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Maternal Deaths in Patients Evacuated to the Fousseyni Daou Hospital in Kayes over a Decade

Open Journal of Obstetrics and Gynecology 2023年第8期13卷 1389-1398页

作者： Mahamadou Diassana Sitapha dembele Ballan Macalou Alima Sibibe Falaye Keita Mamadou Haidara Famakan Kane Cheickna Sylla Amadou Bocoum Sanogo Siaka Amara Soumaila Traoré Department of Gynecology and Obstetrics Fousseyni Daou Hospital Kayes Mali Kayes Reference Health Centre Kayes Mali Reference Health Center of Kalaban-Coro Bamako Mali Bla Reference Health Centre Ségou Mali Department of Gynecology and Obstetrics Gabriel Toure University Hospital Center in Bamako Bamako Mali Department of Gynaecology and Obstetrics Regional Hospital of Sikasso Sikasso Mali

Introduction: Evacuation refers to the rapid transfer of a patient in an emergency, from one health center to another more equipped and better specialized. The objective of this study was to study maternal mortality in patients evacuated to the gynecology and obstetrics department at the Fousseyni Daou Hospital in Kayes over a period of 10 years. Materials and Methods: This was a descriptive, cross-sectional, retrospective study over nine years from January 1, 2011 to December 31, 2019 and prospective over one year from January 1, 2020 to December 31, 2020 involving all patients or parturients evacuated for obstetrical causes and died in the gynecology-obstetrics department of the Fousseyni Daou Hospital. Confidentiality and anonymity were respected. The processing and analysis of the statistical data was carried out using SPSS 20.0 software. Results: during our study period we identified 38,854 obstetric admissions including 6758 evacuations or 17.4%, among the 6758 cases of obstetric evacuations 284 died, a frequency of 4.2%. The maternal death audit committee of the Fousseyni Daou hospital in Kayes audited 101/284 cases (files) or 35.5% of which 64 maternal deaths (63.4%) were considered inevitable. In our study the 20 - 29 age group was more represented with 38%. 85% of the deceased patients lived in rural areas. In our series, 63.7% of the deceased patients had not had antenatal consultations (NPC). Eclampsia accounted for 26.8% of admissions diagnoses and 30.9% of causes of death. Seventy-two (72%) of deaths occurred postpartum, 15% perpartum and 13% prepartum. Direct obstetric causes were predominant at 65.1%. Conclusion: Indicators of maternal deaths among evacuated patients remain poor in our work. Maternal deaths were driven by socio-economic and cultural factors, but also by factors related to the health system.

关键词： Maternal Mortality Evacuation Kayes Hospital

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Intestinal Invagination in Adults: About a Case at the “Mother-Child” Hospital Le Luxembourg in Mali

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Surgical Science 2023年第9期14卷 583-589页

作者： Cheickna Tounkara Oumar Amadou Malle Amara Coulibaly A. Boubacar Maiga Sory Ibrahim Diawara Kassim Kayentao Bakary Tientigui dembele Alhassane Traore Adégné Pierre Togo Lassana Kante Department of general surgery of the Hospital “Mother Child” Le Luxembourg Bamako Mali University of Sciences of Techniques and Technologies of Bamako Mali (USTTB) Bamako Mali Department of General Surgery of the CHU Gabriel Touré Bamako Mali

Intussusception is a pathology of infants and young children. Its occurrence in adults is very unusual. In the vast majority of cases, it is secondary to a benign or malignant tumor. Small bowel malignancies are relatively rare, 1% - 5% of malignant tumors of the gastrointestinal tract. Acute intussusception, a rare pathology in adults, often presents with non-specific symptoms. Contrary to children, the organic origin remains preponderant in the elderly, where the origin of neoplasia must be suspected in first intention. We report the case of a 49-year-old patient admitted urgently from the Luxembourg “Mère Enfant” hospital center in Bamako, Mali, for an occlusive syndrome. Several abdomino-pelvic ultrasounds were performed in several clinics with mixed conclusions: Hydro-aeric distension and a cessation of matter and gas without a clearly visible mass (04/09/2022);Demonstration of the central hydro-aeric levels wider than high containing fine and regular folds corresponding to connivents whose aspect is in factor of left acute small intestine occlusion, to be completed by the surgical opinion (06/09/2022) and a third ultrasound showed a normal appearance of the liver, gallbladder, kidneys, pancreas, spleen, bladder and prostate;diffuse aero-colic distention without lesion of secondary appearance (21/11/2022). A frontal standing ASP dated 11/25/2022 showed hail-like hydro-aeric levels. Surgical management consisted of an open oncological resection of an obstructive bowel tumor with ileo-ileal invagination. The anatomopathological and immunohistochemical study of the surgical specimen concluded to diffuse small cell non-Hodgkin’s lymphoma, without vascular embolism. The resection limits pass into the healthy zone.

