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Tonsillitis and Their Complications: Epidemiological, Clinical and Therapeutic Profiles

International Journal of Otolaryngology and Head & Neck Surgery 2019年第3期8卷 98-105页

作者： Abdoul Wahab Haidara Youssouf Sidibé Djibril Samaké Amady coulibaly Mamadou Karim Touré bréhima bolonpé coulibaly Siaka Soumaoro Boubacary Guindo Kassim Diarra Kalifa coulibaly Boubacar Sanogo Mohamed Kéï ta Alhousseini Ag Mohamed ENT and Head and Neck Surgery Department CHU Mother-Child “Luxembourg” Bamako Mali ENT and Head and Neck Surgery Department Reference Health Center Bamako Mali Department of Stomatology and Maxillofacial Surgery CHU-CNOS Bamako Mali Department of Anesthesia Resuscitation CHU Mother-Child “Luxembourg” Bamako Mali ENT and Head and Neck Surgery Department CHU Gabriel Toure Bamako Mali

Tonsillitis or angina, is considered as an inflammation of the palatine tonsils most often of infectious origin. It can be acute or chronic. The germs in question are mostly viruses and bacteria. Objectives: The objective of this work was to study the epidemiological and therapeutic profile of tonsillitis and their complications in the ENT Department and Head and Neck Surgery of the Mother-Child University Hospital in Luxembourg. Patients and Methods: This is a prospective study over a 12-month period from January 2018 to December 2018, including all patients who presented with tonsillitis and/or their complications. Results: Three hundred and fifteen (315) patients were collected during this period. The average age in our study was 14.25 years with extremes ranging from 2 years to 61 years. The sex ratio was 0.65 in favor of the female sex. During this period we recorded 80.95% of cases of uncomplicated tonsillitis including 60.50% for acute tonsillitis, 24.5% for chronic tonsillitis 5% for adenoid tonsillitis and 19.05% for complications. Complications included peritonsillar phlegmon 42.22%, heart disease 33.33%, cervical cellulitis 8.89%, adeno-phlegmon 6.67%, para-pharyngeal abscess 4.44%, and sepsis 4.44%. The exclusive medical treatment was performed in 44.31%. Surgical treatment (drainage incision and tonsillectomy) was performed in 55.69%. Conclusion: Tonsillitis and its complications represent an important pathology in ENT. Feynophagy febrile is the pair-origin symptom that can lead to the diagnosis. The prevention of complications is the guarantor of the reduction of its morbidity. We recommend that in the absence of RDT (Rapid Diagnostic Test), it is necessary to systematize antibiotic therapy to prevent serious complications.

关键词： Tonsillitis Complication Mali

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Environmental Risk Factors for Stomach Cancer in an African Setting about 193 Cases at the CHU Point G in Bamako/Mali

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Surgical Science 2021年第2期12卷 23-30页

作者： Souleymane Sanogo Drissa Traoré Mamadou coulibaly Birama Togola bréhima Bengaly Ousmane Ibréhima Touré Drissa Ouattara bréhima coulibaly Babou Ba Siaka Diallo Nouhoum Ongoiba Surgery B CHU Point G Bamako Mali USTTB Faculty of Medicine Bamako Mali Koutiala Regional Hospital Koutiala Mali

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. Aim: To study the environmental risk factors of stomach cancer in the B surgery department of the Point G University Hospital in Bamako. Patients and Methods: We performed a cross-sectional study with retrospective collection from January 2008 to June 2018 (126 months). Results: We have identified 380 cases of digestive cancer, including 193 cases of stomach cancer or 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 tô 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).

关键词： Stomach Cancer Environmental Risk Factors African Setting CHU Point G

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Left Atrium Emboligenic Myxoma: Case Report and Review of the Literature

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Open Journal of Thoracic Surgery 2021年第1期11卷 18-24页

作者： bréhima coulibaly Abdoulaye Kanté Mamadou Diakité Samba Sidibé Drissa Traoré bréhima Bengaly Mariam Daou Demba Yattera Nouhoum Ongoïba Department of Thoracic and Cardiovascular Surgery CHU Point G Bamako Mali Laboratory of Anatomy University of Sciences Techniques and Technologies of Bamako Bamako Mali Cardiology Department CHU Point G Bamako Mali Department of Neurology CHU Gabriel Touré in Bamako Mali

