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Relevance of Medical Imaging in the Pre-Therapeutic Evaluation of Acute Intestinal Obstruction at CIMED

Open Journal of Medical Imaging 2024年第1期14卷 31-41页

作者： Mamoudou Camara aly mampan k.undouno Siré Nabe Toumin Camara Ousmane Aminata Bah Center for Medical Imaging Exploration and Diagnostics University of Conakry Conakry Guinea General Surgery Department of the kankan Regional Hospital Kankan Guinea Ministry of Health and Public Hygiene Conakry Guinea General Medicine Department of the Siguiri Prefectural Hospital Siguiri Guinea CIRA Conakry Guinea

Objective: We initiated this work with the aim of studying the contribution of imaging in the diagnosis of acute intestinal obstruction at CIMED. Patients and methods: This was a prospective, descriptive and analytical study involving 96 patients collected at the radiology and medical imaging department of CIMED, from January 2022 to January 2023. Result: The age of our patients varied between 11 and 86 years with an average age of 36 years. There was a male predominance of 64.6% compared to 35.4% for women, i.e. a sex ratio of 1.82. The notion of previous surgery was found in 61.5% of our patients. Pain was present in all patients. Radiography of the ASP was performed in 89.6% of patients. It showed hydro-aerial levels in 96.5% of patients. Abdominopelvic CT was performed in 12 patients and made it possible to make the diagnosis of occlusion in all patients. The results of the positive diagnosis were concordant with those intraoperatively in 92% of cases. 8% of our patients, compared to the treatment, spontaneously resumed their transit, 91% benefited from surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients or 83.3%, poor with death in 16 patients or 16.7% of cases. Conclusion: Acute intestinal obstruction remains a serious pathology for which ASP radiography often remains the only radiological examination performed urgently. However, abdominopelvic CT seems widely indicated thanks to its contribution both for the positive diagnosis and for the serious and etiological diagnoses. However, this imaging technique is largely underused in our practice due to its high cost and lack of availability.

关键词： Imaging Acute Intestinal Obstruction CIMED

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Right Diaphragmatic Rupture with Passage of an Intrathoracic Ileal Segment Apropos of a Case and Review of the Literature at the kankan Regional Hospital

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Open Journal of Internal Medicine 2023年第2期13卷 126-130页

作者： aly mampan k.undouno Saikou Yaya Diakite Saa Yawo kondano Fodé Lansana Camara Labilé Togba Soumaoro Soryba Naby Camara Abdoulaye korsé Balde Hamidou Sylla Aissatou Taran Diallo Moussa Doumbouya Aboubacar Toure Visceral and Digestive Surgery at the kankan Regional Hospital Kankan Guinea General Surgery at the Ignace Deen National Hospital Conakry Guinea Visceral and Digestive Surgery at the Sino-Guinean Friendship Hospital Conakry Guinea

Traumatic rupture of the right diaphragmatic dome with herniation of a segment of the hail into the thorax is a rare lesion. It is often the result of a thoraco-abdominal trauma. It can generally lead to early or late cardiopulmonary complications due to compression. The objective of this clinical case is to study the physiopathological mechanisms, the diagnostic and therapeutic modalities of this complication. The diagnosis is often difficult in front of a diaphragmatic rupture since there are no specific clinical signs. In our case, the clinical picture on arrival was that of a high occlusion in an immediate postoperative context. The X-ray which makes it possible to visualize the ascended organs but more difficultly the rupture itself could not be carried out. Treatment is essentially surgical. Although the thoracic approach is preferred by several surgeons because of the difficulties of exposing the diaphragm in the presence of the liver, we chose the abdominal approach instead. The postoperative course is made up of parietal suppuration.

关键词： Rupture Diaphragmatic Intrathoracic Ileal Segment

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Intestinal Resection: Indications and Prognostic Factors at the General Surgery Department of kankan Regional Hospital

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Surgical Science 2024年第11期15卷 588-597页

作者： k.undouno aly mampan Fofana Housein Bah Mamadou Foinké k.undouno Saa Amadou Leno Tamba keita Lancinè Fanta koivogui Yaraboye Camara Sékou Tiguidan k.undouno Samuel Sanoh Lamine Doumbouya Moussa Cherif Mamady Sacko Mamoudou Sano Amara Thiam Mohamed Department of Surgery Kankan Regional Hospital Kankan Guinea Department of General Surgery Ignace Deen National Hospital CHU of Conakry Conakry Guinea Department of General Surgery Conakry Military Hospital Conakry Guinea The Nelson Mandla Health School in Matoto Conakry Guinea Department of Maternity Kankan Regional Hospital Kankan Guinea

Introduction: Intestinal resection is the disconnection or removal of part of the intestine with its meso. The aim was to describe the indications and prognostic factors for intestinal resections at the surgical department of kankan Regional Hospital. Patients and Methods: This was a retrospective descriptive study covering the files of patients who had undergone intestinal resections in the surgery department of the kankan regional hospital over a period of 4 years from 1st January 2019 to December 31, 2022. Results: We collected 164 cases of intestinal resection representing 4.19% of all surgical procedures. (N = 3909). The average age of our patients was 37.78 years with extremes of 1 and 90 years. The male gender was predominant (64.6%) and the sex ratio was 1.8. The majority of patients consulted after 72 hours. Acute intestinal obstruction was the pathology motivating the most intestinal resection 42.90% followed by acute peritonitis 33%, digestive fistula 4.3%, tumors 3.6% and wounds 2.4%. Intestinal necrosis with 91 cases (56.5%) constituted the first indication for resection in our study followed by intestinal perforations 41 cases (24.9%). We performed an anastomotic resection of the small intestine in 70 cases (42.9%), an ileostomy in 4 cases (2.4%), a right hemi colectomy in 26 cases (15.9%), a left hemi colectomy in 2 cases (1.2%), segmental colectomy plus immediate anastomosis in 57 cases (34.2%) and 5 cases of colostomy. We recorded 48 deaths (29.3%). Conclusion: Intestinal resection is a common procedure in our context. These indications are multiple. An improvement in the prognosis should be achieved by reducing the diagnostic and treatment time associated with the training of surgical staff.

关键词： Intestinal Resection Anastomosis Indication Mortality

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