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

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Spontaneous External Digestive Fistula of Tuberculosis Origin, Medical Treatment: About a Case at the Timbuktu Hospital

Case Reports in Clinical Medicine（临床医学病理报告） 2024年第1期

作者： Abdoulaye Kanté Mamady Almami Kéita idrissa tounkara Drissa Ouattara Bréhima Bengaly Souleymane Sanogo Bréhima Togola Drissa Traoré Nouhoum Ongoiba

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Surgical Science 2021年第1期12卷 17-22页

作者： Oumar Ongoïba idrissa tounkara Thiam Souleymane Charles Dara Jacques Saye Karim Dao Djibril Kassogué Timbuktu Mali Regional Hospital Mali Timbuktu Mali Reference Health Center of Commune II Bamako Mali Gao Regional Hospital Gao Mali Point G University Hospital Center Bamako Mali

In the literature, the management of enterocutaneous fistula of tuberculosis origin is rare. The aim of this work was to report a case of external digestive fistula of tuberculosis origin in a 10-year-old girl in northern Mali in a situation of armed conflict. She was a 10-year-old patient who was admitted to our general surgery ward for external digestive fistula evolving for more than (4) four years, at admission the general. The karnofsky index was at 40%, she could not sit or hold a cup to drink water. A 3 cm enterocutaneous fistula deafened foul-smelling liquid stools, on clinical examination, the conjunctivas were pale, the lips were dry, the eyes were sunk in the eye sockets, the ribs visible from a distance. The paraclinical aspects (Itra-Dermo-Reaction (IDR) to tubercria, anatomopathology) were positive, specifying the place of medical treatment and evolution under medical treatment. Digestive fistula of tuberculosis origin is a rare condition in surgical settings.

关键词： Spontaneous External Digestive Fistula Non-Surgical Treatment Timbuktu

Epididymo-Testicular Tuberculosis: A Case Report from Bamako

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Surgical Science 2023年第3期14卷 197-202页

作者： Coulibaly Amara Mamadou Almamy Keita Moussa Sissoko Drissa Kaloga Bagayoko Cheickna tounkara idrissa tounkara Abdoul Karim Simaga Bakary Coulibaly Sidiki Konaré Adama Drabo Seydou Sissoko Sekou Koumaré Abdoulaye Diarra Keita Soumaila General Surgery Department Reference Health Center of The Second Municipality of Bamako Bamako Mali Department of Surgery of The CHU du Point G Faculty of Medicine and Odontostomatology of Bamako Bamako Mali

We report a case of epididymo-testicular tuberculosis in a 31-year-old man in the surgical department “A” at the University Hospital Point G of Bamako. Epididymitis or orchi-epididymitis is an infection of the epididymis and/or testis. It is the most frequent reason for consultation in urology and affects mainly young people between 30 and 50 years of age. Mycobacterium tuberculosis is very rarely incriminated (2% to 3% of cases). The main problem with genital tuberculosis lies in the diagnosis, which is often difficult and delayed in the absence of other suggestive locations, a notion of contagion or a history of tuberculosis. In the absence of germs in the urine or semen, the diagnosis of certainty is based on histological examination of biopsy fragments of the testicle or epididymis. Delayed treatment results in impaired fertility, such as oligospermia or azoospermia due to reversible or irreversible organic damage to the genitalia.

关键词： Tuberculosis Epididymis Testicle

Digestive Surgical Emergencies at the Commune II Reference Health Centre in the District of Bamako

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Surgical Science 2022年第5期13卷 258-264页

作者： idrissa tounkara Abdoulaye Diarra Amadou Traore Boubacar Karembe Sayon Diakite Konimba Keita Oumar Ongoiba Madiassa Konate Seydou Sangare Bakary Coulibaly Bakary Tientigui Dembele Adegne Togo Reference Health Center of the Municipality II Bamako Mali Hospital-University Center of Kati Kati Mali University Hospital Gabriel Touré Bamako Mali Reference Health Center of the Municipality III Bamako Mali Timbuktu Regional Hospital Timbuktu Mali

We conducted a prospective descriptive study from January 1 to December 31, 2018 with the objectives of determining the frequency of digestive surgical emergencies, describing the clinical and para-clinical aspects of the management of digestive surgical emergencies, evaluating the therapeutic aspect of digestive surgical emergencies and analysing the post-operative follow-up of patients operated on in emergencies. We counted 120 patients operated on for digestive surgical emergencies, which corresponds to 5.80% of all consultations and 44.80% of all surgical interventions. The male sex was the most represented with a ratio of 1.80. The average age was 27.5 years. The majority of patients were from Bamako. Abdominal pain was the reason for consultation in 80% of cases. The diagnosis was essentially clinical and paraclinical in doubtful cases. These included ultrasound, unprepared abdomen and sometimes abdominal CT scans. Acute appendicitis was the most common pathology with 42.5%. General anaesthesia and spinal anaesthesia were used with 50% each. The majority of patients were operated on between 30 minutes and 12 hours after their admission to the department (71.7%). Acute peritonitis accounted for 67% of deaths from sepsis. The surgical technique was decided according to the pathology and the surgeon’s choice. The postoperative course was simple in the majority of cases. The prognosis is good when the management is early. The treatment is medical-surgical.

