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Small Bowel Obstruction Induced by Phytobezoar: A Case Report in Innocent Abdomen and Literature Review

Surgical Science 2021年第6期12卷 187-195页

作者： Bréhima Traoré Djibril Traoré Modibo Coulibaly Oumar Guindo Abdoulaye Traoré Fodé Mory Keita Kiffery Ibrahim Keita Korotimi Mallé Pierre Coulibaly aly boubacar diallo Dramane Cissé Dramane Samaké Pierre A. Togo Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Anesthesia and Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclique des Armées de Kati Koulikoro Mali Department of Gynecology and Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery H&ocirc pital Régional de Sikasso Sikasso Mali Department of Medicine H&ocirc pital Sominé DOLO de Mopti Mopti Mali Faculty of Medicine and Odonto Stomatology University of Sciences Technics and Technologies de Bamako Bamako Mali

Introduction: Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. Herein, we report a case of small bowel obstruction (SBO) following excessive consumption of wild grapes with no previous abdomen medical or surgical history. Presentation of case: A 65-year-old male farmer presented with cessation of materials and gas associated with vomiting of food and then bilious. The abdomen was bloated and painful on palpation with a moving, painful mass in the left iliac fossa. The hypothesis of acute occlusion of the colon was retained and confirmed on the X-Ray which showed a dilation of small bowel with air-fluid levels. The diagnostic of acute SBO was retained. We performed urgently a median laparotomy. We found the dilation of the loops from the jejunum to the sigmoid colon with a compact mass at the sigmoid colon of 15 cm in length and 6 cm in diameter. We proceeded to crush the mass that was made up with wild grape seed fecal, and push it back to the rectum. The phytobezoar made up with wild grape seeds was extracted through the anus with the fingers after anal dilation. After extraction of the bezoar, the patient’s complaints completely subsided. Discussion: SBO is a frequent emergency surgical pathology. SBO induced by phytobezoar often occurs in patients with abdomen surgery history. However, it is particularly rare in virgin abdomen. Conclusion: This case report aims to raise awareness of phytobezoar as a cause of SBO in elderly even though without abdomen surgery history.

关键词： Small Bowel Obstruction Phytobezoars Innocent Abdomen

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Small Bowel Obstruction: Epidemiological, Clinical and Therapeutic Aspects in the General Surgery Department of Hôpital SominéDOLO de Mopti

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Surgical Science 2021年第6期12卷 196-203页

作者： Bréhima Traoré Modibo Coulibaly Djibril Traoré Oumar Guindo Fodé Mory Keita Nouhoum Samassekou Abdoulaye Traoré Souleymane Sanogo Korotimi Mallé Kiffery Ibrahim Keita Pierre Coulibaly aly boubacar diallo Dramane Cissé Dramane Samaké Lassana Kanté Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclinique des armées Kati Mali Department of Anesthesia-Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Medical Imagery CHU Luxembourg Bamako Mali Department of Gynecology-Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery H&ocirc pital de Sikasso Sikasso Mali Department of Medicine H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery of CHU du Point-G Bamako Mali

Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. We report an observational study which aims to describe the epidemiological, clinical and therapeutic aspects of small bowel obstruction. This study was carried out in the General Surgery Department of Hôpital Sominé DOLO de Mopti from October 1, 2016 to October 1, 2018. A total of 114 patients were recorded for whom the diagnosis was related to an occlusion. The median age was 37 years with extremes ranging from 6 months to 90 years. Male sex was predominant with a sex-ratio of 1.8. The frequency of small bowel occlusions over all occlusions was 74.03%. The most encountered clinical signs were as followed: abdominal pain (100%), vomiting (88.6%), cessation of materials and gas (79.9%) and meteorism (62.3%). All patients underwent medical imaging, the most common of which was an abdomen without preparation X-ray (AWP). On the etiological level, the main causes found postoperatively were: flanges and adhesion (55.2%), strangulated hernias (28.0%), acute intussusception (6.1%), small bowel volvulus (3.5%) and small bowel tumor (1.6%). Releasing the bridles was the most common surgery process (28.0%). The morbidity of the immediate follow-up was (13.1%) and the mortality was (7.0%). This high mortality is due to ignorance of the signs of seriousness and the socio-cultural barrier (decision of the patriarch to agree to a surgical intervention), the late use of hospital facility and the limited financial capability of the patients.