关键词： Acute Intestinal Intussusception Organic Etiology Digestive Lymphoma Mali

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A Case Report of an Invasive Scalp Actinomycosis

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Case Reports in Clinical Medicine 2021年第2期10卷 34-38页

作者： Youssouf Sogoba Jean Paul dembele Boubacar Sogoba Moussa Diallo Seybou Hassane Diallo Oumar Coulibaly Quenum Kisito Oumar Diallo Drissa Kanikomo Youssoufa Maiga Department of Neurosurgery H&ocirc pital Gabriel Touré Bamako Mali Department of Infectious Diseases H&ocirc pital du Point G Bamako Mali Department of Neurologie H&ocirc pital Gabriel Touré Bamako Mali Department of Neurosurgery H&ocirc pital du Mali Bamako Mali Department of Neurosurgery University Hospital of Parakou Parakou Benin

Background: Actinomycosis is a bacterial infection characterized by a chronic, suppurative and granulomatous process. The causative organism was identified in 1891 as Actinomycosis israelii. The disease is usually caused by the introduction of the bacteria through minor wound. Actinomycosis was classified by Cope into 3 different forms: cervicofacial (50%), pulmonothoracic (30%) and abdominopelvic (20%). Actinomycosis is an insidious disease but occasionally the clinical course can be more aggressive, involving underline tissue and organs. Involvement of scalp by actinomycosis is rare causing diagnostic dilemma and could be mistaken for different pathologies, such as tuberculosis or carcinoma. The most common clinical findings are local tumefaction with abscesses and sinuses draining pus that contains the granule of the causative organism. CT scan and MRI are aspecific for diagnosis, but they can help in defining the localization and the extension of the lesion. The certain diagnostic is based on cytology and/or biopsy. Case: A 24 year-old-man was admitted to our neurosurgical department with a 16-month history of multiple scalp ulcerated lesions and swelling of the head. He was complaining of headache. Physical examination revealed multiple scalp subcutaneous nodules and ulcerated lesions with swelling of the head. Our examination of the oral cavity revealed a poor oral hygiene condition with multiple caries. The CT scan revealed multiple scalp subcutaneous masses with chronic inflammatory changes of the skull. Routine laboratory test was normal. Surgical biopsy was performed and the histological result was compatible with actinomycosis. After histological confirmation, parenteral Penicillin 20 million units daily were given for 4 weeks. Clinical improvement was observed after completing a 4-week regimen of intravenous antibiotics. Conclusion: Involvement of scalp by actinomycosis could be mistaken for dif

关键词： Actinomycosis Bacterial Infection Computed Tomography

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Clinical and Therapeutic Aspects of Inguinal Hernia in Children in the General Surgery Department of Reference Health Center in Commune I of Bamako Mali

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Surgical Science 2024年第2期15卷 54-63页

作者： Tounkara Cheickna Samake Hamidou Simpara Mama Diarra Issaka Sanogo Modibo Sidibe Souleymane Togola Modibo dembele Bakary Tientigui Coulibaly Yacaria Togo Pierre Adégné Kante Lassana Department of General Surgery the Reference Health Center of Commune I Bamako Mali Directorate of Social Health Service the Armed Forces of Mali Bamako Mali Department of Pediatric Surgery Mali Hospital Bamako Mali Department of General Surgery the Gabriel TOURE University Hospital Bamako Mali Department of Pediatric Surgery Gabriel TOURE University Hospital Bamako Mali

Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to study inguinal hernia in children in the general surgery department of the Reference Health Center of Commune I of the Bamako District;to determine the frequency of inguinal hernia;describe the epidemiological, clinical and therapeutic aspects of inguinal hernias and in order to evaluate the cost of treatment. This was a prospective study from April 2017 to March 2018 during which 60 children with an inguinal hernia were collected. Inguinal hernias in children represented 9.23% of patients operated on in the department. The average age was 59.23 months with extremes of one month and 180 months and a standard deviation of 49.23 years. The male sex was dominant with a sex ratio equal to 9:1. The notion of prematurity was found in 11.7% and was associated with a testicle not in place in 1.7% of cases. 41.7% of our patients were referred by a doctor and 66.7% of patients presented with painless, intermittent inguino-scrotal swelling (83.3% of cases). The hernia was discovered before one week of life in 50% of cases. Inguinal swelling was absent in 11.7% but observed intraoperatively. The inguinal hernia was unilateral in 91.7% of cases and 70% of hernias were discovered by the parents during pushing efforts. The inguinal hernia was located on the right in 61.7% of cases. The hernia swelling was soft, painless, impulsive and reducible in 78.3% of cases. The swelling was inguino-scrotal in 58.3% of cases. The hernia was simple in 95% of patients and hernial strangulation was observed in 3 cases or 5% of cases. 98.3% of patients were ASA I. The treatment was carried out openly in all our patients including closure of the vaginal peritoneal canal in 95% of cases under general anesthesia in 98.3% of cases. The morbidity rate was 8.4% (surgical site infection: 6.7% of ca

