kacem
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Pathology Department, Tunisia
| | - Marouene Chakroun
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Mohamed Riadh Ben Slama
- University of Tunis El Manar, Faculty Of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
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Chebbi S, Saadi A, Mokadem S, Chakroun M, Blel A, Ben Slama MR. Inflammatory suppurated tumor of urachus mimicking a malignant urachus adenocarcinoma. Urol Case Rep 2023; 50:102531. [PMID: 37664532 PMCID: PMC10469526 DOI: 10.1016/j.eucr.2023.102531] [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: 06/21/2023] [Revised: 08/13/2023] [Accepted: 08/13/2023] [Indexed: 09/05/2023] Open
Abstract
This is a case report about a patient presenting with a urachal mass mimicking a urachus adenocarcinoma. Cystoscopy showed a vesicourachal patent diverticulum. Histological findings after the removal of the umbilicus, urachus, urachal tumor, as well as a bladder cuff, consisted of a nonspecific polymorphous suppurative inflammatory infiltrate. Urachal adenocarcinoma is an aggressive tumor with poor prognosis if not treated while it is still localized. Surgical excision is the only recommended treatment that offers the best chances of survival. As no preoperative procedure has been proven accurate enough to rule out the diagnosis of adenocarcinoma, surgery appears to be inevitable.
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Affiliation(s)
- Sami Chebbi
- University of Tunis El Manar, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Ahmed Saadi
- University of Tunis El Manar, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Seif Mokadem
- University of Tunis El Manar, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Marouene Chakroun
- University of Tunis El Manar, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Ahlem Blel
- University of Tunis El Manar, Charles Nicolle Hospital of Tunis, Pathology Department, Tunisia
| | - Mohamed Riadh Ben Slama
- University of Tunis El Manar, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
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Saadi A, Bedoui MA, Zaghbib S, Mokadem S, Boussaffa H, Hermi A, Ayed H, Bouzouita A, Derouiche A, Chakroun M, Slama RB. Can radiological scores predict difficulties in removal of encrusted ureteral stents? Urolithiasis 2023; 51:108. [PMID: 37612572 DOI: 10.1007/s00240-023-01482-y] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/09/2023] [Indexed: 08/25/2023]
Abstract
In the present study, we aimed to report our single-center experience in encrusted ureteral stent management and to compare the utility of two different scoring systems in patient management. This is a retrospective study of patients who underwent various surgical procedures to remove encrusted ureteral stent. Encrusted stent grading was performed using KUB and FECal grading sytems. FECal grading system scored from Grade 1 to Grade 5 according to stone size, location, and degree of stent incrustation and the KUB score is the sum of the stone burden scores of three different parts of an encrusted stent within the kidney, ureter, and bladder determined using a scale from 1 to 5 according to the maximal diameter of encrustation. We compared these two classifications for the prediction of perioperative outcomes. Fifty patients were included in the study (52% female, mean age 48 years). The mean time from ureteral stent insertion until diagnosis of encrustation was 11.4 ± 13.6 months. High-grade incrustations (FECal Grade 3, 4, and 5) accounted for 62% of cases. The mean KUB score was 9.8 ± 2.7. The average number of procedures required to remove the stent was 1.71 ± 1.38. Multimodal surgery was required to remove 42% of the stents. Both, a total KUB score ≥ 9 and high-grade FECal classification were found to be significant predictors of longer operative time (> 100 min), need for multiple surgeries, and need for invasive surgery. While high-grade FECal classification showed a significant association with need for multimodal surgery (OR 6.92, p = 0.008), a total KUB score ≥ 9 showed no association (OR 2.91, p = 0.086). These two scores seem to be good indicators in predicting difficulties for surgical management of encrusted ureteral stent with a clear advantage of the FECal score in terms of prediction of multimodal surgery.
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Affiliation(s)
- Ahmed Saadi
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Mohamed Ali Bedoui
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia.
| | - Selim Zaghbib
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Seif Mokadem
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Hamza Boussaffa
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Amine Hermi
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Haroun Ayed
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Abderrazek Bouzouita
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Amine Derouiche
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Marouene Chakroun
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Riadh Ben Slama
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
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Saadi A, Maatougui J, Hermi A, Mokadem S, Boussaffa H, Zaghbib S, Bellali M, Allouche M, Jrad M, Ayed H, Bouzouita A, Derouiche A, Chakroun M, Ben Slama MR. Management of blunt renal trauma on pre-existing diseased kidneys: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:2432-2436. [PMID: 37363469 PMCID: PMC10289701 DOI: 10.1097/ms9.0000000000000594] [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: 02/08/2023] [Accepted: 03/22/2023] [Indexed: 06/28/2023] Open
Abstract
Pathological kidney trauma is a special entity. Congenital or acquired lesions may interfere with clinical presentation, radiological imaging, and the therapeutic approach. Objective Our objective was to determine the clinical, radiological, and therapeutic features of this entity. Materials and methods The medical records of 37 observations were retrospectively collected from January 1992 to February 2022. All cases were explored by a kidney ultrasound and/or a computed tomography scan, and classified according to the American Association of Surgery of Trauma. Pre-existing renal abnormalities were found in 37 patients among 203 (18.2%). The most common underlying lesion were urolithiasis (37.8%) followed by pyelo-ureteral junction syndrome (32.4%). Surgical abstention was decided in 11 cases, four nephrectomies were performed as a matter of urgency, and seven nephrectomies were performed remotely. The cure of uropathy was performed after an average delay of 3 months. Conclusion Kidneys with underlying pathology are habitually more susceptible to trauma. Contusions are often benign contrasting with a high nephrectomy rate.
