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Contribution to the Study of Hemorrhages in the Third Trimester of Pregnancy, Etiology and Management

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Open Journal of Obstetrics and Gynecology 2022年第4期12卷 323-336页

作者： Seydou Mariko Pierre Coulibaly Bréhima Traoré Nanko dit Seydou Bagayogo Souleymane D. Sanogo Tiounkani Augustin Théra Mamadou traoré Nanko Doumbia Department of Gynecology Mali Hospital Bamako Mali Department of Obstetrics Gynecology Sominé Dolo Hospital in Mopti Mali Department of General Surgery Sominé Dolo Hospital in Mopti Mali Department of Obstetrics Gynecology The University Hospital Center (CHU) of Point “G” Bamako Mali Reference Health Center of Commune V Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Department of Medicine Mali Hospital Bamako Mali

Third trimester bleeding is a common concern in obstetrics. The main objective of this work was to study the management of hemorrhages in the third trimester of pregnancy in the maternity ward of the Sominé Dolo hospital in Mopti. Our prospective descriptive cross-sectional survey type study conducted at the maternity ward of Sominé Dolo hospital in Mopti over a period from January 1, 2017 to December 31, 2017 included 94 cases collected. During this period we had performed 1485 deliveries including 94 cases of pregnancies complicated by 3rd trimester hemorrhage, a frequency of 6.33%. The main cause of hemorrhage in the third trimester was represented by placenta preavia 42.6% followed by retroplacental hematoma 28.7%, uterine rupture 26.6% and association Placenta preavia and retroplacental hematoma 2.1%. The type of intervention depended on the cause of the hemorrhage and the maternal and fetal condition. More than half of the cases of uterine rupture 52% had benefited from a hysterorrhaphy during a laparotomy (n = 13/25) against 48% from hysterectomy (n = 12/25). Caesarean section was performed in 87.5% (n = 35/40) against 12.5% vaginal delivery (n = 5/40) in case of placenta preavia. In the end, in 74% of cases (n = 20/27) of retroplacental hematoma, first-line cesarean section was performed. The maternal prognosis was represented by a mortality rate of 12% (n = 11/94) and morbidity dominated by hypovolemic shock 48.9% (n = 22/94), infections 28.8% (n = 13/94) and coagulopathy 11.1% (n = 5/94). The fetal prognosis was very poor. More than half (55%) of the newborns had succumbed against 45% of the newly born. In 55.3% of cases neonatal mortality occurred antenatally. Neonatal morbidity was represented by prematurity, i.e. 20.2% (n = 19/94) and low birth weight, i.e. 22.3% (n = 21/94).

关键词： Hemorrhage Pregnancy 3rd Trimester Management Prognosis

Stranched Internal Hernia Revealed by Occlusion of the Large Libra: A Propos of a Case

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Case Reports in Clinical Medicine 2024年第1期13卷 37-42页

作者： Abdoulaye Kanté Mamady Almami Kéita Idrissa Tounkara Drissa Ouattara bréhima Bengaly Souleymane Sanogo bréhima Togola Drissa traoré Nouhoum Ongoiba General Surgery Department of The Kati-Mali Reference Health Center Koulikoro Mali Service of Surgery “B” of The CHU Du Point G Faculty of Medicine and Odontostomatology Bamako Mali

The left para-duodenal internal hernia, whose origin is generally embryological, is a rare etiology of intestinal obstruction found mainly in young adults. We report here the case of acute intestinal obstruction by left para-duodenal internal hernia in a 36-year-old young man. It was a patient who consulted urgently for occlusive syndrome with cessation of materials and gases. Abdominal percussion noted abdominal tympanism and pre-hepatic dullness was preserved. The flow and icicle signs were negative. Palpation did not objectify hepatosplenomegaly and did not find any organomegaly either. On the other hand, she found an epigastric defense. The abdominal X-ray without preparation showed water levels that were wider than high, hail-like. We performed a median above and below umbilical laparotomy and intraoperatively, it was an internal hernia with incarceration of small loops in a voluminous left paraduodenal sac of 12 cm. They were not necrotic and quickly recolored after extrication. We resected the hernial sac and closed the hernial orifice with separate stitches with absorbable suture 0. The postoperative course was simple. The patient was discharged from the hospital on the 4th postoperative day. After 18 months of hindsight, he is doing well.

