Introduction: Biometrics therefore corresponds to the measurement of the morphological elements of humans. One of the most common ultrasound requests by clinicians is the assessment of liver size. The aim of our study...Introduction: Biometrics therefore corresponds to the measurement of the morphological elements of humans. One of the most common ultrasound requests by clinicians is the assessment of liver size. The aim of our study was to study liver biometry using ultrasound in healthy adult subjects. Material and Methods: This was a prospective, descriptive and analytical study, carried out at CHU Point-G over a period of 7 months. A liver ultrasound was performed on 100 individuals without lesions, by a doctor in his final year of specialization in radiology and medical imaging. For each subject, we determined the height and anteroposterior diameter of the right liver and the left liver. Results: The mean age was 39.05 ± 16.86 years. The body mass index (BMI) 18.5 - 24.9 group was the most represented with 58%. The mean height of the right liver was 138.40 ± 14.85 mm. It was 136.81 ± 14.70 mm in men and 139.92 ± 14.99 mm in women (P = 0.306). That of the left liver was 95.55 ± 14.34 mm, in men, it was 91.79 ± 13.51 mm and 99.16 ± 14.31 mm in women (P = 0.019). We found a significant correlation between right liver height and BMI (P = 0.013). Conclusion: The mean values of liver biometry were established in our series. There was a significant correlation between right liver height and BMI. Liver ultrasound remains a reliable technique for liver biometry.展开更多
<b>Background:</b>The objective of this work was to evaluate the first results of the radio ablation of the great saphenous vein in the processing of chronic venous insufficiency. <b>Method: </b&g...<b>Background:</b>The objective of this work was to evaluate the first results of the radio ablation of the great saphenous vein in the processing of chronic venous insufficiency. <b>Method: </b>This is a monocentric retrospective study of radio ablation of the great saphenous vein using VNUS Closure<sup>®</sup> FAST for superficial venous insufficiency of the great saphenous vein, between January 2012 and December 2014. <b>Results:</b> 42 patients (57 limbs) were operated on with this technology. There were 33 women and 9 men (mean age: 46.5 years). Thirty-nine patients (92. 8%) were symptomatic. Thirty-two patients (76.1%) were classified CEAP 2. The average diameter of the saphenous vein was 8.5 ± 1.5 mm. Three patients (7.1%) had a percutaneous approach. A perfect occlusion of the saphenous vein was observed in all patients. No incident or undesirable event was observed during the procedure. One case of delayed deep-vein thrombosis was observed. At one month of follow-up, six patients (14.2%) had induration opposite to the occluded vein. Forty-three percent of the pati<span style="letter-spacing:-0.1pt;">ents stated they were very satisfied with the procedure. <b>Conclusion:</b> The effectiveness, security and simplicity of the closure method are real. More studies are necessary to assess the long-term results of this procedure.</span>展开更多
Aim: This paper aims to evaluate the epidemiological and pathological aspects of stomach cancer at Koutiala District Hospital. Methods: This was a retrospective study carried out in the General Surgery Department of t...Aim: This paper aims to evaluate the epidemiological and pathological aspects of stomach cancer at Koutiala District Hospital. Methods: This was a retrospective study carried out in the General Surgery Department of the Koutiala District Hospital Health Centre. The records of patients admitted for stomach cancer in the period from August 1, 2017 to December 31, 2022 were collected. Patients who underwent surgery for stomach cancer were included in the study. Patients who had not undergone surgery were excluded. Results: We collected records from 40 patients operated on for stomach cancer. The median age was 58.4 years ± 5.7. Men were in the majority with 72.5% The sex ratio was 2.6. The incidence rate of stomach cancer in the general population in the circle was 4.9 cases per 100,000 population. Patients had a history of gastric ulcer in 90%, Helicobacter pylori infection in 47.5% and a notion of excessive salt consumption in 47.5%. The median duration of disease progression was 5 years ± 2.3. The seat was antro-pyloric in 77.5%. The cancer was ulcerative budding in 23 patients. Adenocarcinoma was the histological type in all patients. The cancer was classified as stage III in 30 cases and stage IV in 10 cases. Palliative surgical treatment was the most performed (47.5%). Postoperative morbidity was 15% and mortality was 42.5% at one year. Conclusion: Stomach cancer is common in the ward. Most patients consult at the stage of metastasis. Palliative surgery remains the most practical. Postoperative morbidity and mortality is very high.展开更多
