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Ectopic Pregnancy Combined with Intra-Uterine Pregnancy with a Full-Term Live Baby: A Case Report and Review of Literature

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Case Reports in Clinical Medicine 2019年第1期8卷 29-34页

作者： Mamadou Almamy Keita Daouda Camara Abdoulaye Kanté assitan Koné Abdoulaye Diarra Bréhima Coulibaly Zoseph Koné Seydou Fané Cheick Fantamady Camara assitan traoré Bakary Danfaga Moussa Sogoba Ismaila Simaga Bakary Keita Moussa Konaré Jules Sangala Drissa traoré Nouhoum Ongoiba General Surgery Service of the Kati-Mali Reference Health Centre Kati Mali Gynecology and Obstetrics Service of the Kati-Mali Reference Health Centre Kati Mali Service of Surgery “B” of CHU Point G Bamako Mali Service of Anesthesia and Resuscitation of Reference Health Centre Kati Mali Service of Gynecology and Obstetrics of CHU-Gabriel Touré Faculty of Medicine and Odontostomatology Bamako Mali Service of Anesthesia and Resuscitation of CHU-Gabriel Touré Bamako Mali

Heterotopic pregnancy is no more a medical breakthrough. It combines intrauterine pregnancy and extra-uterine pregnancy regardless of location. We report a case of intra-uterine pregnancy associated with a ruptured abdominal ectopic pregnancy located on the pelvic colon in a 29-year-old patient, third gestation, primigravida, having a live baby and a prior history of two abortions. She has blood group O negative of Rhesus. It has been diagnosed at the stage of the rupture of ectopic pregnancy. An emergency laparotomy performed under blood transfusion has revealed heavy hemoperitoneum (1100 ml), a ruptured abdominal extra-uterine localized on the pelvic under blood transfusion and a bulging uterus. We have proceeded with the aspiration of hemoperitoneum, the ablation of the extra-uterine pregnancy and the hemostasis of the section part. The post-operative follow-up has been easy. The intra-uterine pregnancy has developed normally and has given birth to a full-term live, and healthy baby.

关键词： Heterotopic Pregnancy Diagnosis Maternal and Fetus Prognostic

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Kati Chu BSS External Genital Organ Delivery Syndrome: Inguinal Pedicle Flap Plasty

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Surgical Science 2021年第11期12卷 357-364页

作者： Koniba Keita Sidiki Keita Oulematou Coulibaly Abdoulaye Diarra Fodé Mory Keita Boubacar Kone Lassina traoré Salia Coulibaly Amadou traoré assitan Kone Amadou Kassogué Issa traoré Oumou traoré Ismael Konaré Daouda Diallo Drissa traoré Bacary T. Dembélé General Surgery Department Hospital BSS Kati Mali General Surgery “A” Department Hospital Point-G Bamako Mali Reference Health Centre of the Commune VI Bamako Mali Medical Imaging Department Hospital BSS Kati Mali General Surgery Department Hospital Gabriel Toure Bamako Mali Urology Department Hospital BSS Kati Mali Anesthesia Resuscitation Department Hospital BSS Kati Mali General Surgery “B” Department Hospital Point-G Bamako Mali

Fournier’s syndrome is a poly microbial necrotizing fasciitis, of severe evolution of the perineum and external genitals. Objectives: We report the experience of the service in the management of Fournier gangrene of the external genital organs by inguinal flap pediculated in front of the loss of significant substances of the scrotum. Patients and method: This was a mono-centric retrospective study from January 2008 to August 2021 in the General Surgery Department of the Bocar Sidi Sall University Hospital (CHU BSS) in Kati. It focused on patients treated for Fournier gangrene of external genitals. The variables studied were age, sex, blood count, germs encountered, the antibiogram, duration of evolution, reconstruction of the scrotum by pedicle flap, and morbidity. Results: During the study period we collected 5 cases of Fournier gangrene of external genitals in the service. The average age was 57.6 years and all the patients were male. The average duration of evolution was 5 days for an average age of 57.6 years. All patients were male. Echerichia coli (E. coli)

关键词： Fournier’s Gangrene Scrotum Inguinal Pedicular Flap

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Fascist Leg Necrosis at the Bocar Sidi Sall University Hospital (BSS) in Kati (Mali)