Introduction: Cardiac myxomas represent the most frequent forms of primary tumors of the heart. The most frequent location is the interatrial septum. We report the clinical case of a myxoma of the left atrium and discuss its epidemiological and therapeutic aspects through a review of the literature. Observation: This was a 41-year-old female patient who presented with sudden rotational dizziness associated with vomiting. MRI revealed multiple punctiform bilateral supra and subtentorial strokes of different ages, recent and semi-recent, suggesting an embologenic etiology. Transesophageal echocardiography found a large pedunculated, homogeneous, avascular tumor hanging from the interatrial septum. The patient is operated on urgently under cardiopulmonary bypass for resection of a large tumor located in the left atrium. The pathological examination concluded with the diagnosis of myxoma of the left atrium. The postoperative follow-up was straightforward and the patient was discharged from the hospital via home hospitalization. Conclusion: The diagnosis of cardiac myxomas is suspected in the presence of symptoms associated with echocardiographic images of intracardiac masses and confirmed by histological study. Embolic accidents are one of the formidable complications of myxomas. Surgical management is urgent, especially in the presence of predictive morphological features of embolism on echocardiography.

关键词： Myxoma of the Left Atrium Cerebral Embolism Interest of Trans-Esophageal Ultrasound Surgery

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Aortic Root and Ascending Aortic Aneurysm Related to One Case. Reimplantation of the Right Coronary Artery by 8 mm Dacron Tube (Cabrol Hemi Mustache) and Review of the Literature

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Open Journal of Thoracic Surgery 2021年第1期11卷 1-10页

作者： Abdoulaye Kanté bréhima coulibaly Mamadou Diakité Samba Sidibé Drissa Traoré bréhima Bengaly Mariam Daou Demba Yattera Nouhoum Ongoïba Department of Thoracic and Cardiovascular Surgery CHU Point G Bamako Mali Laboratory of Anatomy University of Sciences Techniques and Technologies of Bamako Mali Cardiology Department CHU Point G Bamako Mali Department of Neurology CHU Gabriel Touré in Bamako Mali

The aortic aneurysm is the 13th leading cause of death in Western countries. The incidence of thoracic aortic aneurysms is estimated at 4.5 cases per 100,000. The diagnosis is often made on a chest x-ray or other imaging tests, such as an echocardiogram done for other heart diseases. Echocardiography is the first test to assess the diameter of the ascending aorta and its progression over time. Most patients are first assessed and followed up with spiral thoracic computed tomography with injection of contrast medium, supplemented by 3-dimensional reconstruction of the aneurysm in order to improve the accuracy of measurements, identification of its proximal part and distal. When dilation of the ascending aorta reaches the critical diameter of 50 mm, there is a risk of aortic dissection or rupture. Supravalvular aneurysms are treated by replacing the ectatic portion with a Dacron® tube in the supracoronary position. Aortic root aneurysms, including coronary ostia, require tube replacement, reimplantation of coronary ostia, as well as surgery on the aortic valve. In this article, we report a case of aneurysm of the aortic root and the ascending aorta treated by aortic valve replacement and the ascending aorta associated with the Cabrol hemi-mustache technique and we review the literature.

关键词： Aortic Root and Ascending Aortic Aneurysm Aortic Valve Replacement and Ascending Aorta Cabrol’s Hemi Mustache

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Anatomy of the Gall-Bladder in the Ultrasound about 1000 Cases

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Forensic Medicine and Anatomy Research 2019年第2期7卷 44-49页

作者： bréhima coulibaly Abdoulaye Kanté Abdoulaye Koné bréhima Bengaly Babou Ba Youlouza coulibaly Oncoumba Diarra Adama Seriba Diarra Drissa Traoré Mariam Daou Nouhoum Ongoiba Service of Surgery B.CHU Point G BamakoMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali Imaging Department CHU Point G BamakoMali Service of Neurology.CHU Gabriel Touré BamakoMali

Aim: The aim of this work is to determine the dimensions and the capacity of the gall-bladder by ultrasound. Methodology: We realized a descriptive study over 2 years (from January, 2015 till December, 2017). It concerned an ultrasound exploration of the gall-bladder. The studied population was healthy voluntary subjects visible and on an empty stomach for 12 hours, without history of abdominal trauma and abdominal operating scar. The carrying subjects of the tracks of abdominal trauma or of abdominal operating scar were not included. Results: The average age was of 39 years ± 12.16 with extreme of 10 years and 89 years. It was 500 women (50%) and of 500 men (50%) with a sex ratio of 1. To 450 subjects (45%) the width of the gall-bladder of the subjects varied between 21 and 30. The average was 22.63 mm ± 7.9. Extremes were from 9 to 55 mm. The measurements made by the three sonographers showed no significant difference. The sensitivity of ultrasound in the visualization of the gallbladder was 100%. The length of the gall-bladder was between 61 and 70 mm. The average was 65.35 ± 14.48. Extremes were 26 and 142 mm. Conclusion: This original study shows the normal dimensions of the gall-bladder to Malian.