Purpose: This paper aims to assess the incidences and risk factors for surgical site (ISO) infections in the general surgery department of the Koutiala District Hospital. Patients and Methods: This was a prospective a...Purpose: This paper aims to assess the incidences and risk factors for surgical site (ISO) infections in the general surgery department of the Koutiala District Hospital. Patients and Methods: This was a prospective and descriptive study from August 1, 2017 to October 31, 2020 involving all patients who underwent laparotomy in the general surgery department of the Koutiala District Hospital. Patients who were not operated on and who did not have a laparotomy were not included. Age, sex, frequency, patient history, National Nosocomial Infections Surveillance (NNIS) index, time to occur, bacteriological test results and course of infection were analyzed. Results: Fifty patients were registered. The average age was 34.2 ± 21.2 years old. Eleven patients were 60 years old or older. The hospital incidence rate was 4.3% and the community incidence rate was 6.1 cases per 100,000 population. The concept of smoking was noted in 15 patients. Patients were operated on in emergency 84% of cases. Peritonitis was the most common initial lesion with 32% of cases. Our patients had an NNIS index greater than 0 in 84% of cases. The time to develop infection from the surgical site was less than 3 days in 8 patients (16% of cases). Depending on the depth of the infection, it was superficial (cutaneous) in 39 patients (78%) and deep (subcutaneous and organic) in 11 patients (22%). Escherichia coli was the most common germ with 72% followed by staphylococcus aureus at 24%. We noted 22% morbidity. The median length of hospitalization was 9 ± 2.2 days. Conclusion: ISO is common in our service. Prevention and mastery require knowledge of risk factors.展开更多
The left para-duodenal internal hernia, whose origin is generally embryological, is a rare etiology of intestinal obstruction found mainly in young adults. We report here the case of acute intestinal obstruction by le...The left para-duodenal internal hernia, whose origin is generally embryological, is a rare etiology of intestinal obstruction found mainly in young adults. We report here the case of acute intestinal obstruction by left para-duodenal internal hernia in a 36-year-old young man. It was a patient who consulted urgently for occlusive syndrome with cessation of materials and gases. Abdominal percussion noted abdominal tympanism and pre-hepatic dullness was preserved. The flow and icicle signs were negative. Palpation did not objectify hepatosplenomegaly and did not find any organomegaly either. On the other hand, she found an epigastric defense. The abdominal X-ray without preparation showed water levels that were wider than high, hail-like. We performed a median above and below umbilical laparotomy and intraoperatively, it was an internal hernia with incarceration of small loops in a voluminous left paraduodenal sac of 12 cm. They were not necrotic and quickly recolored after extrication. We resected the hernial sac and closed the hernial orifice with separate stitches with absorbable suture 0. The postoperative course was simple. The patient was discharged from the hospital on the 4th postoperative day. After 18 months of hindsight, he is doing well.展开更多
CHU (University Hospital Center) Point G: The department of surgery B is a surgical department of CHU Point G. The department is par excellence a reference department for cases of visceral surgery, cancer surgery, car...CHU (University Hospital Center) Point G: The department of surgery B is a surgical department of CHU Point G. The department is par excellence a reference department for cases of visceral surgery, cancer surgery, cardiovascular surgery, plastic and endocrinology surgery. As a reminder, the CHU Point G is the largest 3rd level referral hospital in Mali. <b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> To study the environmental risk factors of stomach cancer in the B surgery department of the Point G University Hospital in Bamako. </span><b><span style="font-family:Verdana;">Patients and Methods:</span></b><span style="font-family:Verdana;"> We performed a cross-sectional study with retrospective collection from January 2008 to June 2018 (126 months). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We have identified 380 cases of digestive cancer, including 193 cases of stomach cancer </span><span style="font-family:Verdana;">o</span><span style="font-family:;" "=""><span style="font-family:Verdana;">r 50.79% of digestive cancers. The mean age of the patients was 57.21 ± 13 years. Male sex represented 55% (n = 106). Eating habits were dominated by the consumption of t<span style="font-family:Verdana, Helvetica, Arial;white-space:normal;background-color:#FFFFFF;">ô</span> with potash (cereal paste) with 64.76% (n = 185). The main methods of preserving meat and fish were curing and smoking with 57.51% (n = 111). Chronic smoking was found in 24.35% (n = 47), alcohol + tobacco consumption in 2.59% (n = 5). The low socio-economic class represented 126 cases or 65.38%. Housewives and cultivators were respectively 37.82% (n = 73) and 227.97% (n = 54). 20.20% (n = 39) had a history of epigastric pain. Epigastralgia was the most common functional sign with 84.5% of cases (n = 169). An epigastric mass was found in 72 patients or 37.3%. Adenocarcinoma represented 97.4% (n = 188). Palliative surgery concerned the majority of ou展开更多
<strong>History:</strong> In Mali, several studies have been carried out on acute peritonitis but in the Koutiala circle it is a first. <strong>Aim:</strong> To evaluate the epidemiological, et...<strong>History:</strong> In Mali, several studies have been carried out on acute peritonitis but in the Koutiala circle it is a first. <strong>Aim:</strong> To evaluate the epidemiological, etiological and therapeutic aspects of generalized acute peritonitis at the Koutiala reference health center. <strong>Method:</strong> This was a 14-month prospective and descriptive study from August 1, 2017 to November 30, 2019, covering all patients admitted and operated for generalized acute peritonitis. The parameters studied were age, sex, frequency, clinical aspects, etiologies, treatment and postoperative operations. <strong>Result:</strong> The number was 93 cases, 72 men and 21 women. The average age was 34.2 years (Extremes: 2 - 75 years). The hospital frequency was 2.0%. The incidence rate of generalized acute peritonitis in the circle was 12.4 cases per 100,000 population. The clinical picture was still of peritonitis. The Widal-Félix serology was positive in 19 cases. Perioperative bacteriological sampling was systematic. The etiologies were dominated by digestive perforations in 81 cases (87%) of which 33 were located at the ileal level, postoperative peritonitis (6 cases) and ruptured pyocholecyst (2 cases). There were also 3 cases of primary peritonitis and 1 case of gynecological peritonitis. Excision-suturing was the most used surgical technique with 35.5% (n = 33). Postoperatively, we identified 10 cases of parietal suppuration (10.8%), 6 cases of postoperative peritonitis (6.5%), 2 cases of external digestive fistula (2.2%) and 7 cases of death (7.5%). <strong>Conclusion:</strong> Acute peritonitis occupies second place in abdominal surgical emergencies in the Koutiala circle. The etiologies are multiple and varied and are dominated by the ileal perforation which is secondary to typhoid fever more often. In most cases the surgical treatment is done by excision-suturing of the perforation. Mortality and morbidity remain high.展开更多
<strong>Aim:</strong> To assess the epidemiological profile of intestinal obstructions at the Koutiala district hospital. <strong>Patients and Method:</strong> This was a prospective and descri...<strong>Aim:</strong> To assess the epidemiological profile of intestinal obstructions at the Koutiala district hospital. <strong>Patients and Method:</strong> This was a prospective and descriptive study taking place from August 1, 2017 to April 30, 2020. The files of patients with acute intestinal obstruction in the general surgery department of the Koutiala district hospital were collected. In this study, patients operated on for acute intestinal obstruction were included. Non-operated patients were not included in the study. <strong>Result:</strong> The records of 65 patients operated on for acute intestinal obstruction were collected. The mean age was 32 ± 22 with extremes of 1 year and 94 years. 