关键词： Occlusions of the Small Intestine Etiology Surgical Treatment Hôpital Sominé DOLO de Mopti

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Splenectomy: Indications in the General Surgery Department of Ignace Deen Hospital

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Surgical Science 2024年第4期15卷 219-224页

作者： Mamadou Sakoba Barry boubacar Barry Sandaly Diakité Aboubacar Touré Aissatou Taran diallo General Surgery Department Ignace Deen National Hospital at Conakry University Hospital Conakry Guinea Faculty of Health Sciences and Technology Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: Splenectomy is the surgical removal of the spleen. It can be performed during various pathologies, ranging from abdominal trauma to hemoglobinopathies. The progress made in the knowledge of the immune functions of the spleen and the fear of post-splenectomy infectious complications have favored the development of surgical or non-surgical splenic preservation techniques calling into question the dogma of splenectomy. The aim of this study was to determine the indications for splenectomy. Methodology: This was a retrospective, descriptive study lasting 5 years in the general surgery department of the Ignace Deen National Hospital. All files of splenectomized patients were included, our variables were clinical, therapeutic and progressive. Results: We collected 42 cases of splenectomies out of the 2478 surgical procedures performed, representing 1.7% of the department’s surgical activities. The average age was 44 years. The age group of 41 to 50 years was the most represented, i.e. 26% (n = 11) of cases. Sex ratio = 1. Abdominal pain was the reason for consultation in patients, i.e. 100% (n = 42) of cases. The antecedents were dominated by recurrent malaria with 52.3% (n = 22) of cases, then recurrent anemia in 21% (n = 9), and 16.7% (n = 7) had sickle cell disease. Splenomegaly was found in 31 patients, or 73.6%. Ultrasound was performed in all patients. The indications for splenectomy were: isolated splenomegaly with risk of rupture (38%, n = 16), hypersplenism (26%, n = 11) and trauma to the spleen (19.04%, n = 8). Total splenectomy was performed in all cases. The surgical consequences were favorable in 85.7%, (n = 36) with morbidity of 14% (n = 6) and mortality of 9.52% (n = 4). The average length of hospitalization was 10.4 days with extremes of 1 and 22 days. Conclusion: Splenectomy constitutes a relatively common surgical procedure in our context. The indications for splenectomy were isolated splenomegaly with risk of rupture, hypersplenism and tra

关键词： Splenectomy Indications Ignace Deen

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Ruptured Ectopic Pregnancy: Epidemiology and Management in the General Surgery Department of the Ignace Deen National Hospital, Conakry University Hospital