关键词： Anatomy Gall-Bladder Ultrasound Bamako-Mali

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Morphometry of the Portal Vein:Ultrasound Anatomy about 1000 Cases

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Forensic Medicine and Anatomy Research 2019年第2期7卷 37-43页

作者： Abdoulaye Kanté Abdoulaye Koné Daouda Camara bréhima Bengaly bréhima coulibaly Drissa Traoré Babou Ba Mariam Daou Nouhoum Ongoiba Service of Surgery B.CHU Point G BamakoMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali Imaging Department CHU Point G BamakoMali Service of Gynecology and Obstetrics of the CHU KatiMali

Aim: The aim of this study is to determine from a series of 1000 cases the usual dimensions of the portal vein according to the medical ultrasound. Methodology: We realized a transverse study over 2 years (from January 2015 to December 2017). It concerned an ultrasound exploration of the portal vein. The studied population was healthy voluntary subjects visible without history of abdominal trauma and abdominal operating scar. Results: The average age was 39 years ± 12.16 with extremes of 19 years and 70 years. The decade of 21 - 29 years represented 46.2%. The transverse diameter of the portal vein in its origin varied between 8 and 10 mm in 57.9% of the cases. The average was 9.05 ± 2.82 mm with extremes of 5 and 16 mm. The transverse diameter of the portal vein in its ending varied between 8 and 10 mm in 56.9%. In 29.8% of the cases, the length of the portal vein was between 61 and 70 mm and in 8.8% between 81 and 100 mm. The average length was 58 ± 22.3 mm. Before its penetration in the liver, the portal vein divided into 2 branches in 967 cases (96.7%) and in 3 branches in 33 cases (3.3%). Conclusion: This original study shows the normal dimensions of the portal vein to Malian.

关键词： Anatomy Portal Vein Ultrasound Bamako-Mali

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Indications and Techniques of Digestive Anastomoses at the Hospital in Koutiala District, Mali

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Surgical Science 2020年第11期11卷 379-384页

作者： Mahamadou coulibaly Drissa Traoré Birama Togola Souleymane Sanogo bréhima Bengaly Drissa Ouattara Department of Surgery Koutiala Hospital Bamako Mali Faculty of Medicine University of Science Technique and Technologies of Bamako Bamako Mali Department of Surgery University Hospital Center Point G Bamako Mali

Purpose: Describe the indications and techniques of digestive anastomoses at the Koutiala District Hospital. Patients and Methods: This was a prospective and descriptive study conducted in the general surgery department of the Koutiala District Hospital. Patients who benefited from digestive anastomosis between the hollow organs of the digestive tract during the period from August 1, 2017 to September 30, 2020 were included. The anastomoses with solid organs were not selected in this study. Results: One hundred and thirty-two patients were registered. Digestive anastomosis accounted for 11.5% of all surgical procedures. The average age was 38.6 years. Men were in the majority with 70.5%. The Karnofsky index was estimated to be less than 50% in 12 patients. Digestive anastomoses were indicated after resection of ileal necrosis in 43 patients (32.6%) followed by tumor resection in 32 patients (24.2%) and typhic perforations in 20 patients (15.1%). There were also 12 cases of digestive stoma (9.1%), 15 cases of volvulus of the sigmoid colon (11.4%), 7 cases of rectal prolapse (5.3%) and 3 cases of Hirschprung’s disease (2.3). Digestive anastomosis was performed in 89 patients in an emergency and was manual in all patients. Post-operative morbidity was 18.9%. These recorded complications, classified grade I (10 cases), grade II (3 cases), grade IIIa (2), grade IIIb (6 cases) and grade IV (4 cases) according to Clavien-Dindo, consisted of 8 cases of postoperative peritonitis (6.1%), 3 cases of external digestive fistula (2.3%), 2 cases of evisceration (1.5%), 12 cases of parietal suppuration (9.1%) and 4 cases of death (3.0%). Conclusion: Young male subjects are the most affected. Anastomoses are performed more often after the removal of the island necroses. Morbi-mortality is high. Success depends on several factors, including the general condition of the patient and the mastery of the anastomosis techn

关键词： Digestive Anastomosis Surgery Indications Technical

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Acute Appendicitis: Epidemio-Clinical and Therapeutic Aspects in Koutiala, Mali