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Affiliation(s)
| | | | | | | | | | | | - Mohamed Bellali
- Department of Legal Medicine
- Department of Foresnic Medicine, Faculty of Medicine, Faculty Tunis Manar, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohamed Allouche
- Department of Legal Medicine
- Department of Foresnic Medicine, Faculty of Medicine, Faculty Tunis Manar, Charles Nicolle Hospital, Tunis, Tunisia
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Hermi A, Saadi A, Mokadem S, Blel A, Chakroun M, Ben Slama MR. Coexistence of multiple clear cell papillary renal cell carcinoma with renal oncocytoma: a case report. Ann Med Surg (Lond) 2023; 85:2017-2019. [PMID: 37228922 PMCID: PMC10205370 DOI: 10.1097/ms9.0000000000000570] [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: 02/24/2023] [Accepted: 03/18/2023] [Indexed: 05/27/2023] Open
Abstract
Clear cell papillary renal cell carcinoma (CCPRCC) is a new entity, previously known as unclassified renal cell carcinoma, and initiallly identified in patients suffering of end-stage kidney failure. It is extremely rare to see this new entity associated with others renal malignant lesions. Case presentation The authors report a case of a female 65-year-old suffering from end-stage kidney failure for 10 years, who presented with a double left renal tumor, composed by an oncocytoma associated to multiple CCPRCC, a very rare entity. A radical left nephrectomy was realized by lumbotomy, with an uneventful postoperative course. Histological examination was challenging. Immunohistological examination showed diffuse positivity of cytokertain 7. No local recurrence nor metastatic progression were found during the 12 months of follow-up. Clinical discussion CCPRCC, is a new entity, previously known as the unclassified rena cell carcinoma, is a malignant renal tumor, initially reported in patients at end-stage kidney failure. Oncocytoma is a well-known rare benign renal tumor. The association of both is rare, and should be kept in mind, especially when scanoguided diagnosis biopsy is realized. Histopathological confirmation may be challenging, given the recent identification of CCPRCC. The nuclei disposal toward the luminal surface is a characteristic pathological landmark of CCPRCC. Immunohistopathological examination is of great help, showing a distinctive profile: diffuse staining for cytokertain 7 and carbonic anhydrase IX. Conclusion CCPRCC is a new malignant pathological entity in renal tumors. It can be associated with other benign renal lesions. This should be taken into consideration while histopathological examination, mainly of scanoguided biopsy cores.
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Affiliation(s)
| | | | | | - Ahlem Blel
- Department of Pathology, Faculty of Medicine, Faculty Tunis Manar, Charles Nicolle Hospital, Tunis, Tunisia
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Hermi A, Saadi A, Mokadem S, Boussaffa H, Zaghbib S, Haroun A, Bouzouita A, Derouiche A, Chakroun M, Ben Slama MR. Retrovesical hydatid cyst: an unusual location of hydatid disease about a case series. Ann Med Surg (Lond) 2023; 85:722-726. [PMID: 37113869 PMCID: PMC10129112 DOI: 10.1097/ms9.0000000000000380] [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: 02/06/2023] [Accepted: 02/25/2023] [Indexed: 04/29/2023] Open
Abstract
Hydatid disease is an endemic zoonosis in regions with temperate climates where pastoral farming is common. Retrovesical localization is rare. Given the rarity of this entity, the lack of personal clinical experience, and the difficulty with detecting early symptoms, the diagnosis remains elusive for years. Methods This is a 30-year retrospective, descriptive and analytic study of seven patients who were hospitalized and operated on in the Department of Urology during 30 years (1990-2019). Outcomes The average patient age was 54 years (range: 28-76). Signs of bladder irritation were the predominant presenting complaint. No cases of hydaturia were noted. Preoperative diagnosis was based on ultrasonography and serology tests. Hydatid serology was positive for three patients. In three cases, a hydatid cyst of the liver was associated. A partial cystopericystectomy was performed for five patients, it was total for one patient. The resection of the prominent dome was realized once. No cystovesical fistula was found. The mean postoperative stay was 16 days. The postoperative course was uneventful for five patients. Urinary fistula occurred in one patient. One case of infection of the residual cavity was observed. One patient had a retroperitoneal cyst recurrence requiring reoperation. Conclusion The preoperative diagnosis of retrovesical hydatid cysts is based mainly on ultrasonography. Open surgery is the treatment of choice. Different approaches are possible. Given the rarity of this entity, management should be guided by experienced experts.