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 503-508页

作者： Barry Mamadou Sakoba Barry boubacar Guirassy Mariam Touré Aboubacar diallo Aissatou Taran Department of General Surgery Ignace Deen National Hospital/Conakry University Hospital Conakry Guinea Faculty of Health Sciences and Technology Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: The aim of this study was to contribute to improving the quality of GEUR management in the general surgery department and in the maternity ward of the Ignace Deen national hospital, Conakry University Hospital. Methodology: This was a retrospective, descriptive study lasting two years (January 1, 2020 to December 31, 2022), carried out in the general surgery and gyneco-obstetrics departments of the Ignace Deen national hospital, Conakry University Hospital. We included all patients with a ruptured ectopic pregnancy who received surgical treatment during the study period. Results: We collected 13,524 cases of surgical interventions in the two services, among them, we recorded 89 cases or 0.66% GEUR. The average age of the patients was 24.26 years. Brides were the most represented with 80.96% of cases. Women practicing a liberal profession were 51.69% (n = 46) and housewives 26.97% (n = 24). Clinically, amenorrhea was noted in all patients, i.e. 100%, abdominal-pelvic pain in 95.2% (n = 85) of cases, metrorrhagia in 94.08% (n = 84), abdominal-pelvic sensitivity in 97.44% (n = 87) of cases and anemia in 85.39% of cases. The GEUR was ampullary in 69.66% (n = 62) cases. Salpingectomy was performed in 90.72% (n = 81). The surgical outcomes were satisfactory in 98.87% (n = 88) of cases. We recorded one case of surgical site infection. We have not recorded any deaths. The average length of hospitalization was 4 days. Conclusion: GEUR is relatively high in our context. A good understanding of the prognostic factors of GEUR, awareness and family planning could reduce GEUR.

关键词： Ruptured Ectopic Pregnancy Epidemiology and Management

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Thyroidectomy: Frequency and Indications in the General Surgery Department of the Hôpital National Ignace Deen/CHU de Conakry

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第3期13卷 157-167页

作者： Mamadou Sakoba Barry Mamadou Mouctar Ramata diallo Houssein Fofana Vignin Baudouin Kpossou boubacar Barry Aboubacar Touré Aissatou Taran diallo General Surgery Department H&#244pital National Ignace Deen/CHU de Conakry Conakry Guinea Faculté des Sciences and Techniques de la Sant&#233-Universit&#233 Gamal Abdel Nasser de Conakry Conakry Guinea ENT Department Mamou Regional Hospital Mamou Guinea

Introduction: Thyroidectomy is a surgical procedure to remove all or part of the thyroid gland. The aim of this study was to report the results of thyroidectomy in the general surgery department of the Hôpital national Ignace Deen/CHU de Conakry. Methodology: This was a retrospective study, of seven (07) years (January 1, 2016 - August 31, 2023), in the General Surgery Department of the Ignace Deen National Hospital-CHU in Conakry. We included all records of patients admitted and operated on for thyroidectomy and with up-to-date medical records. The variables were epidemiological, clinical and therapeutic. Results: During the study period, we recorded 3221 cases of surgery, including 40 thyroidectomies (1.24% of cases). The average age was 42.4 years. Women were the most represented, with a sex ratio of 0.16. The reason for consultation was anterior cervical swelling in 86% (n = 25) of cases, followed by signs of cervical compression 21% (n = 6) and signs of thyrotoxicosis 31% (n = 9). Indications for thyroidectomy were dominated by homogeneous goitres in 69% (n = 20) of cases, basedow’s disease in 20.7% (n = 6) and nodular goitres in 6.9% (n = 2) of cases. The surgical procedures were lobo-isthmectomies in 72.4% (n = 21), subtotal thyroidectomies 13.8% (n = 4), total thyroidectomies 10.3% (n = 3). Postoperative follow-up was straightforward in 69% (n = 20). Complications included haemorrhage in 20.7% (n = 6) and recurrence in 6.9% (n = 2). The average hospital stay was 7 days. Conclusion: Thyroidectomy is a relatively frequent surgical procedure in our department. Indications are dominated by homogeneous goitres. Morbidity is related to hemorrhage. Rigorous hemostasis could improve the quality of thyroidectomy.