7 infants (10.8%) and 1 4-year-old child (1.5%) were identified. The 16 to 59 age group was more common. Males were the majority with 70.8% (n = 46). The sex ratio was 2.4. The rate of bowel obstruction in the general population in the circle was 8.1 cases per 100,000 population. According to provenance, patients came from inside the circle (rural areas) in 87.7% of the cases (n = 57) and from the city of Koutiala in 12.3% (n = 8). 33.9% of our patients had undergone laparotomy (n = 22). Patients consulted urgently in 93.8%. The etiologies are dominated by post-operative straps (33.8%) and volvulus (24.6%). We noted 12 cases of intestinal necrosis. Postoperative morbidity was 13.8% of cases (n = 9) and mortality of 6.1% of cases (n = 4). <strong>Conclusion:</strong> Bowel obstruction is one of the most frequent surgical emergencies in our circle. They most often affect young subjects and young adult males. The etiologies are dominated by the post-operative flanges. Complications remain elevated.展开更多
<strong>Purpose:</strong> To assess the epidemiological, clinical and therapeutic aspects of acute appendicitis at the Koutiala Reference Health Centre. <strong>Methods:</strong> This was a pro...<strong>Purpose:</strong> To assess the epidemiological, clinical and therapeutic aspects of acute appendicitis at the Koutiala Reference Health Centre. <strong>Methods:</strong> This was a prospective study conducted in the general surgery department of the Koutiala Reference Health Centre. Patient records admitted for simple and complicated appendicitis during the period from August 1, 2017 to August 31, 2018 have been collected. Patients operated on for simple and complicated acute appendicitis were included in the study. Patients who did not have surgery were excluded. <strong>Results:</strong> We collected records of 62 patients who had surgery for simple and complicated acute appendicitis. They accounted for 11.9% of surgical procedures (n-520) and 27.3% (n-227) of surgical emergencies. The average age was 33.1 years-15.7. Men were in the majority with 72.5%. Simple acute appendicitis accounted for 56.4% of cases (n-35) and complicated appendicitis 43.6% of cases (these were 16 cases of appendicular peritonitis, 09 cases of appendicular abscess and 02 cases of appendicular plastron). Therapeutically, appendectomy was performed in 58 patients. In 4 patients the appendix was completely necrotized. The average length of hospitalization was 3.3 days-0.8 for single acute appendicites and 6 days-2.7 for complicated appendicites. Postoperative morbidity of complicated appendicitis was 6.4% (no. 4) and mortality was zero. <strong>Conclusion:</strong> Simple acute appendicitis is more common. Laparotomy remains the only way at present. Postoperative morbidity is high in complicated appendicitis and mortality is zero.展开更多
<strong>Aim:</strong> To analyze the practice of skin grafting in the surgery department “B” of the CHU of Point “G” in Bamako. <strong>Patients and Methods:</strong> This was a retrospecti...<strong>Aim:</strong> To analyze the practice of skin grafting in the surgery department “B” of the CHU of Point “G” in Bamako. <strong>Patients and Methods:</strong> This was a retrospective and prospective study carried out between 1980 and 2014, covering all patients who underwent a skin graft and hospitalized. It covered all patients who underwent a skin transplant and were hospitalized in the department during the study period. <strong>Result:</strong> There were 50 patients including 25 women and 25 men. The mean age was 25.2 ± 19 years. The average duration of lesion evolution was 1 year. The lesions to be grafted were located in the lower limbs in 60%. The average area of substance loss was 13.2 cm<sup>2</sup>. The indication for skin graft was asked for loss of substance following scar bridles in 40%, ulcerative-necrotic wounds of infectious or traumatic origin (32%), malignant skin tumor (14%). In pathology, there were 5 cases of malignant melanoma and 2 cases of squamous cell carcinoma. Thin skin grafting was the most used technique (62%). The postoperative follow-ups were simple in 94%. There were 3 cases of graft necrosis. The average length of hospital stay was 28 days. The esthetic result was judged satisfactory in 84% of the cases (n = 42), average in 14% of the cases (n = 7) and unsatisfactory in 2% of the cases (n = 1). The sensitivity was good in 36 patients (72%), average in 12 patients (24%) and poor in 2 patients (4%). <strong>Conclusion:</strong> They mainly affect young people. The reduction of accidents on the public highway, good management of burn injuries, wounds and good hygiene of the population will considerably reduce the rate of its affections.展开更多