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Affiliation(s)
- Amine Hermi
- Corresponding author. Address: Department of Urology, Faculty of Medicine, Charles Nicolle Hospital, Tunis, Tunisia 1007. Tel.: +216 5570 4699. E-mail address: (A. Hermi)
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Chebbi S, Mokadem S, Saadi A, Ksentini M, Chakroun M, Ben Slama MR. Oncocytoma with a vascular extension, associated with a papillary carcinoma: A case report. Urol Case Rep 2023; 48:102385. [PMID: 37035720 PMCID: PMC10074495 DOI: 10.1016/j.eucr.2023.102385] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/09/2023] [Accepted: 03/19/2023] [Indexed: 03/22/2023] Open
Abstract
This is a case report about a patient which presents with two right renal tumors, one of them being an oncocytoma with typical histopathological features and renal vein extension. Recent studies show that despite renal vein thrombus being a histological sign of malignancy; when associated with renal oncocytoma, it should not alter the benign prognosis of oncocytoma, and a simple follow-up may be carried. Further explorations should be done when easily available, and when the histopathologic diagnosis of oncocytoma is uncertain, to rule out the differential diagnosis of a chromophobe renal cell carcinoma, oncocytic variant.
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Affiliation(s)
- Sami Chebbi
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
- Corresponding author.
| | - Seif Mokadem
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Ahmed Saadi
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Meriem Ksentini
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Pathology Department, Tunisia
| | - Marouene Chakroun
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Mohamed Riadh Ben Slama
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
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12
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Hermi A, Saadi A, Mokadem S, Blel A, Chakroun M, Ben Slama M. Paratesticular leiomyoma: A case report of a rare entity. Urol Case Rep 2023; 47:102380. [PMID: 36941869 PMCID: PMC10023848 DOI: 10.1016/j.eucr.2023.102380] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/07/2023] [Accepted: 03/07/2023] [Indexed: 03/09/2023] Open
Abstract
Paratesticular leiomyoma is an extremely rare benign tumour. It is often asymptomatic. It is sometimes difficult to distinguish leiomyomas from malignant testicular tumours, which leads to radical orchidectomy, despite its benign nature. Magnetic resonance imaging can be helpful to make conservative management of this lesion.
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Affiliation(s)
- A. Hermi
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
- Corresponding author.
| | - A. Saadi
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - S. Mokadem
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - A. Blel
- Department of Pathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - M. Chakroun
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - M.R. Ben Slama
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
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13
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Mokadem S, Chakroun M, Hermi A, Saadi A, Zaghbib S, Ben Slama MR. Air gun accident: A case report of a penile injury. Urol Case Rep 2023; 47:102371. [PMID: 36910506 PMCID: PMC9995279 DOI: 10.1016/j.eucr.2023.102371] [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: 01/31/2023] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 03/05/2023] Open
Abstract
Air rifle, although considered as a toy, can cause injuries ranging from trivial to very grievous. The severity of injuries depends on the type of air rifle, the distance of firing, and the anatomic site at which the bullet hits. We present a case involving a young boy, who was accidently hit by an air rifle while playing. The Bullet penetrated the penis through the glans to be lodged in between the distal extremities of the corpus cavernosum behind the urethra. The surgical treatment was performed and the results were good.
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Affiliation(s)
- Seif Mokadem
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Marouene Chakroun
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Amine Hermi
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Ahmed Saadi
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Selim Zaghbib
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Mohamed Riadh Ben Slama
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
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14
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Mokadem S, Saadi A, Hermi A, Boussaffa H, Chakroun M, Ben Slama MR. Two brothers with congenital bulbar urethral stricture: case report of a very rare condition. J Surg Case Rep 2023; 2023:rjad072. [PMID: 36860355 PMCID: PMC9970558 DOI: 10.1093/jscr/rjad072] [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: 12/07/2022] [Accepted: 01/30/2023] [Indexed: 03/03/2023] Open
Abstract
Congenital urethral stricture is rare. It has been reported in only four sets of brothers. We report the fifth set of brothers. Cases of two brothers aged 23 and 18 years old diagnosed with low urinary tract symptoms are presented. We diagnosed an apparently congenital urethral stricture in both brothers. Internal urethrotomy was performed in both cases. Both are asymptomatic after 24 and 20 months of follow-up. Congenital urethral strictures are probably more frequent than we think. We suggest that a congenital origin should be considered if there is no history of infections or trauma.