关键词： Paraduodenal Internal Hernia Occlusion Laparotomy

Assessment of Rapid Diagnostic Tests Algorithms in Transfusion Medicine Setting

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Advances in Biological Chemistry 2021年第1期11卷 52-63页

作者： Modibo Coulibaly Bakary Maiga Dramane Samaké Moussa Diawara Mahamadou traoré Valentin Sagara Bréhima Traoré Oumar Guindo Amagana Dolo Department of Biomedical Laboratory Sominé DOLO Hospital Mopti Mali Department of Research and Training National Center for Transfusion Bamako Mali Faculty of Medicine and Odonto-Stomatology University of Sciences Techniques and Technologies Bamako Mali Department of Medicine Sominé DOLO Hospital Mopti Mali Department of Public Health Sominé DOLO Hospital Mopti Mali Faculty of Pharmacy University of Sciences Techniques and Technologies Bamako Mali

Background: The rapid diagnostic tests play a pivotal role in the screening of viral markers in blood qualification for transfusion in limited resource setting. Therefore, it is important to assess their analytical performances to ensure their proper functioning. Material and Methods: We performed a cross- sectional study by successive recruitment to assess the diagnostic value of rapid diagnostic tests algorithms using ELISA as a reference test. A total of 661 blood from donors were enrolled for this study. Rapid Diagnostic Tests (RDTs) and ELISA tests were performed for each sample by a couple of double-blinded biotechnologists. Data were collected on case report form and captured in Microsoft Excel then the file was imported and analyzed using R software version 4.0.3. Results: The diagnostic accuracy for the algorithms are summarized in Table 1. For HIV-algorithm, the internal validity parameters were as follow: sensitivity (sens) 99.0% (95% CI = 97.8, 99.5);specificity (spec) 98.3% (95% CI = 90.9, 99.7);positive likelihood ratio (PLR) 57.4 (95% CI = 8.2, 401.0);negative likelihood ratio (NLR) 0.01

关键词： Rapid Diagnostic Tests Analytical Performances Assessment Transfusion Medicine

Etiological and Radiological Profile of Acute Lower Respiratory Infections during the Pre-COVID Period in the Paediatric Ward of the Teaching Hospital of Mali and in the Community Health Centre of Yirimadio in Bamako

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Open Journal of Pediatrics 2023年第2期13卷 262-275页

作者： Bourama Kané Mariam Maiga Oumou Koné Korotoumou Wélé Diallo Aboubacar Sangaré Mody Abdoulaye Camara Mariam Doumbia Abdoul Karim Sangaré Bréhima Traoré Lassine G. Timbiné Ibrahima Cissé Ahmadou I. Dramé bréhima Kouriba Department of Paediatrics CHU Hôpital du Mali Bamako Mali Paediatric Department of the Centre de Santé de Référence de la Commune VI Bamako Mali National Institute of Public Health Bamako Mali Medical imaging department of the CHU Hôpital du Mali Bamako Mali Charles Mérieux Infectious Diseases Centre Bamako Mali Centre de Santé Communautaire de Yirimadio Bamako Mali Department of Anaesthesia and Intensive Care CHU Hôpital du Mali Bamako Mali