文摘Introduction: Biometrics therefore corresponds to the measurement of the morphological elements of humans. One of the most common ultrasound requests by clinicians is the assessment of liver size. The aim of our study was to study liver biometry using ultrasound in healthy adult subjects. Material and Methods: This was a prospective, descriptive and analytical study, carried out at CHU Point-G over a period of 7 months. A liver ultrasound was performed on 100 individuals without lesions, by a doctor in his final year of specialization in radiology and medical imaging. For each subject, we determined the height and anteroposterior diameter of the right liver and the left liver. Results: The mean age was 39.05 ± 16.86 years. The body mass index (BMI) 18.5 - 24.9 group was the most represented with 58%. The mean height of the right liver was 138.40 ± 14.85 mm. It was 136.81 ± 14.70 mm in men and 139.92 ± 14.99 mm in women (P = 0.306). That of the left liver was 95.55 ± 14.34 mm, in men, it was 91.79 ± 13.51 mm and 99.16 ± 14.31 mm in women (P = 0.019). We found a significant correlation between right liver height and BMI (P = 0.013). Conclusion: The mean values of liver biometry were established in our series. There was a significant correlation between right liver height and BMI. Liver ultrasound remains a reliable technique for liver biometry.
文摘<b>Background:</b>The objective of this work was to evaluate the first results of the radio ablation of the great saphenous vein in the processing of chronic venous insufficiency. <b>Method: </b>This is a monocentric retrospective study of radio ablation of the great saphenous vein using VNUS Closure<sup>®</sup> FAST for superficial venous insufficiency of the great saphenous vein, between January 2012 and December 2014. <b>Results:</b> 42 patients (57 limbs) were operated on with this technology. There were 33 women and 9 men (mean age: 46.5 years). Thirty-nine patients (92. 8%) were symptomatic. Thirty-two patients (76.1%) were classified CEAP 2. The average diameter of the saphenous vein was 8.5 ± 1.5 mm. Three patients (7.1%) had a percutaneous approach. A perfect occlusion of the saphenous vein was observed in all patients. No incident or undesirable event was observed during the procedure. One case of delayed deep-vein thrombosis was observed. At one month of follow-up, six patients (14.2%) had induration opposite to the occluded vein. Forty-three percent of the pati<span style="letter-spacing:-0.1pt;">ents stated they were very satisfied with the procedure. <b>Conclusion:</b> The effectiveness, security and simplicity of the closure method are real. More studies are necessary to assess the long-term results of this procedure.</span>
文摘Aim: This paper aims to evaluate the epidemiological and pathological aspects of stomach cancer at Koutiala District Hospital. Methods: This was a retrospective study carried out in the General Surgery Department of the Koutiala District Hospital Health Centre. The records of patients admitted for stomach cancer in the period from August 1, 2017 to December 31, 2022 were collected. Patients who underwent surgery for stomach cancer were included in the study. Patients who had not undergone surgery were excluded. Results: We collected records from 40 patients operated on for stomach cancer. The median age was 58.4 years ± 5.7. Men were in the majority with 72.5% The sex ratio was 2.6. The incidence rate of stomach cancer in the general population in the circle was 4.9 cases per 100,000 population. Patients had a history of gastric ulcer in 90%, Helicobacter pylori infection in 47.5% and a notion of excessive salt consumption in 47.5%. The median duration of disease progression was 5 years ± 2.3. The seat was antro-pyloric in 77.5%. The cancer was ulcerative budding in 23 patients. Adenocarcinoma was the histological type in all patients. The cancer was classified as stage III in 30 cases and stage IV in 10 cases. Palliative surgical treatment was the most performed (47.5%). Postoperative morbidity was 15% and mortality was 42.5% at one year. Conclusion: Stomach cancer is common in the ward. Most patients consult at the stage of metastasis. Palliative surgery remains the most practical. Postoperative morbidity and mortality is very high.