关键词： Surgical Emergencies Digestive Tract General Surgery CSRéf CII

Parietal Infiltration for Postoperative Analgesia

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Surgical Science 2023年第2期14卷 72-76页

作者： Kanté Lassana Issiaka Diarra idrissa tounkara Maiga Amadou Traore Amadou Madiassa Konaté Ibrahima Diakite Dembélé Bakary Tientigui Alassane Traore Adegné Togo Faculty of Medicine and Odonto Stomatology (FMOS) General Surgery Department Gabriel Touré University Hospital Center Bamako Mali General Surgery Department of the Reference Health Center of Commune 1 of Bamako District Bamako Mali General Surgery Department of the Reference Health Center of Commune 2 of Bamako District Bamako Mali

The parietal component of pain occupies an important place in the management of postoperative analgesia. Parietal infiltration is a technique that fits into a concept of multimodal analgesia using several analgesic products simultaneously. This simple and reliable technique makes it possible to reduce the use of opioids and therefore their adverse effects;without increasing the risk of infection. It reduces the length of hospitalization.

关键词： Parietal Infiltration Analgesia Surgery

Acute Appendicities in the Reference Health Center of Municipality II of Bamako District

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Surgical Science 2022年第5期13卷 251-257页

作者： idrissa tounkara Boubacar Karembe Sayon Diakite Abdoulaye Diarra Amadou Traore Konimba Keita Oumar Ongoiba Madiassa Konate Moussa L. Coulibaly Bakary Coulibaly Bakary Tientigui Dembele Adegne Togo Reference Health Center of the Municipality II Bamako Mali Reference Health Center of the Municipality III Bamako Mali University Hospital of Kati Kati Mali University Hospital Gabriel Touré Bamako Mali Timbuktu Regional Hospital Timbuktu Mali

This was a prospective study from January 2019 to December 2019 in the reference health center of municipality II of the Bamako district. During this period, we operated on 73 patients for acute appendicitis, including 51 men and 22 women, for a sex ratio of 1.7. The average age was 25.5 with extremes of 1 and 40 years. Abdominal pain was the main reason for consultation. The physical signs were dominated by the positivity of the Blumberg sign in 97.3% of the cases, the defense of the right iliac fossa in 79.5%, and the Rovsing sign in 61.6% of the cases. This physical examination made it possible to make the diagnosis in the majority of cases. In the face of some doubtful cases, we requested an abdominal ultrasound. Locoregional anesthesia was the most used anesthesia technique at 72.6%. The classic anterograde appendectomy with stump burial by Mac Burney was the most commonly used technique, respectively. The postoperative consequences were straightforward in 87.6%. Anatomopathology examination was performed on 69 surgical specimens and 4 appendectomy specimens were not subjected to an anatomo-pathological examination. Phlegmonous appendicitis was the most common at 63% of cases. Appendicitis remains the most common surgical emergency in a community setting. The early diagnosis and the speed of treatment guarantee improvements in the prognosis. The treatment is mainly surgical.

关键词： Acute Appendicitis Clinical Aspects Appendectomy Postoperative Effects

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

Clinical and Therapeutic Aspects of Inguinal Hernia at the Reference Health Centre of Commune II of the District of Bamako

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Surgical Science 2022年第5期13卷 265-271页

作者： idrissa tounkara Boubacar Karembe Souleymane Thiam Sayon Diakite Abdoulaye Diarra Amadou Traore Konimba Keita Oumar Ongoiba Moussa Sanogo Moussa L. Coulibaly Bakary Tientigui Dembele Adégné Togo Reference Health Center of Commune II Bamako Mali Commune III Reference Health Centre Bamako Mali University Hospital Center of Gao Gao Mali University Hospital Center of Kati Kati Mali University Hospital of Gabriel Touré Bamako Mali Regional Hospital of Tombouctou Tombouctou Mali

Objective: To study the diagnostic and therapeutic aspects of uncomplicated inguinal hernias in the general surgery unit of CSRéf CII. Method: This was a prospective, descriptive, single-centre study from 1 January 2016 to 31 December 2016 of 84 patients operated on for inguinal hernias in the general surgery unit of CSRéf CII. Results: Inguinal hernia accounted for 8% of surgical consultations and hernia repair accounted for 30.22% of surgical procedures. Hernia repair accounted for 30.22% of surgical procedures. The male sex was the most represented with a ratio of 7.40. The average age of our patients was 43.19 years. Recurrence occurred in 10% of cases. The right side was most affected in 71.43% of cases, 19.05% on the left side in;it was bilateral in 09.52%. Local anaesthesia was used in 67.86% of our patients, general anaesthesia in 13.09% of cases and locoregional anaesthesia in 19.05% of cases. The hernia was external oblique in 75% of cases. Shouldice’s technique was the most used with 88%;Bassini’s technique was used in 7% and Mac Vay’s in 5% of cases. The postoperative course was simple in 96.43% of cases, with an early postoperative morbidity rate of 3.57%, one case of wall abscess and two cases of parietal haematoma. No deaths were observed during our study. Conclusion: The new methods of tension-free cure should be used more and more by our users in our facilities.

关键词： Inguinal Hernias Strangulation Management CSRéf CII

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