Introduction: Every year, nearly 4 million people pass away from acute respiratory infections. 98% of such deaths are due to lower respiratory tract infections. Even though studies have been carried on lower respiratory infections x-ray aspects in Mali, very few studies have been done to reveal bacteriological and virological evidence of this disease. Materials and methods: It is about a descriptive prospective study carried out from January to December 2018 having involved patients of all ages, coming for medical consultation at the Yirimadio Community-based health center as well as children from 6 months to 15 years old coming at the pediatric department of UHC Hôpital du Mali for a lower respiratory infection. They had all undergone chest X-ray and a PCR. The purpose: of this work is to study etiological and x-ray aspects of acute lower respiratory infections at the Yirimadio Community-based Health Center and at the UHC pediatric department of Hôpital du Mali. Findings: From January to December 2018, we recorded a frequency of 1.19%. The age group 0 - 5 years was the most represented (64.5%) with a sex ratio of 0.97 for women. Cough was the most common clinical sign (98.7%) followed by fever (58.9%). Standard frontal chest X-ray was pathological in 70% of our patients. It was bronchitis in 75.4% of cases, pneumonia (13.5%), and bronchopneumonia (12.3%). PCR positive was in 83.9% of patients. It revealed a co-infection in more than half of the patients (52.5%), bacterial infection (16.1%) and viral infection (15.2%). Pathogens isolated ranked by frequency were Streptococcus pneumoniaa (87.6%) followed by Staphylococcus aureus (24.9%) and human rhinovirus (17%). The most common viral causes were human rhinovirus (17%), followed by influenza A and B virus (7%) and human parainfluenza virus (7%). Conclusion: It stemed from the study that lower respiratory infections were mainly due to Streptococcus pneumonea and human rhinovirus during pre-COVID at the Yirimadio Community-based health center and UHC Hôpital du Mal

关键词： Lower Respiratory Infections Etiologies Children Mali

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 technique.

关键词： Digestive Anastomosis Surgery Indications Technical

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

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

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

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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

Epidemiological Profile of Cyanotic Congenital Heart Disease in the “B” Surgery Department of Point G University Hospital, before the Advent of Extracorporeal Circulation

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World Journal of Cardiovascular Surgery 2023年第11期13卷 159-166页

作者： Abdoulaye Kanté Djénèba Konaté Mamadou A. Keita Mamadou Diakité Bakary Keïta bréhima Bengaly bréhima Togola Drissa traoré Nouhoum Ongoïba Sadio Yena “B” Surgery Department of Point G University Hospital Bamako Mali Pediatrics Department of Gabriel Touré University Hospital Bamako Mali Cardiology Department of Point G University Hospital Bamako Mali Anesthesia-Resuscitation Service Commune II Reference Health Center Bamako Mali Thoracic Surgery Department of Mali Hospital Bamako Mali

Aim: Evaluate the epidemiological profile of cyanotic congenital heart disease in Mali before the advent of extracorporeal circulation in the “B” Surgery Department at the Pont G University Hospital. Patients and Methods: This was a retrospective and descriptive study that took place from January 1, 2011 to December 31, 2017. The records of patients with cyanotic congenital heart disease in the “B” surgery department of Point G University Hospital were collected. Patients operated on for cyanotic congenital heart disease were included in this study. Non-operated patients were not included. Results: The records of 17 patients operated on for cyanotic congenital heart disease were retained. The average age of patients at the time of surgery was 5.18 years with extremes of 2 and 18 years. Boys were in the majority with 59%, i.e. a sex ratio of 1.42. Patients resided in Bamako in 82% of cases. Inbreeding was found in 35.3%. Eighty-eight percent of children were born at term and 94% had up-to-date vaccination status. The average duration of patient follow-up between diagnosis and surgical management was 5 years with extremes of 2 years and 12 years. Tetralogy of Fallot regular form was the most represented heart disease. Conclusion: Cyanogenic congenital heart disease remains the most frequent congenital pathologies in our country. They most often affect male children. Consanguinity is the most common etiological factor found. Tetralogy of Fallot regular form remains the most common.

关键词： Epidemiology Congenital Heart Disease CHU Point G Mali