文摘Purpose: This paper aims to assess the incidences and risk factors for surgical site (ISO) infections in the general surgery department of the Koutiala District Hospital. Patients and Methods: This was a prospective and descriptive study from August 1, 2017 to October 31, 2020 involving all patients who underwent laparotomy in the general surgery department of the Koutiala District Hospital. Patients who were not operated on and who did not have a laparotomy were not included. Age, sex, frequency, patient history, National Nosocomial Infections Surveillance (NNIS) index, time to occur, bacteriological test results and course of infection were analyzed. Results: Fifty patients were registered. The average age was 34.2 ± 21.2 years old. Eleven patients were 60 years old or older. The hospital incidence rate was 4.3% and the community incidence rate was 6.1 cases per 100,000 population. The concept of smoking was noted in 15 patients. Patients were operated on in emergency 84% of cases. Peritonitis was the most common initial lesion with 32% of cases. Our patients had an NNIS index greater than 0 in 84% of cases. The time to develop infection from the surgical site was less than 3 days in 8 patients (16% of cases). Depending on the depth of the infection, it was superficial (cutaneous) in 39 patients (78%) and deep (subcutaneous and organic) in 11 patients (22%). Escherichia coli was the most common germ with 72% followed by staphylococcus aureus at 24%. We noted 22% morbidity. The median length of hospitalization was 9 ± 2.2 days. Conclusion: ISO is common in our service. Prevention and mastery require knowledge of risk factors.
文摘The left para-duodenal internal hernia, whose origin is generally embryological, is a rare etiology of intestinal obstruction found mainly in young adults. We report here the case of acute intestinal obstruction by left para-duodenal internal hernia in a 36-year-old young man. It was a patient who consulted urgently for occlusive syndrome with cessation of materials and gases. Abdominal percussion noted abdominal tympanism and pre-hepatic dullness was preserved. The flow and icicle signs were negative. Palpation did not objectify hepatosplenomegaly and did not find any organomegaly either. On the other hand, she found an epigastric defense. The abdominal X-ray without preparation showed water levels that were wider than high, hail-like. We performed a median above and below umbilical laparotomy and intraoperatively, it was an internal hernia with incarceration of small loops in a voluminous left paraduodenal sac of 12 cm. They were not necrotic and quickly recolored after extrication. We resected the hernial sac and closed the hernial orifice with separate stitches with absorbable suture 0. The postoperative course was simple. The patient was discharged from the hospital on the 4th postoperative day. After 18 months of hindsight, he is doing well.