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Surgical Science 2022年第3期13卷 119-123页

作者： Abdoulaye Diarra assitan Koné Amadou traoré Koniba Kéïta Idrissa Tounkara Tounkara Issa traoré Oumou traoré Boubacar Karembé Madiassa Konaté Oulématou Coulibaly Modibo Togola Daouda Diallo Alhassane traoré Bkary Tientigui Dembélé Ibrahim Diakité Adégné Togo Department of General Surgery Kati University Hospital Kati Mali Department of General Surgery CHU Gabriel Touré Bamako Mali Department of Anesthesia and Resuscitation CHU of Kati Kati Mali

Necrotizing fasciitis is a bacterial dermo-hypodermitis of necrotizing type with involvement of the superficial fascia of the muscles. We report the case of a 50-year-old patient with necrotizing fasciitis of the left leg following erysipelas. Clinical Case: A 50-year-old patient, received at the emergency department for necrotizing wound of the left leg, evolving for 25 days. The examination of the patient made it possible to find: an alteration of the general condition with a WHO score classified stage II. A necrotizing wound of the lower 2/3 of the left leg and the dorsal side of the left foot allowing pus to flow in places, the pedious pulse was well perceived, lymphadenopathy at the root of the homolateral thigh. The complete blood count made it possible to objectify a predominantly neutrophil hyperleukocytosis greater than 10,000/mm3. We first carried out a complete debridement of the necrotic tissues, in a second time we took the patient back to do the autocutaneous graft. The surgical follow-up was simple. Conclusion: Necrotizing fasciitis is a serious infection, management is multidisciplinary.

关键词： Necrotizing Fasciitis Lower Limb Kati Mali

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Rare Case of Acute Peritonitis by Perforation of an Appendicular Schistosomiasis at the CHU BSS in Kati

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Surgical Science 2020年第12期11卷 385-392页

作者： Koniba Keita Abdoulaye Diarra Sidiki Keita Oulématou Coulibaly assitan Koné Salia Coulibaly Amadou traoré Idrissa Tounkara Lamine Soumaré Mamadou Diallo Bourama Togola Drissa traoré Pierre A. Togo Department of General Surgery CHU BSS Kati Mali Department of General Surgery CHU Point-G Bamako Mali Reference health center of the commune VI of the district of Bamako Bamako Mali Medical Imaging Department CHU BSS Kati Mali General Surgery Department CHU Gabriel Touré Bamako Mali

Perforation of a pseudo appendicular tumor of bilharzial origin (bilharzia) is a rare etiology of acute peritonitis. His diagnosis is histopathological. The existence of comorbid malaria and surgical pathology is frequent in having a positive thick drop with Schistosoma mansoni eggs in his stool. After 3 months, the patient is doing well. In conclusion, we recommend the histopathological analysis of the surgical specimen after appendectomy and the detection of haematozoa for malaria in any case of fever in a surgical environment.

关键词： Acute Peritonitis Bilharzia Ileocecal Appendix

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TyphicIleal Perforation at Kati Chu-BSS for Diagnostic and Therapeutic Aspects (Mali)

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Surgical Science 2021年第8期12卷 286-295页

作者： Koniba Keita Abdoulaye Diarra Sidiki Keita Salia Coulibaly Oulematou Coulibaly Amadou traoré assitan Kone Oumou Koné Fodé Mory Keita Daouda Diallo Boubacar Kone Drissa traoré Bacary T. Dembélé General Surgery Department Hospital BSS Kati Mali General Surgery “A” Department Hospital Point-G Bamako Mali Medical Imaging Department Hospital BSS Kati Mali Reference Heath Centre of the Commune VI Bamako Mali General Surgery Department Hospital Gabriel Touré Bamako Mali General Surgery “B” Department Hospital Point-G Bamako Mali Anesthesia Resuscitation Department Hospital BSS Kati Mali

