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

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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Ileal Occlusion on Bezoars at Kati BSS Hospital

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Surgical Science 2019年第1期10卷 39-43页

作者： Keita Koniba Abdoulaye Diarra Sidiki Keita Issa Traore Salia Coulibaly Fadima Tall Daouda Diallo Oulematou Coulibaly Assitan kone boubacar kone Mahamadou Bacary Coulibaly Daouda Konate Ismael Konare Drissa Traore General Surgery Department Kati Mali Medical Imaging Department Kati Mali Anesthesia Resuscitation Department Kati Mali Ophthalmology Department Kati Mali

Bowel occlusions by bezoars are rare pathologies. They are due to an ob-struction of the intestinal lumen by a solid mass of fruits or undigested vegetable fibers. They are seasonal (wild fruit season from March to June) in the Sahel Zone. We report a case of small bowel obstruction in a 35-year-old rural man after swallowing a significant amount of wild grapes (Lannea microcarpa). We proceeded to the resection of the occluded ileal segment and performed an ileal terminal ileal anastomosis. There weren’t any complications during the postoperative site.

关键词： Bezoars Occlusion Jejunum Season

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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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Sigmoid Colon Volvulus: Surgical Management at Kati BSS Hospital (Mali)

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Surgical Science 2019年第3期10卷 76-82页

作者： Koniba Keita Abdoulaye Diarra Salia Coulibaly Sidiki Keita Issa Traore Moussa Doumbia Fadima Tall Daouda Diallo Oulematou Coulibaly Assitan kone boubacar kone Daouda Konate Amadou Kassongue Moussa Salifou Diallo Ismael Konare Drissa Traore Nouhoum Ongoiba General Surgery Department Kati Mali Medical Imaging Department Kati Mali Anesthesia Resuscitation Department Kati Mali Ophthalmology Department of Kati Kati Mali Department of Urology of Kati Kati Mali

The objective of this study was to describe the therapeutic aspects and to evaluate the surgery results of sigmoid Volvulus in the Kati (MALIA) General Surgery Department. Patients and Methods: This was a descriptive study conducted in our General Surgery Department. It took place in two phases for six years: A retrospective phase from January 1st, 2010 to December 31st, 2015 and a prospective phase from January 1st, 2016 to December 31st, 2017. This study has been approved by the Ethics Committee. It’s concerned all the patients operated in the department for colon Volvulus. Results: We collected 70 patients’ files. The Sigmoid Volvulus represented 7.8% of emergency surgery activities and 37.2% of intestinal obstruction. The male sex predominated with 98.57% against 1.43% of the female sex. The average age was 42.11 years old with limits of 18 to 70. The average deadline evolution was 2.53 days with limits of 1 to 3. The sigmoidectomy with immediate anastomosis was performed in 66% of patients, colectomy with 2-times anastomosis: according to Hartman 20% and Bouilly Volkman 11%, detorsion with colopexy 3%. The early morbidity rate was 5.71%. The average duration of hospitalization was 10.8 days with limits of 5 to 40 days. Two deaths were recorded. Conclusion: Sigmoid Volvulus is frequent in young adult sex male in Africa. We did not find any significant difference between the surgical technique and the advent of complications. The Colectomy with immediate anastomosis seems to be ideal to us that anytime the conditions are appropriate.

关键词： Volvulus Sigmoid Colectomy Surgery

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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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Ramsay Hunt Syndrome Revealing HIV Conditions

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第3期11卷 112-118页

作者： Ghislaine Neuilly Ngniee Tafo Fatogoma Issa kone boubacar Maiga Mohamed Keita Reference Health Center I in Bamako Bamako Mali University Hospital of Gabriel Touré of Bamako (CHU) Bamako Mali