文摘CHU (University Hospital Center) Point G: The department of surgery B is a surgical department of CHU Point G. The department is par excellence a reference department for cases of visceral surgery, cancer surgery, cardiovascular surgery, plastic and endocrinology surgery. As a reminder, the CHU Point G is the largest 3rd level referral hospital in Mali. <b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> To study the environmental risk factors of stomach cancer in the B surgery department of the Point G University Hospital in Bamako. </span><b><span style="font-family:Verdana;">Patients and Methods:</span></b><span style="font-family:Verdana;"> We performed a cross-sectional study with retrospective collection from January 2008 to June 2018 (126 months). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We have identified 380 cases of digestive cancer, including 193 cases of stomach cancer </span><span style="font-family:Verdana;">o</span><span style="font-family:;" "=""><span style="font-family:Verdana;">r 50.79% of digestive cancers. The mean age of the patients was 57.21 ± 13 years. Male sex represented 55% (n = 106). Eating habits were dominated by the consumption of t<span style="font-family:Verdana, Helvetica, Arial;white-space:normal;background-color:#FFFFFF;">ô</span> with potash (cereal paste) with 64.76% (n = 185). The main methods of preserving meat and fish were curing and smoking with 57.51% (n = 111). Chronic smoking was found in 24.35% (n = 47), alcohol + tobacco consumption in 2.59% (n = 5). The low socio-economic class represented 126 cases or 65.38%. Housewives and cultivators were respectively 37.82% (n = 73) and 227.97% (n = 54). 20.20% (n = 39) had a history of epigastric pain. Epigastralgia was the most common functional sign with 84.5% of cases (n = 169). An epigastric mass was found in 72 patients or 37.3%. Adenocarcinoma represented 97.4% (n = 188). Palliative surgery concerned the majority of ou
文摘<strong>History:</strong> In Mali, several studies have been carried out on acute peritonitis but in the Koutiala circle it is a first. <strong>Aim:</strong> To evaluate the epidemiological, etiological and therapeutic aspects of generalized acute peritonitis at the Koutiala reference health center. <strong>Method:</strong> This was a 14-month prospective and descriptive study from August 1, 2017 to November 30, 2019, covering all patients admitted and operated for generalized acute peritonitis. The parameters studied were age, sex, frequency, clinical aspects, etiologies, treatment and postoperative operations. <strong>Result:</strong> The number was 93 cases, 72 men and 21 women. The average age was 34.2 years (Extremes: 2 - 75 years). The hospital frequency was 2.0%. The incidence rate of generalized acute peritonitis in the circle was 12.4 cases per 100,000 population. The clinical picture was still of peritonitis. The Widal-Félix serology was positive in 19 cases. Perioperative bacteriological sampling was systematic. The etiologies were dominated by digestive perforations in 81 cases (87%) of which 33 were located at the ileal level, postoperative peritonitis (6 cases) and ruptured pyocholecyst (2 cases). There were also 3 cases of primary peritonitis and 1 case of gynecological peritonitis. Excision-suturing was the most used surgical technique with 35.5% (n = 33). Postoperatively, we identified 10 cases of parietal suppuration (10.8%), 6 cases of postoperative peritonitis (6.5%), 2 cases of external digestive fistula (2.2%) and 7 cases of death (7.5%). <strong>Conclusion:</strong> Acute peritonitis occupies second place in abdominal surgical emergencies in the Koutiala circle. The etiologies are multiple and varied and are dominated by the ileal perforation which is secondary to typhoid fever more often. In most cases the surgical treatment is done by excision-suturing of the perforation. Mortality and morbidity remain high.