关键词： Inguinal Hernia Child Surgery Cs Ref C I Bamako Mali

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Pulmonary and Extra-Pulmonary Tuberculosis: Epidemiological and Diagnostic Aspects at Sominé DOLO Hospital in Mopti

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Journal of Tuberculosis Research 2021年第1期9卷 63-71页

作者： Dramane Samake Modibo Coulibaly Mamadou Sayon Keita Mamoutou dembele Aboubacar Sidiki Traore Damissa Samuel Coulibaly Oumar Guindo Madou Traore Bakary Sayon Keita Sounkalo Dao Infectious Diseases and Infectious and Tropical Diseases Research Officer Head of Medicine Sominé DOLO Hospital Mopti Mali Laboratory Department of Medical Biology at Sominé DOLO Hospital Mopti Mali Sectorial Unit to Fight HIV/AIDS Tuberculosis and Viral Hepatitis Bamako Mali Department of Medicine at Sominé DOLO Hospital Mopti Mali Department of Medicine at Nianankoro Fomba Hospital Ségou Mali General Director of Sominé DOLO Hospital Mopti Mali Department of Medicine Sikasso Regional Hospital Sikasso Mali Department of Medicine of the Fousseyni Daou Hospital Kayes Mali Head of Infectious Diseases Department at Point G University Hospital Bamako Mali

Despite the efforts made to fight the tuberculosis, Mycobacterium tuberculosis still remains a public health problem, particularly for low-income countries. According to the World Health Organization data, our country, Mali has detected only half of the 10,385 cases of tuberculosis expected for 2014 for a population of 17,309,000 inhabitants. The objective of this present work was to describe the different clinical aspects and the epidemiology of tuberculosis at Hospital Sominé Dolo in Mopti. We performed a retro-prospective and descriptive of tuberculosis cases diagnosed in our department of medicine between May 2016 and August 2018. A total of 96 tuberculosis cases were recorded, i.e. 4.6% and 1.0% for hospitalizations and consultations patterns, respectively. The median of age was 41 with extremes from 5 to 80 years. The age group [31 - 40 years] was the most affected with 20.8%. Men and women were affected in identical proportions, i.e. 50%. Pulmonary locations were the most frequent with 55.2%. Pleural tuberculosis was far the most frequent of the extra-pulmonary forms with 24.0% followed by

关键词： Tuberculosis Clinical Aspects Epidemiology Hospital Sominé DOLO Mopti

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Volvulus of the Sigmoid Colon without Necrosis: Therapeutic Aspects in Hospital Fousseyni Daou Hospital in Kayes, Mali

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Surgical Science 2022年第12期13卷 592-599页

作者： Lamine Issaga Traore Sidy Sangare Mamaye Kouyate Gaoussou Sogoba Drissa Katile Adama S. Diakite Lassana Goita Sadio dembele Djibril Traore Drissa Traore General Surgery Department of the Fousseyni DAOU Hospital Kayes Mali National Center for Scientific Research and Technology (CNRST) Bamako Mali Pediatric Surgery Department of the Fousseyni DAOU Hospital Kayes Mali Gastro-Hepato-Enterology Unit of the Fousseyni DAOU Hospital Kayes Mali Urology Department of Fousseyni DAOU Hospital Kayes Mali Anesthesia and Intensive Care Unit at Fousseyni DAOU Hospital Kayes Mali General Surgery Department of Somine DOLO Hospital Mopti Mali General Surgery Department of the University Hospital of Point G Bamako Mali