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Surgical Science 2020年第8期11卷 216-221页

作者： Mahamadou coulibaly Drissa Traoré bréhima Bengaly Birama Togola Drissa Ouattara Nouhoum Ongoiba Faculty of Medicine University of Science Technique and Technologies of Bamako Bamako Mali Department of Surgery Koutiala Hospital Bamako Mali Department of Surgery University Hospital Center Point G Bamako Mali

Purpose: To assess the epidemiological, clinical and therapeutic aspects of acute appendicitis at the Koutiala Reference Health Centre. Methods: 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. Results: 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. Conclusion: Simple acute appendicitis is more common. Laparotomy remains the only way at present. Postoperative morbidity is high in complicated appendicitis and mortality is zero.

关键词： Appendix Abscess Peritonitis Plastron Surgery

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Total Thrombosis of Bifurcated Endoprosthesis: A Rare Complication of Endovascular Treatment of Abdominal Aortic Aneurysm

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Surgical Science 2019年第9期10卷 338-345页

作者： Birama Togola bréhima Bengaly Madiassa Konaté Laurent Muller Olivier Szymoniak Mahamadou coulibaly Drissa Traoré bréhima coulibaly Skaiste Vaitkevicienne Michel Peret Nouhoum Ongoiba Jean Louis Debrux Department of Surgery “B” CHU Point “G” Bamako Mali Department of General Surgery Hospital Gabriel Touré Bamako Mali Department of Vascular and Thoracic Surgery of CH Cholet France Department of Vascular Surgery in Park Polyclinic of Cholet Cholet France Department of Thoracic and Cardiovascular Surgery Angers CHU Angers France

Background: Aortic stents are a therapeutic alternative to open surgery of abdominal aortic aneurysms. We report a case of treatment of an abdominal aortic aneurysm with a bifurcated stent, complicated by total thrombosis. Aim: The purpose of this presentation was to understand the causes, mechanisms, incidents and accidents that contributed to this complication. Case Presentation: A 48-year-old man patient with a history of high blood pressure, ischemic heart disease, chronic obstructive pulmonary disease, who was found during a surveillance check-up, an infra-renal abdominal aorta aneurysm measured at 56 mm in diameter, asymptomatic but progressive. The indication of an endovascular treatment by the placement of a bifurcated prosthesis was posed and accepted. Thrombosis of the two limbs was intra-operative, upper-end migration without endoleak at 4 months postoperative, total thrombosis of the stent at 13 months postoperatively. Explantation of the stent followed by aortobi-iliac bypass was finally performed in the 15th month. Conclusion: The cardiopulmonary antecedents, the anatomical and evolutionary characteristics of the aneurysm could have played a role in the occurrence of the complications observed in this patient.

关键词： Aneurysm Abdominal Aorta Endovascular Complications Stent Thrombosis

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Premature Division of the Inferior Laryngeal Nerve in Surgery and in ENT and Cervico-Facial Surgery in Mali

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Forensic Medicine and Anatomy Research 2019年第1期7卷 1-7页

作者： Drissa Traoré Abdoulaye Kanté Youssouf Sidibé bréhima Bengaly bréhima coulibaly Babou Ba Drissa Ouattara Siaka Diallo Mariam Daou Birama Togola Nouhoum Ongoiba Service of Surgery B.CHU Point G BamakoMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali ENT and Head and Neck Surgery Department CHU“Mother-Child”BamakoMali Service of Neurology CHU Gabriel TouréBamakoMali

The purpose of this study was to study the frequency of premature division of the inferior laryngeal nerve and its consequences in thyroid surgery. Methodology: We realized a forward-looking and retrospective study from January, 1979 till December, 2017 in the service of surgery B to the University hospital of the Point G of Bamako and in the service of ENT and cervico-facial surgery of the CHU “mother-child”, the Luxembourg of Bamako (Mali). All the patients operated in both services for mild goiters were included. Cancers and other thyroid pathologies were not included. The diagnosis of mild goiter was paused by the histological examination realized on all the surgical specimens. Results: On 2109 dissections of the lower laryngeal nerve realized during the surgical operations on the thyroid 95.1% of the cases, the nerve had a single branch;in 4.1% of the cases, the nerve had two branches;and in 0.8% of the cases, the nerve had more than 2 branches. Conclusion: The complications of the thyroid surgery in touch with the hurts of the lower laryngeal nerve are known. However, our study shows that these do not seem to be influenced by the premature division of the lower laryngeal nerve.

关键词： Anatomy Inferior Laryngeal Nerve Recurring Nerve Thyroid Surgery Goiter

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