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Rupture of a Rudimentary Uterine Horn: A Case Report

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Open Journal of Obstetrics and Gynecology 2017年第7期7卷 748-752页

作者： Kouamé Arthur Didier Adjoby Cassou Roland Konan Joachim Effoh N’Drin Dénis Kakou Charles diomandé Fatoumata Alice Koffi Soh Victor Kouakou Firmin Obstetrics and Gynaecology Department of the University Hospital of Cocody-Abidjan Abidjan C&ocirc te D’Ivoire

Pregnancy in an abnormal uterus is a high-risk situation in obstetrics. Uterus bicornis unicollis with a rudimentary horn is often discovered incidentally. The aim of this report is to warn obstetricians about recurrent abdominal pain in the second trimester of pregnancy without any cause identified. Pregnancy can proceed in the rudimentary horn. We presented a case of a rupture of the rudimentary horn which occurred at 25 weeks of amenorrhea in an unmarried 19-year-old primigravida. The rudimentary horn was removed after performing an emergency laparotomy for an intraperitoneal hemorrhage with signs of shock. This abnormality is often revealed by uterine rupture, which usually occurs in the second trimester of pregnancy. Conclusion: We emphasize the importance of early diagnosis of this uterine abnormality, before pregnancy if possible. Undiagnosed, this condition evolves towards uterine rupture during pregnancy and requires emergency surgery with excision of the rudimentary horn.

关键词： Uterine Rupture Abdominal Pregnancy Uterus Bicornis Rudimentary Uterine Horn

Experience of the Department of Surgery “A” Point-G Hospital in the Management of Hemorrhoids (Mali)

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Surgical Science 2020年第12期11卷 435-445页

作者： sidiki Keita Koniba Keita Mahamadou Coulibaly Lamine Soumare Moussa Sissoko Oumar Sacko Sekou Koumaré Adama K. Koita Soumaîla Keita Zimogo Zié Sanogo General Surgery “A” Department Hospital Point-G. Bamako Mali General Surgery Department Hospital BSS Kati Mali

Introduction: Hemorrhoidal disease is the most common condition in proctology: it is defined by signs or symptoms attributed to hemorrhoids. There is no parallel between the extent of hemorrhoidal anatomical disease and the symptoms described by patients. Our objective was to assess the incidence of hemorrhoidal disease, to diagnose it and to propose therapeutics. Patients and Method: This was a prospective and descriptive study based on a pre-established protocol that had taken place over a 12-month period. All patients (92 cases) underwent a general examination and a proctological examination. Anoscopy has often been associated with rectoscope with or without biopsy of the rectal mucosa. The inclusion criteria were the finding of hemorrhoidal disease, associated or not with other proctological diseases and the criteria for non-inclusion was any other anorectal pathology. Results: Among our patients there were 69 men or 75% of cases and 23 women or 25% of cases. The sex ratio was 3 in favor of men, the average age was 35.42. The duration of progression of the disease was between 0 - 2 years in 59.78%. Constipation (60 cases or 66.3%) and diarrhea (60 cases or 22.8%) were the factors that triggered the disease. Hemorrhoids with 3 packets were the most common (49 cases or 53.26%). 56 patients were treated medically and 36 patients were operated on. The surgical technique was simple hemorrhoidectomy according to MILLIGAN and MORGAN. It was associated with a fissurectomy in 8.33% of cases, a fistulectomy in 13.90% of cases or a thrombectomy in 33.33%. Early surgical sequels were dominated by pain in all patients, rectorragie, and urine retention. We did not deplore any deaths. Conclusion: Hemorrhoidal disease is an anatomoclinical entity that is still poorly elucidated and no direct link between the nature of the lesions and symptomatology can be established.

关键词： Proctology Hemorrhoids Management

Volvulus of the Sigmoid Colon—Management in the Surgery “A” Department of the Teaching Hospital of Point G

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Surgical Science 2020年第12期11卷 469-478页

作者： sidiki Keita Koniba Keita Moussa Sissoko Mahamadou Coulibaly Lamine Soumare Oumar Sacko Sekou Koumare Adama K. Koita Soumaîla Keita Zimogo Zié Sanogo General Surgery “A” Department Hospital Point-G. Bamako Mali General Surgery Department Hospital BSS Kati Mali