Objective: To discuss the diagnostic, therapeutic, and evolutionary aspects of a case of herpes zoster oticus associated with facial palsy in HIV conditions. Case Study: We report the case of a 32-year-old married female beautician patient admitted with severe right otalgia associated with a fever that had been evolving for three days. The addition of homolateral otorrhea and headache was noted. The initial examination on admission noted a vesicular rash of the pinna and the external third of the right external auditory canal with a normal tympanic membrane. The evolution was marked 48 hours later by the appearance of a right facial palsy grade V. The CT scan of the rock showed a mastoid and maxillary sinus hypodensity. The paraclinical exploration found a positive retroviral serology to HIV 1 and 2. The diagnosis retained was a Ramsay Hunt syndrome on HIV condition associated with ipsilateral maxillary sinusitis and mastoiditis. The treatment administered was a combination of amoxicillin/clavulanic acid injection of 3 g per day + oral aciclovir 200 mg, acetaminophen 1 g injectable every 6 h, betamethasone 4mg per day, vitamin B complex, artificial tear. Therapeutic inclusion in the HIV/AIDS national program was performed. The evolution was marked by the total regression of the facial palsy after six months of treatment. Conclusion: Otogenic diseases in HIV remain a problem in our context where the circumstances of discovery are most often fortuitous, hence the need to search for the serological status in front of any suspicion of viral infection in adults. The status may constitute a triggering factor or a factor of the severity of the pathology or of the symptoms such as facial palsy or deafness in our case. Early and adapted management has been shown to improve the prognosis.

关键词： RAMSAY HUNT Syndrome Zona Ear Facial Paralysis HIV

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Study on Compliance with Radiation Protection Rules in the Medical Imaging Department of Pr Bocar Sidy Sall Hospital of Kati (Mali)

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Open Journal of Radiology 2022年第4期12卷 239-257页

作者： Issa Diarra Salia Coulibaly Ilias Guindo Cheick Oumar Keita Soumaïla Diallo Souleymane Sanogo Hawa Diarra boubacar Sonfo Aboubacar Sidiky N’diaye Youssouf kone Bourama Diarra Medical Imaging Department The CHU Pr Bocar Sidy Sall Kati Mali Medical Imaging Department Perinatal Clinic Mohamed VI Bamako Mali Medical Imaging Department The Mother-Child Hospital Luxembourg Bamako Mali Medical Imaging Department The Hospital of Mali Bamako Mali Pasteur Polyclinic Bamako Mali Centre Hospitalier Jacques Boutard Saint Yrieix La Perche France Centre de Radiologie Diagnostique et Interventionnelle CRDI Bamako Mali

Objective: Evaluate the level of compliance with radiation protection rules in the medical imaging department of the University Hospital Center (CHU) of Kati. Methodology: This was a cross-sectional and descriptive study carried out in the medical imaging department of Pr Bocar Sidy Sall (BSS) Hospital of Kati. A questionnaire was developed and sent to the staff of the medical imaging department. The assessment focused on the radiation protection of personnel, radiation protection measures for patients, the delimitation and signage of zoning as well as the application of radiation protection principles. Results: Twenty-one people participated in the study, 90% of whom were men. The 30 - 39 age group was predominant with 61.90%. 33.33% of the staff knew the principles of radiation protection;86% of our sample knew the basic rules of radiation protection. The majority of the staff in the imaging department (61.90%) had a perfect knowledge of protective equipment. For 76% of our workforce, the limits of the radiation doses received are regulated in Mali. 76% of those surveyed have not taken any additional training in radiation protection. The doors are closed during the X-ray examination for 76.19% of the respondents and 95% of the staff put themselves behind the sealed screen during the examination. For 81% of the respondents, the design of the premises met radiation protection standards. 62% of practitioners have a dosimeter and 80% of them wear it during their shift. For 62% of our sample, the change of the dosimeter is quarterly. The systematic request for DDR (date of last menstrual period) in women and the adaptation of the delivered dose to the patient’s morphology was only carried out by 65% of practitioners. The majority of staff (81%) did not benefit from medical surveillance, while for 55% of respondents the level of radiation protection in the establishment was average. Conclusion: This study enabled us to highlight the shortcomings in terms of radiation pr

关键词： Radiation Protection Compliance X-Rays Dosimetry

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Complete Ureteral Duplicity Complicated by Lithiasis with Right Ureterohydronephrosis with Left Renal Excretion Defect: Apropos of a Clinical Case

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Surgical Science 2023年第9期14卷 575-582页

作者： Cheickna Tounkara Amadou Maiga boubacar Yoro Sidibe Tani kone Hamidou Samake Kaloga Daye Bagayoko Oumar Amadou Malle Jean Baptiste Honoré Berthe Mamadou Lamine Diakite Department of General Surgery of the “Mother Child” Hospital Luxembourg Bamako Mali General Surgery Department of Gabriel TOURE Hospital Bamako Mali Urology Department of Point-G Hospital CHU Bamako Mali