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Affiliation(s)
- Seif Mokadem
- Department of Urology, Charles Nicolle Hospital, University Tunis Manar, Faculty of Medicine Tunis, Tunis 1001, Tunisia
| | - Ahmed Saadi
- Department of Urology, Charles Nicolle Hospital, University Tunis Manar, Faculty of Medicine Tunis, Tunis 1001, Tunisia
| | - Amine Hermi
- Correspondence address. Department of Urology, Charles Nicolle Hospital, University Tunis Manar, Faculty of Medicine Tunis, Tunis 1001, Tunisia. Tel: 00216 71 764 033; E-mail:
| | - Hamza Boussaffa
- Department of Urology, Charles Nicolle Hospital, University Tunis Manar, Faculty of Medicine Tunis, Tunis 1001, Tunisia
| | - Marouene Chakroun
- Department of Urology, Charles Nicolle Hospital, University Tunis Manar, Faculty of Medicine Tunis, Tunis 1001, Tunisia
| | - Mohamed Riadh Ben Slama
- Department of Urology, Charles Nicolle Hospital, University Tunis Manar, Faculty of Medicine Tunis, Tunis 1001, Tunisia
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15
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Mokadem S, Saadi A, Saideni B, Ben Salah M, Bouzouita A, Chebil M. Bladder exstrophy in adulthood: About a case report. Urol Case Rep 2022; 42:102001. [PMID: 35116225 PMCID: PMC8792434 DOI: 10.1016/j.eucr.2022.102001] [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: 12/13/2021] [Revised: 01/09/2022] [Accepted: 01/12/2022] [Indexed: 10/26/2022] Open
Abstract
Bladder exstrophy is a severe malformation characterized by the lack of the anterior sub-umbilical abdominal wall, and the front wall of the bladder. We present a rare case of a 26-year-old woman without any previous medical or surgical history, that we treated for bladder exstrophy. We performed an iliac osteotomy, bladder enlargement using the ileum and a Monti-type continent urinary derivation and a Promentofixation. A vesico-cutaneous fistula was diagnosed after surgery and we failed to manage it after two surgical revision. Therefore, we performed a cystectomy and a non-continent Bricker external urinary derivation.
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Affiliation(s)
- Seif Mokadem
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Ahmed Saadi
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Bilel Saideni
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Mohamed Ben Salah
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Orthopedics Department, Tunisia
| | - Abderrazak Bouzouita
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Mohamed Chebil
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
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16
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Saadi A, Mokadem S, Chakroun M, Hermi A, Boussaffa H, Ayed H, Allouche M, Bouzouita A, Derouiche A, Ben Slama MR, Hamdoun M, Chebil M. A cadaveric anatomical study: anatomy and anatomical variations of left adrenal vein. Surg Radiol Anat 2022; 44:689-695. [PMID: 35362770 DOI: 10.1007/s00276-022-02930-x] [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: 11/29/2021] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Control of adrenal vein is the key of adrenal surgery. Its anatomy can present variations. Our aim was to study the anatomy of the main left adrenal vein (LAV) and its anatomical variations. METHODS Our work is based on dissection of 40 cadavers. We studied the number of LAV and the drainage of the main adrenal vein as well as its level of termination. We measured its length, its width and the distance between its termination level and the termination level of the gonadal vein (GV). RESULTS The average length of the LAV was 21 mm its mean width was 5 mm. It ended in 100% of cases at the upper edge of the left renal vein after an anastomosis with the lower phrenic vein in 36 cases (90%) and without anastomosis with the lower phrenic vein in four cases (10%). The left adrenal vein ended at the upper edge of the left renal vein either at the same level as the termination of the left GV in 14 cases (35%) or within the termination of the left GV in 26 cases (65%) by an average of 8 mm. The LAV was unique central vein in 22 cases (55%) and in 12 cases (30%), a major central adrenal vein with several small veins was found. CONCLUSIONS The LAV is usually unique but there are variations in number. There are also variations in the level of its termination in the left renal vein as well as its anastomosis. During surgery, in case of difficulty, the left GV and the adrenal-diaphragmatic venous trunk could be used as benchmarks.
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Affiliation(s)
- Ahmed Saadi
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia.
| | - Seif Mokadem
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Marouene Chakroun
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Amine Hermi
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Hamza Boussaffa
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Haroun Ayed
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Mohamed Allouche
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Department of Legal and Forensic Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Abderrazak Bouzouita
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Amine Derouiche
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Mohamed Riadh Ben Slama
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Moncef Hamdoun
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Department of Legal and Forensic Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Mohamed Chebil
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
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17
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Saadi A, Mokadem S, Chakroun M, Nouioui MA, Allouche M, Bouzouita A, Derouiche A, Ben Slama MR, Hamdoun M, Ayed H, Chebil M. A cadaveric anatomical study of the adrenals: Relationship with the posterior abdominal wall muscles revisited. Morphologie 2020; 105:210-216. [PMID: 33071051 DOI: 10.1016/j.morpho.2020.09.006] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 10/23/2022]
Abstract
AIM OF THE STUDY The main difficulties during retroperitoneal laparoscopic adrenalectomies are due to its location. Our objective was to define the relationship of the adrenals with the diaphragm and the psoas muscle. METHODS Our work is an anatomical dissection of 80 fresh cadavers' adrenals. To study the right adrenal, we performed a right nephrectomy and adrenal remained attached to the Inferior vena cava by its main vein. On the left, the edges of the adrenal have been identified by needles and the adrenal was reclined to study its projection on the posterior muscular wall. RESULTS The right adrenal is located higher, 13mm [4-20mm] above the medial arcuate ligament (MAL) in 16 cases (40%). Its lower border was at the same level as the MAL in 18 cases (45%) and 11mm [10-17mm] below the MAL in 6 cases (15%). The posterior support of the right adrenal was the right crus of the diaphragm (Right-CD) in 34 cases (85%) and straddling the Right-CD and the psoas in 6 cases (15%). The study of the relationships of the left adrenal with the MAL showed that the lower edge of the gland was at its same level in 16 cases (40%) and below in 24 cases (60%) by 14mm [8-24mm]. The posterior support of the left adrenal was the left crus of the diaphragm (Left-CD) in 16 cases (40%) and straddling the Left-CD and the psoas in 24 cases (60%). CONCLUSIONS Our results showed that the right adrenal is higher. The MAL is an important posterior element to the adrenal gland that could serve as an anatomical landmark to identify the adrenal during laparoscopic adrenalectomy.