Introduction: The volvulus of the sigmoid colon is the twist of the sigmoid handle on its mesocolic axis, achieving a low occlusion by strangulation. Methodology: The study was conducted in the surgery “A” department of the Teaching Hospital of Point G in Bamako. The study is retrospective and descriptive, over 5 years, ranging from January 2014 to December 2018. We conducted a comprehensive recruitment of all patients operated on for sigmoid volvulus during the study period. The only criterion for inclusion was patients operated on for volvulus of the sigmoid colon in the surgery “A” department of the Point G Hospital and the non-inclusion criteria were all patients operated on for other sigmoid pathologies without volvulation and patients operated on for other types of occlusions. Result: We conducted an exhaustive recruitment of 55 patients operated on for sigmoid volvulus during the study period. Sigmoid volvulus accounted for 13.75% of intestinal obstructions. The average age of patients was 48.013 ± 18.042 years with extremes of 24 years and 82 years. The age group 40 - 49 was the most represented at 21.8%. The sex ratio (M/F) was 8 in favour of male sex. The duration of the disease was less than 1-day in 50.94% of patients. There were two cases of ileo-sigmoid nodes. Immediate anastomosis resection was performed in 27 patients or 49.2% of cases. The time to restore continuity when specified was between 60 - 90 days and the median incision was the most common route of recovery at 80.8% of cases. The average length of hospitalization was 9 days with extremes of 2 days and 42 days. The morbidity rate was 7.3%. In our study we had 3 deaths or 5.5% of the cases. Conclusion: The volvulus of the sigmoid colon is the twist of the sigmoid handle on its mesocolic axis, achieving a low occlusion by strangulation. The volvulus of sigmoid is a serious surgical emergency that requires early diagnosis and m

关键词： Volvulus Sigmoid Sigmoidectomy Hartmann Bouilly-Volkmann Anastomosis

Etiologies of Bone Metastases at the Rheumatology Department (UTH) of Abidjan

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Open Journal of Rheumatology and Autoimmune Diseases 2020年第1期10卷 1-7页

作者： Mariam Gbané Jean Claude Soglo Mohamed diomandé Guy Léopold Kengni Baly Ouattara Jean Mermoz Djaha Kouassi You Nina Carmelle Kpami Yaya Coulibaly Edmond Eti Rheumatology Department University Teaching Hospital (UTH) of Cocody Abidjan C&#244 te d'Ivoire

Objectives: The aim of this study was to describe the diagnostic and etiological aspects of bone metastases in the Rheumatology Department of Cocody’s University Teaching Hospital (UTH). Methodology: This was a descriptive, 11-year retrospective study (January 1, 2006 to December 31, 2016) of inpatient records of bone metastases. The diagnosis was made on clinical (bone signs), radiological (osteolysis, bone condensation) and sometimes histological basis. Result: Eighty out of 6, 1111 inpatients suffered from bone metastasis with a hospital frequency of 1.30%. The average age was 60.74 years (range 26 to 81 years). Men were predominant (53 men for 27 women) with a sex ratio of 1.96. The main complaints were pain (97.6%). chronic (90%), severe (73.8%), inflammatory (93.8%). There was sometimes a neurological complication: a motor deficit (21.3%), sensitive (13.8%). These symptoms were associated with fever (56.3%) and altered general state (85%). Bone metastases have been revealing in the vast majority of cases (93.75%);the primary cancer was known only in 5 patients (prostate = 2, breast = 2 and cervix = 1). Bone condensation (61.3%), osteolysis (50%) and mixed lesions (7.5%) where the main radiological lesions observed. The primary tumors were: prostatic (50%), pulmonary (18.8%), mammary (11.3%), uterine (5%), renal (2.5%), hepatic (2.5%), bladder (1.3%) and adrenal (1.3%). Conclusion: Bone metastases affect mostly the elderly;inflammatory spinal pain is the main symptom. Bone condensation is the most common radiologic lesion. The prostate, breast and lungs are the main primary tumors.

关键词： Bone Metastases Bone Condensation Prostate Cancer Africa

Popliteal Artery Aneurysms

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Surgical Science 2021年第4期12卷 127-134页

作者： sidiki Keita Koniba Keita Moussa Sissoko Mamadou Coulibaly Lamine Soumare Oumar Sacko Oulématou Coulibaly Sekou Koumaré Adama K. Koita Soumaîla Keita Zimogo Zié Sanogo General Surgery “A” Department Hospital Point-G Bamako Mali General Surgery Department Hospital BSS Kati Mali Reference Health Center of Commune VI Bamako Mali