Ileal perforation of typhus origin is a common and serious complication of typhoid fever in tropical environments. It is one of the main causes of morbidity in surgery in Mali. However, it would be preventable if salmonellosis were properly managed upstream, and if our living environments were cleaned up. The purpose of this study is to report on the experience of the Kati UHC General Surgery Department in the management of peritonitis by typhic perforation and to assess its prognosis. Patients and Method: This is a retrospective descriptive study that took place from January 2007 to December 2020 in the General Surgery department of the Hospitalo-University BSS Center of Kati (Mali). We have included patients who have undergone peritonitis with confirmed typhic ileal perforation with laparotomy. The other etiologies of peritonitis by ileal perforation were not retained. Results: In 14 years, we collected 89 cases of peritonitis by typhic ileal perforation. It accounted for 3.14% (89/2829) of surgical procedures, 37.5% (89/1181) of visceral surgical emergencies and 27.6% (89/322) of all acute peritonitis causes combined. There were 70 men against 29 women;the sex ratio was 2.4 with an average age of 25.8 years (extremes 8 years to 65 years). Anastomosis resetions (ileo ileal and ileocolic) predominated in 71.8% of patients. However, the ileo stoma was performed in 5.6%. A significant relationship (p 0.05) was observed between high mortality and MPI score > 26. Morbidity was 39.4% with mortality of 15.7%. The average length of stay in hospital was 12.2 days. Conclusion: Typhoid ileal perforation is common in young male adolescents in visceral surgery. This pathology generates significant morbidity. However with the extension of hand washing after Ebola disease its frequency has dropped.

关键词： Typhoid Perforation Diagnostic Surgery

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Epidemiological and Clinical Profile and Immediate Outcome of Neonates Transferred from the Maternity Unit to the Neonatology Unit of the CSREF in Commune V of Bamako District, Mali

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Open Journal of Pediatrics 2024年第3期14卷 547-557页

作者： Maimouna Kante Ya traoré Balilé Harber Beydari Mamadou traoré Issiaka Koné Diéneba Sacko Maimouna Haidara Korotoumou Bamba assitan Farota Abdoulaye Kassogué Mohamed Diarra Dramane Touré Abdoul Salam Diarra Leyla Maïga Dicko Fatoumata Paediatric Ward CSR&#233f CV Bamako Mali Paediatric Ward of Nianankoro Fomba Hospital S&#233gou Mali Paediatric Ward of Kalaban CoroCSREF Bamako Mali Pediatric Department of the Mopti Reference Health Center Mopti Mali National Centre for Scientific and Technological Research Bamako Mali Paediatrics Department Mohamed VI Perinatal Clinic Bamako Mali Department of Paediatrics Gabriel Tour&#233 University Hospital Bamako Mali

Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019. The aim of our study was to describe the main morbid conditions and their lethality in newborns admitted to the paediatric ward of the CSREF in Commune V. Methodology: We conducted a 12-month prospective descriptive and analytical study from August 2020 to July 2021. Results: During the 12 months of the study, out of 2654 neonates admitted to hospital, 216 met our inclusion criteria, i.e. 8%. Newborns admitted in the first few hours of life represented 99.54% of cases. Full-term newborns accounted for 65.74% of the total. Forty-eight percent of newborns had hypothermia on admission. The most common diagnosis was asphyxia in 55.56% of cases, followed by neonatal infection in 27.78% and prematurity in 10.65%. Death was recorded in 22.2% of cases. Asphyxia was the main cause of neonatal death, followed by prematurity in our context. Conclusion: Improving the prognosis of newborn babies will require a thorough understanding of neonatal pathologies and the implementation of a pre- and perinatal prevention policy.

关键词： Newborns Morbidity Mortality

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Double Volvulus, Transverse Colon and Sigmoid at Kati Chu BSS: About 2 Cases

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Surgical Science 2021年第8期12卷 296-301页

作者： Koniba Keita Abdoulaye Diarra Sidiki Keita Fodé Mory Keita Oulematou Coulibaly Amadou traoré assitan Kone Salia Coulibaly Aimé Christophe Dembélé Oumou Koné Birama Togola Daouda Diallo Boubacar Kone Drissa traoré Bacary T. Dembélé General Surgery Department Hospital BSS Kati Mali General Surgery “A” Department Hospital Point-G Bamako Mali Reference Heath Centre of the Commune VI Bamako Mali General Surgery Department Hospital Gabriel Touré Bamako Mali Medical Imaging Department Hospital BSS Kati Mali General Surgery “B” Department Hospital Point-G Bamako Mali Anesthesia Resuscitation Department Hospital BSS Kati Mali

The simultaneous double volvulus of the transverse colon and sigmoid in the same patient is a rare cause of intestinal occlusion. Two cases were observed in general surgery in Kati. Its clinical symptomatology does not differ from other occlusions as well as simple radiological images. It is an extreme surgical emergency, the diagnosis is generally intraoperative. Extensive left hemi colectomy with terminoterminal rectal anastomosis was performed. The surgical follow-up was simple.