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Affiliation(s)
- A Saadi
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - S Mokadem
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - M Chakroun
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - M A Nouioui
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - M Allouche
- Department of legal and forensic medicine, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - A Bouzouita
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - A Derouiche
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - M R Ben Slama
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - M Hamdoun
- Department of legal and forensic medicine, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - H Ayed
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - M Chebil
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
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18
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Yonli DS, Chakroun M, Mokadem S, Saadi A, Rammeh S, Chebil M. Adrenal solitary fibrous tumor: A case report. Urol Case Rep 2019; 27:100919. [PMID: 31687355 PMCID: PMC6819790 DOI: 10.1016/j.eucr.2019.100919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/07/2019] [Revised: 05/19/2019] [Accepted: 05/21/2019] [Indexed: 11/28/2022] Open
Abstract
Solitary fibrous tumor (SFT) is a rare spindle cell neoplasm, originally described in the pleural cavity. It may also occur in extrapleural organs like adrenal gland. We present a case of a fifty two-year old Arab man who has been admitted in urology department for right lumbar pain. A suspect malignant adrenal mass has been detected. He underwent right adrenalectomy and histologically it was SFT. The follow-up three years after surgery is unremarkable. The prognosis of SFT after surgery is unpredictable. A long term follow-up is mandatory to detect local recurrence or distant metastasis.
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Affiliation(s)
- Diataga Sylvestre Yonli
- Department of Urology, Yalgado Ouedraogo University Hospital of Ouagadougou, 03 BP 7022 Ouagadougou 03, Burkina Faso
| | - Marouene Chakroun
- Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia
| | - Seif Mokadem
- Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia
| | - Ahmed Saadi
- Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia
| | - Soumaya Rammeh
- Department of Pathology, Charles Nicolle University Hospital of Tunis, Tunis, Tunisia
| | - Mohamed Chebil
- Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia
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19
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Gharbi M, Chakroun M, Chaker K, Mokadem S, Ayed H, Chebil M. Intravesical migration of intrauterine device resulting in stone formation: About a case report. Urol Case Rep 2019; 23:65-66. [PMID: 30666292 PMCID: PMC6329691 DOI: 10.1016/j.eucr.2019.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 01/09/2019] [Indexed: 11/28/2022] Open
Affiliation(s)
- Maroua Gharbi
- Departement of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | | | - Kays Chaker
- Departement of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Seif Mokadem
- Departement of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Haroun Ayed
- Departement of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohamed Chebil
- Departement of Urology, Charles Nicolle Hospital, Tunis, Tunisia
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20
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Alami Aroussi A, Fouad A, Omrane A, Razzak A, Aissa A, Akkad A, Amraoui A, Aouam A, Arfaoui A, Belkouchi A, Ben Chaaben A, Ben Cheikh A, Ben Khélifa A, Ben Mabrouk A, Benhima A, Bezza A, Bezzine A, Bourrahouat A, Chaieb A, Chakib A, Chetoui A, Daoudi A, Ech-Chenbouli A, Gaaliche A, Hassani A, Kassimi A, Khachane A, Labidi A, Lalaoui A, Masrar A, McHachi A, Nakhli A, Ouakaa A, Siati A, Toumi A, Zaouali A, Condé AY, Haggui A, Belaguid A, El Hangouche AJ, Gharbi A, Mahfoudh A, Bouzouita A, Aissaoui A, Ben Hamouda A, Hedhli A, Ammous A, Bahlous A, Ben Halima A, Belhadj A, Bezzine A, Blel A, Brahem A, Banasr A, Meherzi A, Saadi A, Sellami A, Turki