关键词： Thyroidectomy Indication Ignace Deen

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Unusual Brain Trauma Injury

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Open Journal of Modern Neurosurgery 2024年第3期14卷 218-227页

作者： diallo Moussa Traoré Youssouf Kanikomo Drissa Diarra Sounkalo Izoudine B. Koumaré Sogoba Youssouf Sogoba boubacar diallo Oumar Gabriel Tour Teatching Hospital Bamako Mali Bocar Sidy Sall Teatching Hospital Kati Mali Hopital du Mali Teaching Hospital Bamako Mali

Unusual head trauma is rare with various mechanisms of occurrence. The injuries can be similar to those of road accidents but sometimes with significant complexities. The objective was to determine the frequency of this pathology in our practice, describe the different mechanisms and report the craniocerebral lesions caused by this type of trauma. Materials and Method: This was a descriptive study with retrospective collection spread over a period of 3 years. After selecting the files, the patients and/or their companions were contacted by telephone to inquire about them and then returned to the consultation for reassessment. Disease history and information were obtained from patients’ medical records. Result: The frequency of this pathology was 1.78% and his incidence was 0.4 cases per month. The average age of the patients was 13.47 years. All the victims were male. 41.17% of patients were in school. The mechanisms of trauma were the hoof blow 47.1%, the horn blow 29.4% and the stone blow 11.7% respectively. 23.5% of patients were confused and 11.7% children were in coma. One patient presented an anisocoria. The motor deficit was present in 5 cases. CT-scan made it possible to highlight a skull depressing fracture 58.8% and confirm a craniocerebral wound in 35.3%. The average time between patient admission to hospital and completion of surgery was 24.5 hours. The surgery had consisted of the trimming of cranio-cerebral wounds, exploration, duroplasty and lifting of skull depressing fracture. After 15 months of follow-up, the evolution was favorable in 53.3%, the morbidity was 33.4% and the mortality 17.6%. Conclusion: These are rare but serious conditions because they are fatal and disabling. An early and multidisciplinary management can hope to have a good favorable.

关键词： Brain Trauma Injury Insolite Unusual Skull Depressing Fracture Hoof Kick Horn Blows Stone Bows Motorcycle Gear Lever

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Management of Acute Bowel Obstruction in Adults in Ziguinchor Hospital Establishments: About 163 Cases Followed Up

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Surgical Science 2024年第4期15卷 207-218页

作者： Omar Sow Cheikh H. Badji Mouhamed Dieng Reymond Seydi Aissata diallo Cheikh Diouf Papa A. Ba boubacar Fall Department of General Surgery Peace Hospital Assane Seck University of Ziguinchor Ziguinchor Senegal Department of General Surgery Central Regional Hospital of Ziguinchor Assane Seck University of Ziguinchor Ziguinchor Senegal Department of General Surgery University of Iba Der Thiam Thies Senegal

Acute intestinal obstruction represents a very frequent admission to surgical emergencies. The aim of our study was to make a descriptive analysis of the management of acute intestinal obstructions at the level of hospital establishments in Ziguinchor. Materials and Methods: This was a retrospective, descriptive, multicenter study from the period of January 1, 2017 to December 31, 2021. Patients over 15 years of age admitted for occlusive syndrome in the two surgical departments of the Ziguinchor regional hospitals were included in the study. Epidemiological, diagnostic, therapeutic and evolutionary data were studied. Results: Acute intestinal occlusions accounted for 8.3% of admissions. A total of 163 patients were enrolled, 61.9% were men, sex ratio of 1.6. The mean age was 48.7 years. The average consultation time was 74.8 hours (3.12 days). The total occlusive syndrome was in 48.5% of the cases. Abdominal pain was present in 87.1%, vomiting in 74.2%, cessation of matter and gas in 60.7% and meteorism in 36.2%. Biological lab tests reported hyperleukocytosis in 28.1% of the cases. Abdominal CT scans were performed in 71.2%, confirming the diagnosis in 90.5% and determining the etiology in 93.1%. The zone of the obstruction in the small bowel was 62.7%, and in the colon in 37.3%. Functional occlusions accounted for 22.7% of cases and mechanical for 77.3%, including 120 cases of strangulation occlusion (95.2%) and 6 cases of obstruction. Etiologies were dominated by adhesions and/or fibrous bands (61.2%). Medical treatment resolved the occlusive syndrome in 9.2% of cases, instrumental treatment in 17.1% and surgical treatment in 77.3%. Adhesiolysis/section of fibrous bands (55.7%), detorsion (14.3%) and resection anastomosis (11.9%) were the most common surgical procedures. Overall morbidity was 11.6%, dominated by surgical site infection (7.14%). The mean resumption of intestinal transit was 2.7 days, and the mean hospital stay was 7.9 days. Overall mortality was