关键词： Volvulus Transverse Sigmoïde Surgery Colon

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Appendicular Abscess in General Surgery at the Bocar Sidi Sall University Hospital in Kati

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Surgical Science 2020年第12期11卷 479-485页

作者： Abdoulaye Diarra Koniba Keita Amadou traoré assitan Koné Idrissa Tounkara Issa traore Souleymane Thiam Fadima K. Tall Daouda Diallo Madiassa Konate Aboubacar Koné Deborah Sanra Sanogo Ismaël Konare Alhassane traoré Adégné Togo Department of General Surgery CHU of Kati Kati Mali General Surgery Department CHU Gabriel Touré Bamako Mali Department of Anesthesia and Resuscitation CHU of Kati Kati Mali Gastroenterology Department Point G Hospital Bamako Mali

Introduction: Appendicular abscess is a progressive complication of acute appendicitis in which the spread of infection is contained by the greater omentum and the slender loops resulting in the formation of a true septate abscess of the large peritoneal cavity. Materials and Methods: This was a retrospective study from January 2010 to December 2019 carried out at the Bocar Sidi Sall University Hospital in Kati (CHU BSS in Kati) in general surgery. It concerned all patients operated on for appendicular abscess in the department. Results: 75 cases of appendicular abscess were collected, which represented 5.76% of surgical emergencies and 25% of acute appendicitis. The average age of the patients was 29 years. The male sex represented 67% of our patients with a sex ratio of 2. The average consultation time was 5 days. Abdominal pain was noted in all patients. It was localized in the right iliac fossa in 80% (n = 60) and diffuse in 2.7% of cases (n = 2). It was accompanied by nausea and vomiting in 93% of cases (n = 70), urinary disorders in 20% (n = 15), fever in 94% (n = 71), cessation of materials and gas in 1.33% (n = 1). Abdominal ultrasound was performed in 86% (n = 65). It made it possible to suggest a peri-appendicular effusion. Biological examination revealed a neutrophilic hyperleukocytosis greater than 20,000/mm3 in 47 patients, or 63%. All the patients were operated on by laparotomy (Marc Burney or midline subumbilical) under general anesthesia. The length of hospitalization was 6 days. We have not recorded any deaths. Morbidity was 8% (n = 6) represented by parietal suppuration. The postoperative course was straightforward in 92% of cases (n = 69). Conclusion: Appendicular abscess is a frequent medico-surgical emergency, the prognosis of which depends greatly on early diagnosis and adequate and immediate management.

关键词： Appendicular Abscess Surgery Kati Mali

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Bacteriology of Healthcare-Associated Infections in the Gynecology and Obstetrics Department of CHU Gabriel Touré

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Open Journal of Obstetrics and Gynecology 2019年第10期9卷 1336-1346页

作者： Amadou Bocoum Seydou Fané Youssouf traoré Siaka Amara Sanogo Ibrahim Kanté Aminata Kouma Mamadou Sima Abdoulaye Sissoko Ibrahima Ongoiba Soumana Oumar traore Ibrahima Tegueté Maténé Sacko Daouda Camara Alassane traoré assitan Wane Niani Mounkoro Amadou Dolo Gynecology-Obstetrics Department of CHU G. Touré Bamako Mali Gynecology-Obstetrics Service of CHU of Point G Bamako Mali Gynecology-Obstetrics Department of CHU of Kati Bamako Mali Gynecology-Obstetrics Service of Referral Health Center of Kati Kati Mali Gynecology-Obstetrics Service of Referral Health Center of Commune V Bamako Mali Gynécology-Obstétrics Department of CHU of Mali Bamako Mali.