A, Ben Miled A, Ben Slama A, Daib A, Zommiti A, Chadly A, Jmaa A, Mtiraoui A, Ksentini A, Methnani A, Zehani A, Kessantini A, Farah A, Mankai A, Mellouli A, Zaouali A, Touil A, Hssine A, Ben Safta A, Derouiche A, Jmal A, Ferjani A, Djobbi A, Dridi A, Aridhi A, Bahdoudi A, Ben Amara A, Benzarti A, Ben Slama AY, Oueslati A, Soltani A, Chadli A, Aloui A, Belghuith Sriha A, Bouden A, Laabidi A, Mensi A, Ouakaa A, Sabbek A, Zribi A, Green A, Ben Nasr A, Azaiez A, Yeades A, Belhaj A, Mediouni A, Sammoud A, Slim A, Amine B, Chelly B, Jatik B, Lmimouni B, Daouahi B, Ben Khelifa B, Louzir B, Dorra A, Dhahri B, Ben Nasrallah C, Chefchaouni C, Konzi C, Loussaief C, Makni C, Dziri C, Bouguerra C, Kays C, Zedini C, Dhouha C, Mohamed C, Aichaouia C, Dhieb C, Fofana D, Gargouri D, Chebil D, Issaoui D, Gouiaa D, Brahim D, Essid D, Jarraya D, Trad D, Ben Hmida E, Sboui E, Ben Brahim E, Baati E, Talbi E, Chaari E, Hammami E, Ghazouani E, Ayari F, Ben Hariz F, Bennaoui F, Chebbi F, Chigr F, Guemira F, Harrar F, Benmoula FZ, Ouali FZ, Maoulainine FMR, Bouden F, Fdhila F, Améziani F, Bouhaouala F, Charfi F, Chermiti Ben Abdallah F, Hammemi F, Jarraya F, Khanchel F, Ourda F, Sellami F, Trabelsi F, Yangui F, Fekih Romdhane F, Mellouli F, Nacef Jomli F, Mghaieth F, Draiss G, Elamine G, Kablouti G, Touzani G, Manzeki GB, Garali G, Drissi G, Besbes G, Abaza H, Azzouz H, Said Latiri H, Rejeb H, Ben Ammar H, Ben Brahim H, Ben Jeddi H, Ben Mahjouba H, Besbes H, Dabbebi H, Douik H, El Haoury H, Elannaz H, Elloumi H, Hachim H, Iraqi H, Kalboussi H, Khadhraoui H, Khouni H, Mamad H, Metjaouel H, Naoui H, Zargouni H, Elmalki HO, Feki H, Haouala H, Jaafoura H, Drissa H, Mizouni H, Kamoun H, Ouerda H, Zaibi H, Chiha H, Kamoun H, Saibi H, Skhiri H, Boussaffa H, Majed H, Blibech H, Daami H, Harzallah H, Rkain H, Ben Massoud H, Jaziri H, Ben Said H, Ayed H, Harrabi H, Chaabouni H, Ladida Debbache H, Harbi H, Yacoub H, Abroug H, Ghali H, Kchir H, Msaad H, Ghali H, Manai H, Riahi H, Bousselmi H, Limem H, Aouina H, Jerraya H, Ben Ayed H, Chahed H, Snéne H, Lahlou Amine I, Nouiser I, Ait Sab I, Chelly I, Elboukhani I, Ghanmi I, Kallala I, Kooli I, Bouasker I, Fetni I, Bachouch I, Bouguecha I, Chaabani I, Gazzeh I, Samaali I, Youssef I, Zemni I, Bachouche I, Youssef I, Bouannene I, Kasraoui I, Laouini I, Mahjoubi I, Maoudoud I, Riahi I, Selmi I, Tka I, Hadj Khalifa I, Mejri I, Béjia I, Bellagha J, Boubaker J, Daghfous J, Dammak J, Hleli J, Ben Amar J, Jedidi J, Marrakchi J, Kaoutar K, Arjouni K, Ben Helel K, Benouhoud K, Rjeb K, Imene K, Samoud K, El Jeri K, Abid K, Chaker K, Abid K, Bouzghaîa K, Kamoun K, Zitouna K, Oughlani K, Lassoued K, Letaif K, Hakim K, Cherif Alami L, Benhmidoune L, Boumhil L, Bouzgarrou L, Dhidah L, Ifrine L, Kallel L, Merzougui L, Errguig L, Mouelhi L, Sahli L, Maoua M, Rejeb M, Ben Rejeb M, Bouchrik M, Bouhoula M, Bourrous M, Bouskraoui M, El Belhadji M, El Belhadji M, Essakhi M, Essid M, Gharbaoui M, Haboub M, Iken M, Krifa M, Lagrine M, Leboyer M, Najimi M, Rahoui M, Sabbah M, Sbihi M, Zouine M, Chefchaouni MC, Gharbi MH, El Fakiri MM, Tagajdid MR, Shimi M, Touaibia M, Jguirim M, Barsaoui M, Belghith M, Ben Jmaa M, Koubaa M, Tbini M, Boughdir M, Ben Salah M, Ben Fraj M, Ben Halima M, Ben Khalifa M, Bousleh M, Limam M, Mabrouk M, Mallouli M, Rebeii M, Ayari M, Belhadj M, Ben Hmida M, Boughattas M, Drissa M, El Ghardallou M, Fejjeri M, Hamza M, Jaidane M, Jrad M, Kacem M, Mersni M, Mjid M, Sabbah M, Serghini M, Triki M, Ben Abbes M, Boussaid M, Gharbi M, Hafi M, Slama M, Trigui M, Taoueb M, Chakroun M, Ben Cheikh M, Chebbi M, Hadj Taieb M, Kacem M, Ben Khelil M, Hammami M, Khalfallah M, Ksiaa M, Mechri M, Mrad M, Sboui M, Bani M, Hajri M, Mellouli M, Allouche M, Mesrati MA, Mseddi MA, Amri M, Bejaoui M, Bellali M, Ben Amor M, Ben Dhieb M, Ben Moussa M, Chebil M, Cherif M, Fourati M, Kahloul M, Khaled M, Machghoul M, Mansour M, Abdesslem MM, Ben Chehida MA, Chaouch MA, Essid MA, Meddeb MA, Gharbi MC, Elleuch MH, Loueslati MH, Sboui MM, Mhiri MN, Kilani MO, Ben Slama MR, Charfi MR, Nakhli MS, Mourali MS, El Asli MS, Lamouchi MT, Cherti M, Khadhraoui M, Bibi M, Hamdoun M, Kassis M, Touzi M, Ben Khaled M, Fekih M, Khemiri M, Ouederni M, Hchicha M, Kassis