文摘<strong>Aim:</strong> To assess the epidemiological profile of intestinal obstructions at the Koutiala district hospital. <strong>Patients and Method:</strong> This was a prospective and descriptive study taking place from August 1, 2017 to April 30, 2020. The files of patients with acute intestinal obstruction in the general surgery department of the Koutiala district hospital were collected. In this study, patients operated on for acute intestinal obstruction were included. Non-operated patients were not included in the study. <strong>Result:</strong> The records of 65 patients operated on for acute intestinal obstruction were collected. The mean age was 32 ± 22 with extremes of 1 year and 94 years. 7 infants (10.8%) and 1 4-year-old child (1.5%) were identified. The 16 to 59 age group was more common. Males were the majority with 70.8% (n = 46). The sex ratio was 2.4. The rate of bowel obstruction in the general population in the circle was 8.1 cases per 100,000 population. According to provenance, patients came from inside the circle (rural areas) in 87.7% of the cases (n = 57) and from the city of Koutiala in 12.3% (n = 8). 33.9% of our patients had undergone laparotomy (n = 22). Patients consulted urgently in 93.8%. The etiologies are dominated by post-operative straps (33.8%) and volvulus (24.6%). We noted 12 cases of intestinal necrosis. Postoperative morbidity was 13.8% of cases (n = 9) and mortality of 6.1% of cases (n = 4). <strong>Conclusion:</strong> Bowel obstruction is one of the most frequent surgical emergencies in our circle. They most often affect young subjects and young adult males. The etiologies are dominated by the post-operative flanges. Complications remain elevated.
文摘<strong>Purpose:</strong> To assess the epidemiological, clinical and therapeutic aspects of acute appendicitis at the Koutiala Reference Health Centre. <strong>Methods:</strong> This was a prospective study conducted in the general surgery department of the Koutiala Reference Health Centre. Patient records admitted for simple and complicated appendicitis during the period from August 1, 2017 to August 31, 2018 have been collected. Patients operated on for simple and complicated acute appendicitis were included in the study. Patients who did not have surgery were excluded. <strong>Results:</strong> We collected records of 62 patients who had surgery for simple and complicated acute appendicitis. They accounted for 11.9% of surgical procedures (n-520) and 27.3% (n-227) of surgical emergencies. The average age was 33.1 years-15.7. Men were in the majority with 72.5%. Simple acute appendicitis accounted for 56.4% of cases (n-35) and complicated appendicitis 43.6% of cases (these were 16 cases of appendicular peritonitis, 09 cases of appendicular abscess and 02 cases of appendicular plastron). Therapeutically, appendectomy was performed in 58 patients. In 4 patients the appendix was completely necrotized. The average length of hospitalization was 3.3 days-0.8 for single acute appendicites and 6 days-2.7 for complicated appendicites. Postoperative morbidity of complicated appendicitis was 6.4% (no. 4) and mortality was zero. <strong>Conclusion:</strong> Simple acute appendicitis is more common. Laparotomy remains the only way at present. Postoperative morbidity is high in complicated appendicitis and mortality is zero.
文摘<strong>Aim:</strong> To analyze the practice of skin grafting in the surgery department “B” of the CHU of Point “G” in Bamako. <strong>Patients and Methods:</strong> This was a retrospective and prospective study carried out between 1980 and 2014, covering all patients who underwent a skin graft and hospitalized. It covered all patients who underwent a skin transplant and were hospitalized in the department during the study period. <strong>Result:</strong> There were 50 patients including 25 women and 25 men. The mean age was 25.2 ± 19 years. The average duration of lesion evolution was 1 year. The lesions to be grafted were located in the lower limbs in 60%. The average area of substance loss was 13.2 cm<sup>2</sup>. The indication for skin graft was asked for loss of substance following scar bridles in 40%, ulcerative-necrotic wounds of infectious or traumatic origin (32%), malignant skin tumor (14%). In pathology, there were 5 cases of malignant melanoma and 2 cases of squamous cell carcinoma. Thin skin grafting was the most used technique (62%). The postoperative follow-ups were simple in 94%. There were 3 cases of graft necrosis. The average length of hospital stay was 28 days. The esthetic result was judged satisfactory in 84% of the cases (n = 42), average in 14% of the cases (n = 7) and unsatisfactory in 2% of the cases (n = 1). The sensitivity was good in 36 patients (72%), average in 12 patients (24%) and poor in 2 patients (4%). <strong>Conclusion:</strong> They mainly affect young people. The reduction of accidents on the public highway, good management of burn injuries, wounds and good hygiene of the population will considerably reduce the rate of its affections.