A popliteal artery aneurysm is defined as a dilation of the popliteal artery greater than 20 mm, or greater than 50% at diameter of the native artery. Popliteal artery aneurysms are rare, but are most common in the lower extremities. These aneurysms have a high risk of ischemic complications and amputations even in unoperated patients. We describe the case of a 54-year-old man, hypertensive, with a large popliteal artery aneurysm. Doppler ultrasound and CT angiography of the lower limbs showed a 100 × 80 mm aneurysm of the popliteal artery. This aneurysm is responsible for venous compression with edema of the tissues under the skin. The patient was treated and a flattening of the aneurysm associated with bypass by the inverted right internal saphenous vein taken from the ipsilateral leg was performed. The patient was discharged on the 6th day of the operation. The patient was seen again at the outpatient clinic for one month and in the 3rd month an arterial Doppler ultrasound of the lower limbs performed had shown patency of the venous graft and disappearance of the intermittent claudication.

关键词： Artery Popliteal Aneurysm Surgery

Morphological Diversity within <i>Pterocarpus erinaceus</i>Poir. (Fabaceae), an Overexploited Species in the Savannahs of Côte d’Ivoire

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American Journal of Plant Sciences 2019年第9期10卷 1675-1688页

作者： Koudougnon Alice Estère Goba Léonie Clémence Kouonon Kouamé Guillaume Koffi Béket Sévérin Bony Issoumaila diomandé Raoul Sylvère Sié Laboratoire de Biologie et Amélioration des Plantes UFR Sciences of Nature Université Nangui Abrogoua Abidjan Cote d’Ivoire

Pterocarpus erinaceus is a high socio-economic tree of African savannahs. It is overexploited due to technological qualities of its wood, forage value and medicinal uses. The main objective of this study is the assessment of the morphological variability within this species in Cote d’Ivoire, in sight of rational management. Fourteen morphological traits were used to appraise the variability within 144 trees in production from six sites (Yalo, Moyenne Marahoué, Kahanso, Kouassi-Ndawa, Ouarigué and Téguirdouo). The results indicate that the variability reaches 6.60 for the height of the fruit and 45.99 for the weight of the fruit. The results reveal also that there are three morphological groups of P. erinaceus in Cote d’Ivoire. Of the four traits that revealed a distinction among the three morphotypes, only the width of leaves and the number of leaflets enabled their complete distinction. Trees of group 1 have long leaves with a high number of leaflets and large fruits. Trees of group 2 have small leaves with a reduced number of leaflets and large fruits. Then trees of group 3 have intermediate value of width of leaves and number of leaflet and small fruits. The three morphological groups could be useful for varietal selection of P. erinaceus in Cote d’Ivoire.

关键词： Morphological Traits Pterocarpus erinaceus Rational Management Varietal Selection

Diagnostic accuracy of biochemical markers of fibrosis in black African patients with chronic hepatitis B

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Health 2010年第12期2卷 1413-1420页

作者： Alassan Kouamé Mahassadi Alain Koffi Attia Fulgence M. Yao Bathaix Narcisse Baudouin Agbé Stanislas Doffou Henriette Ya Kissi Isidore Mouhenou diomandé Paul Cales Thérese Ndri-Yoman 不详

Contradictory results of the accuracy of bio-chemical markers to predict the stage of fibrosis in black African patients with chronic hepatitis B (CHB) were previously published. We con-ducted a prospective cohort study to determine the diagnostic accuracy of aspartate ami-notransferase to platelet ratio (APRI), aspartate aminotransferase to alanine aminotransferase ratio (AAR), platelet count, age-platelet (AP) in-dex, and FIB-4 index for the prediction of sig-nificant fibrosis or cirrhosis in 117 black African patients (median age: 38 years, males: 73 %) with CHB not previously treated. Among them, 45 had significant fibrosis and 18 had cirrhosis using the METAVIR score system. Factors as-sociated either with significant fibrosis or cir-rhosis were determined in logistic multivariate analysis. Areas under receiver operating curve were assessed and compared for APRI, AAR, AP index, FIB-4 index and platelet count. Sensitivity, specificity, positive and negative predictive values were determined for each biochemical markers. Multivariate analysis showed that as-partate aminotransferase (p 1.1) and FIB-4 index (cut-off > 2.1) ruled out significant fibrosis with high specific-ity of 84.7 % and 86.1 % respectively and nega-tive predictive values of 78.2 % and 72.9 % re-spectively. More accurately, APRI (cut-off > 0.63) or FIB-4 index (cut-off > 1.26) ruled out cirrhosis with high sensitivity of 94.4% and 88.9% and high negative predictive values of 98.1% and 96.3% respectively. In conclusion, APRI and FIB-4 index are simple readily available markers to exclude significant fibrosis or more accu-rately cirrhosis in black African patients with CHB.