Ureteral duplication is a congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder through two ureteral meati. It is an anatomical variant that remains rare. Its early discovery is due to a lack of diagnostic means, hence the occurrence of long-term complications. To this end, we observe an increased importance of the morbidity linked to the late diagnosis of this duplicity. Our objective was to show the importance of the morbidity linked to the late diagnosis of this anomaly, the incidence of the infection and the complications that this pathology poses as a problem. It was a clinical case of fortuitous discovery taken care of by a general surgeon in the general surgery department of the hospital “Mother Child” Le Luxembourg Bamako Mali. We report a case of complete ureteral duplication complicated by ureterohydronephrosis on a lithiasis wedged in the uretero-vesical junction of one of the left ureters in its lower portion which required a uretero-lithotomy with bladder reimplantation of the left ureters and secondly to a uretero-lithotomy with bladder reimplantation after two months. The postoperative course was simple.

关键词： Ureteral duplication Congenital malformation Duplicity Adult Bamako Mali

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Abdominoperineal Resection in Rectal Cancer in General Surgery Department at Gabriel Toure University Hospital

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Surgical Science 2019年第1期10卷 16-23页

作者： Amadou Traore Abdoulaye Diarra Madiassa Konate Souleymane Thiam Soumaila Keita Tani kone boubacar Karembe Assitan kone boubacar Sidibe Amadou Bah Amadou Maiga Ibrahim Diakite Bakary Tientigui Dembele Alhassane Traore Adegne Togo Lassana Kante Moussa Samake Moustapha Issa Mangane Thierno Madane Diop Mamadou Salia Diarra Adama Diakite Gangaly Diallo Gabriel Toure University Hospital BamakoMali

The objectives: Were to determine the hospital frequency of abdominoperineal resection (APR);to determine mortality and morbidity rates and to assess oncologic outcomes. Method and patients: We performed a retrospective study between 2008 and 2013 in general surgery department at Gabriel Toure University Hospital (UH) which included all patients admitted for rectal cancer confirmed by pathological examination, and having undergone an APR. Results: We have collected 17 cases which accounted for 65.38% of curative resections of rectal cancer. The sex-ratio was 0.89 and the averageage was 49.53 years. The average tumor distance from the anal verge was 4.59 ± 1.7 cm. All patients had adenocarcinoma of the rectum. The histopathologic grade was well in 7 cases, moderate and poor in 5 cases each. According to the pathologic TNM classification, 13 patients were classified T4, 14 patients N+. APR was associated with hysterectomy and partial colpectomy in 4 cases. The average duration of interventions was 202.06 ± 25.68 minutes. The average duration of hospitalization was 18.24 ± 04.89 days. The postoperative mortality and morbidity rates were 5.88% and 29.42%, respectively. Local recurrence was observed in 6 patients and liver metastasis in 2 patients. The overall survival rate was 37.5% at 2 years and 18.75% at 5 years. Conclusion: APR still occupies an important place in our practice. Our results could be improved by the recent introduction of neoadjuvant radio chemotherapy in Mali.

关键词： Abdominoperineal Cancer Mali Rectum Resection Surgery

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Case of Incomplete Ureteral Duplication Complicated with Lithiasis and Right Uretero-Hydronephrosis

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Surgical Science 2023年第7期14卷 502-506页

作者： Cheickna Tounkara Amadou Maiga boubacar Yoro Sidibe Tani kone Samake Hamidou Kaloga Daye Bagayoko Oumar Amadou Malle Jean Batiste Honoré Berthe Mamadou Lamine Diakite Department of General Surgery Luxembourg Hospital Bamako Mali Department of General Surgery CHU Gabriel Touré Bamako Mali Department of Urology Surgery CHU Point-G Bamako Mali

Ureteral duplication is congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder through two ureteral meati. It is an anatomical variant that remains rare. Its early discovery is due to a lack of diagnostic means, hence the occurrence of long-term complications. To this end, we observe an increased importance of the morbidity linked to the late diagnosis of this duplicity. We report a case of incomplete ureteral duplication complicated by ureterohydronephrosis on lithiasis wedged in the uretero-vesical junction of one of the ureters in its lower portion which required uretero-lithotomy with bladder reimplantation of the ureters. Our aim was to show the importance of the morbidity associated with late diagnosis of this anomaly and the incidence of infection and complications that this pathology poses as a problem. This was a clinical case of fortuitous discovery managed by a general surgeon in the general surgery department of the hospital “Mère Enfant” Le Luxembourg Bamako Mali. The suites were simple.

关键词： Ureteral Duplication Congenital Malformation Adult

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