M, Ben Attia M, Yahyaoui M, Ben Azaiez M, Bousnina M, Ben Jemaa M, Ben Yahia M, Daghfous M, Haj Slimen M, Assidi M, Belhadj N, Ben Mustapha N, El Idrissislitine N, Hikki N, Kchir N, Mars N, Meddeb N, Ouni N, Rada N, Rezg N, Trabelsi N, Bouafia N, Haloui N, Benfenatki N, Bergaoui N, Yomn N, Ben Mustapha N, Maamouri N, Mehiri N, Siala N, Beltaief N, Aridhi N, Sidaoui N, Walid N, Mechergui N, Mnif N, Ben Chekaya N, Bellil N, Dhouib N, Achour N, Kaabar N, Mrizak N, Mnif N, Chaouech N, Hasni N, Issaoui N, Ati N, Balloumi N, Haj Salem N, Ladhari N, Akif N, Liani N, Hajji N, Trad N, Elleuch N, Marzouki NEH, Larbi N, M'barek N, Rebai N, Bibani N, Ben Salah N, Belmaachi O, Elmaalel O, Jlassi O, Mihoub O, Ben Zaid O, Bouallègue O, Bousnina O, Bouyahia O, El Maalel O, Fendri O, Azzabi O, Borgi O, Ghdes O, Ben Rejeb O, Rachid R, Abi R, Bahiri R, Boulma R, Elkhayat R, Habbal R, Rachid R, Tamouza R, Jomli R, Ben Abdallah R, Smaoui R, Debbeche R, Fakhfakh R, El Kamel R, Gargouri R, Jouini R, Nouira R, Fessi R, Bannour R, Ben Rabeh R, Kacem R, Khmakhem R, Ben Younes R, Karray R, Cheikh R, Ben Malek R, Ben Slama R, Kouki R, Baati R, Bechraoui R, Fakhfakh R, Fradi R, Lahiani R, Ridha R, Zainine R, Kallel R, Rostom S, Ben Abdallah S, Ben Hammamia S, Benchérifa S, Benkirane S, Chatti S, El Guedri S, El Oussaoui S, Elkochri S, Elmoussaoui S, Enbili S, Gara S, Haouet S, Khammeri S, Khefecha S, Khtrouche S, Macheghoul S, Mallouli S, Rharrit S, Skouri S, Helali S, Boulehmi S, Abid S, Naouar S, Zelfani S, Ben Amar S, Ajmi S, Braiek S, Yahiaoui S, Ghezaiel S, Ben Toumia S, Thabeti S, Daboussi S, Ben Abderahman S, Rhaiem S, Ben Rhouma S, Rekaya S, Haddad S, Kammoun S, Merai S, Mhamdi S, Ben Ali R, Gaaloul S, Ouali S, Taleb S, Zrour S, Hamdi S, Zaghdoudi S, Ammari S, Ben Abderrahim S, Karaa S, Maazaoui S, Saidani S, Stambouli S, Mokadem S, Boudiche S, Zaghbib S, Ayedi S, Jardek S, Bouselmi S, Chtourou S, Manoubi S, Bahri S, Halioui S, Jrad S, Mazigh S, Ouerghi S, Toujani S, Fenniche S, Aboudrar S, Meriem Amari S, Karouia S, Bourgou S, Halayem S, Rammeh S, Yaïch S, Ben Nasrallah S, Chouchane S, Ftini S, Makni S, Manoubi S, Miri S, Saadi S, Manoubi SA, Khalfallah T, Mechergui T, Dakka T, Barhoumi T, M'rad TEB, Ajmi T, Dorra T, Ouali U, Hannachi W, Ferjaoui W, Aissi W, Dahmani W, Dhouib W, Koubaa W, Zhir W, Gheriani W, Arfa W, Dougaz W, Sahnoun W, Naija W, Sami Y, Bouteraa Y, Elhamdaoui Y, Hama Y, Ouahchi Y, Guebsi Y, Nouira Y, Daly Y, Mahjoubi Y, Mejdoub Y, Mosbahi Y, Said Y, Zaimi Y, Zgueb Y, Dridi Y, Mesbahi Y, Gharbi Y, Hellal Y, Hechmi Z, Zid Z, Elmouatassim Z, Ghorbel Z, Habbadi Z, Marrakchi Z, Hidouri Z, Abbes Z, Ouhachi Z, Khessairi Z, Khlayfia Z, Mahjoubi Z, Moatemri Z. 46th Medical Maghrebian Congress. November 9-10, 2018. Tunis. Tunis Med 2019; 97:177-258. [PMID: 31535714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Cherif J, Mjid M, Ladhar A, Toujani S, Mokadem S, Louzir B, Mehiri N, Béji M. [Diagnosis delay of pleural and pulmonary tuberculosis]. Rev Pneumol Clin 2014; 70:189-194. [PMID: 24874402 DOI: 10.1016/j.pneumo.2013.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 10/08/2013] [Accepted: 10/26/2013] [Indexed: 06/03/2023]
Abstract
Tuberculosis (TB) is still being endemic in our country. Time until management determines both evolution and prognosis of this condition. The aim of this work is to evaluate the delay in diagnosis of TB in a respiratory unit from a university hospital series. The authors conducted a cross-sectional study including patients with pulmonary TBC and/or pleural. An evaluation of time management was conducted from the beginning of symptoms and various consultations with reference to the date of hospitalization and treatment set up. One hundred patients were included (pulmonary TB: 68 cases, pleural TB 23 cases, miliary pulmonary TB: 4 cases, pulmonary TB associated with other extrathoracic locations: 5 cases). The mean time of patient delay and total delay institution were respectively 43.6, 25.7 and 69.3 days. Variables responsible for long delays were: number of consultations more than 3 before hospitalization, empirical antibiotic therapy, of a regional hospital first consultation and the presence of extra-respiratory impairment. The patient delay was considered long. A reorganization of the TB control program, in particular by partial decentralization of care and health education is imperative in order to improve the quality of tuberculosis management in our country.