The volvulus of the sigmoid is known since ancient Egypt. In the 5th century BC, hippocrates laid the foundations for its management. The first observation of this condition was not reported until 1836 by Von Rokitansky, and then in 1859, Melchior described its physiopathological consequences. It was the Norwegian Brusgaard who reported, for the first time, in 1947, the effectiveness of a non-operative treatment. Purpose: Describe morbidity, mortality and the impact of co-morbidity factors on the choice of operative techniques. Patients and Methods: This is a retrospective cross-sectional study performed at the Fousseyni Daou Hospital in Kayes from January 2014 to December 2021. We included all patients operated for sigmoid volvulus without necrosis. The parameters studied were the comorbidity factor, surgical modalities, morbidity and mortality. Results: We collected 31 patients, of whom 29 were men and 2 were women, for a sex ratio of 14.5. The mean age was 55 years with extremes (29 - 78 years). Sigmoidectomy with colorectal anastomosis was performed in 19 cases (61.3%), the average age of these patients was 46.16 years, the comorbidity factor was 1 case (3.2%), the postoperative course was simple in 12 cases (63.1%), the morbidity was 6 cases (26.3%) and mortality 1 case (3.2%). Untwisting with colopexy was performed in 11 cases (35.5%), the average age was 65.91 years, comorbidities were present in 9 cases (82%), the postoperative course was simple in 9 cases (82%), morbidity was 1 case (9%) and mortality 1 case (9%). Hartman colostomy was performed in 1 case (3.2%), the age was 60 years, the morbidity was nil. Overall, the postoperative course was simple in 22 cases (71%), the overall morbidity was 7 cases (22.6%) and mortality 2 cases (6.4%). Conclusion: At the end of our study, we can note that the choice of the operative technique for the volvulus of the sigmoid without necrosis can be influenced by the presence of major comorbidity and the morbi-mortality

关键词： Volvulus without Necrosis Surgical Technique Comorbidity Morbidity Mortality

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Post-Traumatic Duodenal Rupture at the Fousseyni Daou Hospital in Kayes, Mali: A Case Report

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Surgical Science 2022年第6期13卷 300-306页

作者： Sangare Sidy Sogoba Gaoussou Traore Lamine Issaga Kouyate Mamaye Katile Drissa Goita Lassana dembele Sadio Traore Allassane Dembélé Bakary Tientigui Traore Drissa Togo Adegné Department of General Surgery Fousseyni DAOU Hospital Kayes Mali Department of Paediatric Surgery Fousseyni DAOU Hospital Kayes Mali Department of Gastroenterology Fousseyni DAOU Hospital Kayes Mali Department of Anaesthesia and Resuscitation Fousseyni DAOU Hospital Kayes Mali Department of General Surgery Gabriel TOURE Hospital Bamako Mali Department of General Surgery Point G Hospital Bamako Mali

Lesions resulting from duodenal involvement are rare. Their diagnosis and management remain difficult because of the topographic location of most of the duodenum in the retroperitoneum. We report a case of isolated duodenal rupture. At the time of the first operation, the duodenal lesion had gone unnoticed. During our management, we discovered a rupture of the lower knee of the second duodenum and we performed a triple anastomosis after the closure of the ends (proximal and distal). The immediate postoperative course was complicated by the death of the patient on the second day of surgery. Duodenal lesions have much mortality which is increased by the delay in diagnosis and management.

关键词： Emergency Duodenal Rupture Abdominal Contusion

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Socio-Epidemiological Aspects and Prognosis of Unassisted Deliveries Arriving at Fousseyni Daou Hospital in Kayes

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 360-371页

作者： Sitapha dembele Mahamadou Diassana Ballan Macalou Alima Sibibe Albachar Hamidou Daouda Fomba Mamadou Haidara Famakan Kane Cheickna Sylla Amadou Bocoum Sanogo Siaka Amara Soumaila Traoré Department of Gynecology and Obstetrics of the Fousseyni DAOU Hospital Kayes Mali Kayes Reference Health Centre Kayes Mali Reference Health Center of Kalaban-Coro Bamako Mali Bla Reference Health Centre Ségou Mali Department of Gynecology and Obstetrics of the CHU GABRIEL TOURE Bamako Mali Department of Gynaecology and Obstetrics of the Regional Hospital of SIKASSO Bamako Mali

Introduction: The World Health Organization estimates that each year more than 20 million women suffer from the after-effects of unattended childbirth, of which 800 women die every day as a result of obstetric complications. Objective: Study the socio-epidemiological aspects and prognosis of unassisted deliveries arriving at the Fousseyni Daou De Kayes hospital. Materials and Methods: This was a descriptive, cross-sectional study with prospective collection, case-control that took place at the maternity ward of the Fousseyni Daou hospital in Kayes, from 1 January to 31 December 2021. Results: The frequency of unattended birth was 4.1%. The 30 - 35 age group was the most represented with 32.5%. In our study 58.1% of cases were out of school, 19.4% were primigestes and 39.4% were multiparous. In our series 60.6% of cases had given birth at home and 39.4% along the way. The majority of cases regretted having given birth without the assistance of qualified personnel in 45.6%. Maternal complications were dominated by perineal lesions in 14.4% of cases, haemorrhage of delivery in 25% of cases, severe anaemia in 30% of cases;16.7% of newborns were in poor condition, 13.6% were fresh stillbirths, 15.6% of newborns had obstetric trauma. The maternal death rate on arrival was 3%. Conclusion: The frequency of unassisted childbirth is high in the Kayes region. Its complications can be serious for both the mother and the newborn.