Introduction: Healthcare-associated infections (HAIs) are a public health issue. An infection is said to be associated with the care if it occurs during or after the care of a patient, and if it was neither present nor incubation at the beginning of the care. Objective: The purpose of this work was to study the bacteriology of infections associated with obstetric care in the gynecology-obstetrics department of CHU Gabriel Touré. Patients and Methods: This is an epidemiological, descriptive, analytical study conducted in the gynecology-obstetrics department of the CHU Gabriel Touré, from April 11th, 2016 to August 29th, 2016 (5 months). Data collection focused on the clinical and laboratory characteristics of healthcare-associated infections in patients during their hospitalization. Included in the study were any patients hospitalized in the Gynecology and Obstetrics Department who agreed to participate in the study. The criteria used to diagnose the associated infection were those of the Atlanta CDC. Operative wound monitoring was done up to the 30th postoperative day. Results: We have recorded 200 patients, out of whom 138 were operated on and 23 cases of bacterial infection associated with care (11.50%). The average age of the patients was 32.52 years ± 13.36 years against 29.36 years ± 10.28 years for the patients who did not present the infection. Seven point five percent of the evacuated patients had an infection associated with care. The most common types of infection were surgical site infection (60.86%), urinary tract infection (26.08%), endometritis and sepsis with 13.04% each. The isolated organisms were all resistant to Amoxicillin, to Amoxicillin + Clavulanic acid (88.88%) and to Ciprofloxacin (77.77%). The average duration of hospitalization for patients who developed the infection was 14.70 days. The lethality was 1.50%. The average cost of management of patients who developed the surgical site infection was 119,837 FCFA. Conclusion: The bacterial infe

关键词： Bacterial Infection Resistances Gabriel Touré University Hospital Antibiotics Obstetrics

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Traumatic Diaphragmatic Injury at Gabriel Toure University Hospital, Mali

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Surgical Science 2022年第3期13卷 110-118页

作者： Amadou traoré Madiassa Konaté Abdoulaye Diarra Idrissa Tounkara Mohamed traoré Arouna Doumbia Amadou Bah Boubacar Yoro Sidibé Amadou Maïga Tani Koné Boubacar Karembé Zakari Saye Koniba Kéita Yacouba Bouaré assitan Koné Ibrahim Diakité Lassana Kanté Bakary Tientigui Dembélé Alhassane traoré Adégné Togo General Surgery Department of Gabriel Touré University Hospital Bamako Mali Surgery Department of Kati University Hospital Kati Mali Reference Health Center of Commune II Bamako Mali Reference Health Center of Commune III Bamako Mali

Traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accident (TRA) or an assault. We initiated this study with the aims of determining the epidemiological, clinical and therapeutic aspects of TDI at Gabriel Toure University Hospital. This was a retrospective study from January 1999 to June 2021 that included all patients who presented a diaphragmatic injury consecutive to abdominal and/or thoracic trauma. In 22 years and 6 months, 46 cases of TDI were collected. They represented 0.17% of hospitalizations, 0.26% of surgical emergencies and 5.5% of thoraco-abdominal traumas. The average age was 31.69 years with a sex ratio of 3.2. Criminal stabbings accounted for 56.5% and TRA for 19.6%. Penetrating injuries accounted for 78.3% of cases. The parietal lesion was thoracic in 21 cases (45.7%), abdominal in 19 cases (41.3%) and thoraco-abdominal in 6 cases (13%). The chest X-ray, performed in 15 patients, showed an intrathoracic gas bubble (4 cases) and hemothorax (6 cases). Diagnosis of diaphragmatic lesion was preoperative in 21.7% (10 cases). The diaphragmatic breach was on the left side in 65.2% (30 cases) and the average size was 3.17 cm. Laparotomy was performed in 89.1%, thoracotomy in 4.4% and thoraco-laparotomy in 6.5% of cases. The surgical procedure consisted of reduction of the herniated viscera in 15.2% (7 cases) and closure of the diaphragmatic breach with non-absorbable sutures in 82.6% (36 cases). Chest tube drainage was performed in 73.9%. The average length of hospital stay was 9.8 days. Mortality was 13.04%. Conclusion: Traumatic diaphragmatic injury is rare but its frequency is increasing in our country. It most often affects the young man victim of assault or TRA. This type of trauma is rarely isolated;you have to think about it in case of any thoraco-abdominal trauma. The treatment is surgical. The prognosis depends on the severity of the associated lesions.

关键词： Diaphragmatic Injury Trauma Surgery Gabriel Toure

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