关键词： Intestinal Obstruction Emergency Surgery Ziguinchor

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Traumatic Digestive Perforation in the Hospital of Sikasso: Epidemio-Clinical and Therapeutic Aspects

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Surgical Science 2023年第6期14卷 405-413页

作者： Moussa Diassana Bathio Traoré aly boubacar diallo Mamadou Bernad Coulibaly Doh Sylla Amadou Maiga Aboubacar Karambé Amadou Bah Aboubacar Yoro Sidibé Layes Touré Ternan Traoré Ousmane Dembelé Salif Traoré Moussa Kanté Mamadou Sangaré Kokoroba Sidibé Youssouf Diakité Mahamadou Coulibaly Moro Sidibé Soumaila Alama Traoré Moussa Samaké Nana Kadidia Fofana Bakary Tientigui Dembélé General Surgery Department of the Sikasso Hospital Sikasso Mali General Surgery Department CHU Gabriel-Touré Bamako Mali Traumatology Department of the Sikasso Hospital Sikasso Mali Urology Department of the Sikasso Hospital Sikasso Mali Anesthesia and Resuscitation Department of the Sikasso Hospital Sikasso Mali Odontostomatology Department Sikasso Hospital Sikasso Mali Surgery Department Koutiala Reference Center Koutiala Mlai Ophthalmology Department Sikasso Hospital Sikasso Mali Gyneco-Obstetrics Department Sikasso Mali Surgery Department Bamako District Hospital Bamako Mali Commune IV District Hospital Bamako Mali

Traumatic digestive perforation is the pathological opening of the wall of a hollow organ of the digestive tract (esophagus, stomach, small intestine, large intestine, rectum, and extrahepatic bile ducts) following trauma. Injuries to the digestive viscera, especially from trauma, have been known since antiquity. Aristotle recognized that a slight blow can cause an intestinal injury. Perforation of a hollow organ of the digestive sphere results in peritonitis, which in this case is the consequence of an infection of the peritoneal cavity by spreading of the digestive contents. The aim of the work was to describe the epidemiological, clinical and therapeutic aspects of traumatic digestive perforation. Patients and method: The study was retrospective and descriptive from January 1, 2016 to December 31, 2020, in the general surgery department of the hospital of Sikasso (Mali). Patients operated for traumatic digestive perforation were included. Results: The clinical records of 42 patients were collected. Traumatic digestive perforations represented 12.3% of patients hospitalized for abdominal trauma. The average age of the patients was 26.6 years, with a sex ratio of 6:1. The most frequent etiology was road traffic accidents with 38% of patients. The average delay of consultation was 5 days. Abdominal pain was present in 38 patients, vomiting in 17 patients. On physical examination, the most frequent signs were abdominal contracture in 61.9% of patients, and disappearance of pre-hepatic dullness in 54.7% of patients. On rectal examination, the douglas was bulging and painful in 21 patients. X-ray of the abdomen without preparation showed pneumoperitoneum in 54.1% of patients. Excision, suture and peritoneal lavage were performed in 31 patients. The postoperative course was marked by parietal suppurations in 5 patients, a digestive fistula in 2 patients and 4 cases of death (9.5%). Conclusion: Traumatic digestive perforation is a frequent pathology in surgery. Road acci

关键词： Perforation Digestive Traumatic Sikasso (Mali)

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Osgood Schlatter Disease: Study of 2 Observations in Conakry, Guinea