关键词： Childbirth Unassisted Prognosis Complications Kayes

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Acute Peritonitis at the Reference Health Center of Commune I of the District of Bamako: Epidemiological, Clinical and Therapeutic Aspects

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Surgical Science 2023年第12期14卷 728-737页

作者： Tounkara Cheickna Samake Hamidou Maïga Amadou Cisse Alou Hamadoun Diarra Issaka Sanogo Modibo Togola Modibo dembele Bakary Tientigui Traore Alhassane Togo Pierre Adegne Kante Lassana Department of General Surgery Cs Ref of Commune I of Bamako Bamako Mali Central Directorate of Social Service of Army Health Bamako Mali Department of General Surgery Gabriel Toure University Hospital Bamako Mali

Acute peritonitis is most often secondary to perforation of the digestive organ and/or the spread of an intra-abdominal septic focus. The objectives of this work were to study acute peritonitis in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of peritonitis, to describe the epidemiological, clinical and therapeutic aspects in order to analyze the surgical consequences and to assess the additional cost of treating acute peritonitis. This study was prospective, descriptive, cross-sectional involving 40 patients received in the surgery department of the Cs ref of commune I for acute peritonitis from January 1, 2018 to December 31, 2018. There were 40 patients among whom 28 (70%) were men and 12 were women (30%), i.e. a sex ratio = 2.3. The average age was 25 years with extremes varying between 16 and 54 years and a standard deviation of 11.78. Abdominal pain was the main reason for consultation. Clinical examination alone made it possible to make the diagnosis in 75% of cases. Surgical treatment depended on the intraoperative etiology. The clinical diagnosis was supported by ASP and abdominal ultrasound;performed respectively in 10% and 90% of patients. Appendiceal peritonitis was the intraoperative diagnosis observed in 50% of cases. All our patients benefited from a peritoneal toilet with drainage. We noted a morbidity rate of 5% dominated by parietal suppuration. The average cost of care was 175,000 FCFA.

关键词： Acute Peritonitis Epidemiology Diagnostic Therapy Surgical Emergencies Cs Ref CI Bamako Mali

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Study of Hemorrhoid Disease in the Department of General Surgery of the Cs Ref of the Commune I Bamako

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Surgical Science 2024年第2期15卷 36-47页

作者： Tounkara Cheickna Diarra Issaka Sanogo Modibo Togola Modibo Camara Ladji Soma dembele Bakary Tientigui Traore Alhassane Togo Adégné Pierre Kante Lassana Ouattara Zanafon Diallo Gangaly Department of General Surgery The Reference Health Center in Commune I Bamako Mali Department of General Surgery The Gabriel Toure University Hospital Bamako Mali Department of Urology The Gabriel Toure University Hospital Bamako Mali

This work was a retrospective prospective study carried out in the general surgery department of the Cs ref of commune I from January 2009 to December 2012. Our study aimed to determine the hospital frequency of hemorrhoidal disease, to identify the contributing factors, describe the clinical and therapeutic aspects and analyze the surgical consequences. We collected 73 patients with an average age of 37.8 years (range: 19 years and 77 years) with a sex ratio of 2.5 in favor of men. We operated on 49 patients or 67.1% of cases. 71.2% of our patients were married and lived in Bamako. Schoolchildren and middle managers made up 39.8% of cases. 82.2% of patients were seen in ordinary consultation and 69.9% complained of progressive anal pain in 66.7% of cases. This pain was triggered by defecation in 88.2% of our patients. The contributing factors were dominated by constipation (53.4%), working in a seated position (41.1%) and a sedentary lifestyle (16.4%) of cases. Stage IV external hemorrhoids and hemorrhoidal thrombosis represented 53.8% of surgical indications. The most used surgical technique was that of Milligan-Morgan, i.e. 51.9% of cases and 45.2% of patients treated medically received a combination of transit regulator, venotonics and analgesics. The surgical aftermath was marked by hemorrhage (3 cases), delayed healing (5 cases), urinary retention (1 case) and scarring anal stenosis (1 case). The morbidity rate was 5.48% of cases and a zero mortality rate. The average length of hospitalization was 2 days with extremes of 1 and 5 days.

关键词： Hemorrhoid Surgery Cs Ref C I Bamako Mali

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