关键词： Non Invasive Models Fibrosis Cirrhsis Hepatitis B Sub-Saharan Africa

Stomach Cancer: Surgical Management and Impact of Lymph Node Dissection in Survival at the Surgery “A” Department of the National Hospital of Point “G” (Mali)

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Surgical Science 2020年第12期11卷 458-468页

作者： sidiki Keita Koniba Keita Moussa Sissoko Mahamadou Coulibaly Lamine Soumare Oumar Sacko Sekou Koumaré Adama K. Koita Soumaîla Keita Zimogo Zié Sanogo General Surgery “A” Department Hospital Point-G. Bamako Mali General Surgery Department Hospital BSS Kati Mali

Introduction: Although its incidence has tended to decrease for several years, stomach cancer remains one of the most frequently diagnosed cancers worldwide. Globally, gastric cancer is the 4th most common cancer in men, the 5th in women, and the third leading cause of cancer death in men, the 5th in women. Patients and Methods: This was an analytical, prospective and descriptive study. Study Framework: Our study took place in the “A” surgery department of the Point “G” Hospital in Bamako. Study Period: August 1, 2003 to August 31, 2005. The design and preparation phase of the fact sheet lasted 1 month. The data collection phase lasted 18 months. All the patients who consulted for gastric tumor had a record. The follow-up phase of the patients lasted 6 months during which the patients were followed by appointment, by contact person or seen at home. Data entry and analysis were conducted with Epi-Info software (version 6.0). Inclusion Criteria: All patients hospitalized for gastric cancer in the “A” surgery department of the Point “G” Hospital. Result: The distribution of patients according to the evolutionary stage TNM was: Stage IV (50 cases, or 64.94%);Stage III (21 cases, or 27.27%);Stage II (6 cases, or 7.79%). In our series the average age was 59 with extremes of 20 to 85 years. The most represented age group was 46 - 65 years. Men were 60 cases (77.90%) 17 cases for women (22.10%). The sex ratio was 3.53 in favor of men. All 77 patients were recruited during the outpatient clinic, including 55 patients referred by a physician and 20 patients who came by themselves. Esogastroduodenal fibroscopy was performed in all of our patients. The tumor was localized: to the cardia in 10 cases;cardiac fundus in 2 cases;antrum in 24 cases;antro-pyloric in 28 cases;Pylorus in 1 case;great curvature in 5 cases;small curvature in 2 cases. Posto

关键词： Cancer Stomach Resectability Lymph Node Dissection Survival

Spinal Cord Injuries without Visible Bone Lesions: Analysis of Four Consecutive Cases

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Open Journal of Orthopedics 2018年第3期8卷 95-101页

作者： Magatte Gaye Sarah Ntshindj Mutomb Amadou Ndiasse Kasse N’famara Sylla Sagar Diop Alvin Nah Doe Aboubacar sidiki Sangharé Mouhamadou Habib Sy Youssoupha Sakho Department of Neurosurgery Grand-Yoff General Hospital Dakar Senegal Department of Orthopedics and Trauma Surgery Grand-Yoff General Hospital Dakar Senegal

Objectives: Interest of this study is to report four cases of spinal cord injuries without bone lesion. Evolution of the injured patients according to the initial clinic assessment at admission and the treatment performed are discussed. Materials and Methods: From January to December 2016, we performed a retrospective study at the Neurosurgery Department of Hospital General Grand Yoff of Dakar. Four patients were followed for spinal cord injury without visible bone lesions. We analyzed the clinical, radiological, therapeutic and evolutionary data. Trauma caused by stabbing was excluded. Results: In a year, 83 cases of spinal trauma with neurological deficit were hospitalized in the department. Among them, 4 had spinal cord injuries without visible bone lesions. The average age was 31.7 years with extremes ranging from 14 to 47 years. The sex ratio of male/female was 3. We have recorded 2 cases of road traffic accidents, 1 case of fall from height and 1 case of sports accident. On the neurological level, we found 3 cases of tetraplegia, and 1 brachial monoplegia. Computed tomography in all patients was normal. All of them benefited from magnetic resonance imaging that showed spinal cord injury. All patients were under conservative treatment. One patient fully recovered, two partially and one passed away. Conclusion: In presence of any post traumatic myelopathy case, the absence of disco-vertebral lesions should bring to mind the SCIWORA as well as indicate the realization of magnetic resonance imaging.

关键词： Spinal Cord Injuries Trauma MRI