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第2期14卷 77-83页

作者： Adama Bah Laetitia Cynthia Abandazegoue Andjembe Abdoulaye Barry Mamadou Lamine diallo Moustapha Niasse aly Badra Kamissoko Rheumatology Department Ignace Deen Hospital Conakry Conakry Guin&#233e Rheumatology Department CHU Aristide Le Dantec of Dakar Dakar S&#233n&#233gal Department of Rhumatology Sylvanus Olypio University Hospital Lom&#233 Lom&#233 Togo

Introduction: OSD is a growth osteochondrosis affecting the apophyseal cartilage of the anterior tibial tuberosity of the knee, 20 to 30% of young growing athletes suffer from this pathology, described by Osgood and Schlatter in 1903. Objective: To report 2 observations and review the literature. Observation 1: This was a 14-year-old Guinean teenager, Halpoular, living in Conakry, a right-handed footballer who presented with a painful swelling of the right knee that looked mechanical, whose father had HLA B27 positive ankylosing spondylitis. X-ray of the right knee showed fragmentation of the anterior tibial tuberosities, and ossicle with edema of the patellar tendons at stage 4 according to Ehrenbord and Lagergren (1961). Thus, the disease of OSD is retained, He received 120 mg of diclofenac, 20 mg omeprazole for 1 month and the cessation of sports activity, the evolution was favorably marked by the regression of pain. Observation 2: A 16-year-old girl, initials M.L.T, Guinean, residing in Coyah (Republic of Guinea), a handball player, consulted for intense pain (VAS: 8/10) in her knees after a violent shock received when she hit the post. The physical examination found a painful, soft swelling at the anterior tibial tuberosity of the right knee, the rest of the examination was normal. The X-ray of the right knee shows fragmentation of the anterior tibial tuberosity, and ossicle with edema of the patellar tendon at stage 4 according to Ehrenbord and Lagergren 1961, thus the OSD disease is retained, the treatment instituted was 120 mg of diclofenac, the cessation of sports activity which gives a good evolution (EVA at 2/10). Conclusion: OSD is a growth osteochondrosis affecting the apophyseal cartilage of the anterior tibial tuberosity of the knee in young growing athletes, resolving at rest.

关键词： Osgood Shlatter Disease Young Athlete

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Grassland Pasture Composition and Quality in the Communes of Ziguinchor and Kolda, Senegal

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Open Journal of Ecology 2024年第9期14卷 683-705页

作者： aly diallo Saboury Ndiaye Arfang Ousmane Kemo Goudiaby Yaya Diatta Mamadou Ndao Mamadou Diamanka Gnima Manga Department of Agroforestry Faculty of Science and Technology Assane Seck University of Ziguinchor Ziguinchor Senegal

In Senegal, natural pasture plays a major role in feeding livestock. During the rainy season, herbaceous plants account for a large proportion of the fodder consumed by ruminants. In Casamance, the composition and quality of these grasses are poorly known and underexploited. In this context, the study aimed to improve the knowledge and valorisation of the herbaceous fodder of the South. Individual interviews were conducted and a questionnaire was sent to farmers living in Ziguinchor and Kolda. A floristic inventory with a phytosociological approach was also carried out. The data collected were processed using Excel and Sphinx software in order to differentiate and classify the herbaceous species eaten by the tail. The majority of respondents were Fulani (55.30%). most of whom ranged in age from 30 to 60. Livestock rearing came second (38.3%) after agriculture (40%) among the principal activities of the people surveyed. The floristic inventory identified 95 species in 68 genera and 22 families. Species of low and medium pastoral value dominate the herbaceous layer. The global rangeland quality index was 48.16% and the brute pastoral value was 54.77%. Thirteen species contributed 54.86% of the pastoral value of the grassland. The floristic composition of community rangelands showed the presence of a varied herbaceous fodder range. The combination of which will help to develop a table of nutritional values for the formation of equilibrated feed rations for farmed livestock.

关键词： Fodder Herbaceous Pasture Nutritional Assessment Livestock

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