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Affiliation(s)
- J Cherif
- Service de pneumologie allergologie, unité de recherche 99/UR/08-21, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie.
| | - M Mjid
- Service de pneumologie allergologie, unité de recherche 99/UR/08-21, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - A Ladhar
- Service de pneumologie allergologie, unité de recherche 99/UR/08-21, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - S Toujani
- Service de pneumologie allergologie, unité de recherche 99/UR/08-21, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - S Mokadem
- Service de pneumologie allergologie, unité de recherche 99/UR/08-21, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - B Louzir
- Service de pneumologie allergologie, unité de recherche 99/UR/08-21, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - N Mehiri
- Service de pneumologie allergologie, unité de recherche 99/UR/08-21, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - M Béji
- Service de pneumologie allergologie, unité de recherche 99/UR/08-21, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
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Mokadem S, Toujani S, Mjid M, Mehiri N, Dhaoui S, Hamdi B, Zakhama H, Ouahchi Y, Ben Salah N, Daghfous J, Louzir B, Chérif J, Beji M. Profil clinique et fonctionnel des BPCO « excerbateurs fréquents ». Rev Mal Respir 2013. [DOI: 10.1016/j.rmr.2012.10.242] [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: 11/25/2022]
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Mjid M, Cherif J, Toujani S, Dhaoui S, Ben Safta B, Mokadem S, Hamdi B, Zakhama H, Ouahchi Y, Ben Salah N, Louzir B, Mhiri N, Beji M. L’exposition à la Tabouna (four de jardin) augmente-elle le risque de survenue d’un carcinome à petites cellules du poumon (CPC) chez les femmes non tabagiques ? Rev Mal Respir 2013. [DOI: 10.1016/j.rmr.2012.10.309] [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: 11/28/2022]
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Abstract
Epitaxial Laser Metal Forming (E-LMF) consists in impinging a jet of
metallic powder onto a molten pool formed by controlled laser heating and
thereby, generating epitaxially a single crystal deposit onto the damaged
component. This new technique aims to be used for the repair and reshape
single crystal gas turbine components. Because of the very localised melting
pool, the high temperature gradients produced during the process must be
carefully controlled in order to avoid both the columnar-to-equiaxed
transition (CET) and the appearance of hot tears. To this end, heat flow
modelling is required to establish the relationship between process
parameters such as laser power, beam diameter and scanning speed, and the
local solidification conditions. When modelling the heat transfer within the
sample, it is necessary to include the liquid flow pattern generated by the
surface tension driven convection known as the Marangoni effect. Indeed, the
fluid flow in the liquid pool dictates the shape of the traces as shown by
the measurements carried out at EPF-Lausanne in re-melting experiments. A
three dimensional (3D) model is implemented in the finite element software
calcosoft$^\text{\textregistered}$ in order to model the
development of the fluid convection within the liquid pool. It is shown that
the velocities due to natural convection are of the order of 1 mm/sec
whereas Marangoni convection produces velocities of the order of 1 m/sec.
Moreover, at low scanning speeds, the liquid pool becomes larger than the
beam diameter and the development of Marangoni eddies leads to a widening
and deepening of the pool. The local solidification conditions such as the
thermal gradient and the solidification speed can be extracted at both the
solidus and liquidus temperatures to assess the risk of CET and hot
cracking.
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