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Traumatic Digestive Perforation in the Hospital of Sikasso: Epidemio-Clinical and Therapeutic Aspects

Surgical Science 2023年第6期14卷 405-413页

作者： Moussa Diassana Bathio Traoré Aly Boubacar Diallo Mamadou Bernad Coulibaly Doh Sylla Amadou Maiga Aboubacar Karambé Amadou Bah Aboubacar Yoro sidib. Layes Touré Ternan Traoré Ousmane Dembelé Salif Traoré Moussa Kanté Mamadou Sangaré Kokoroba sidib. Youssouf Diakité Mahamadou Coulibaly moro sidib. Soumaila Alama Traoré Moussa Samaké Nana Kadidia Fofana Bakary Tientigui Dembélé General Surgery Department of the Sikasso Hospital Sikasso Mali General Surgery Department CHU Gabriel-Touré Bamako Mali Traumatology Department of the Sikasso Hospital Sikasso Mali Urology Department of the Sikasso Hospital Sikasso Mali Anesthesia and Resuscitation Department of the Sikasso Hospital Sikasso Mali Odontostomatology Department Sikasso Hospital Sikasso Mali Surgery Department Koutiala Reference Center Koutiala Mlai Ophthalmology Department Sikasso Hospital Sikasso Mali Gyneco-Obstetrics Department Sikasso Mali Surgery Department Bamako District Hospital Bamako Mali Commune IV District Hospital Bamako Mali

Traumatic digestive perforation is the pathological opening of the wall of a hollow organ of the digestive tract (esophagus, stomach, small intestine, large intestine, rectum, and extrahepatic bile ducts) following trauma. Injuries to the digestive viscera, especially from trauma, have been known since antiquity. Aristotle recognized that a slight blow can cause an intestinal injury. Perforation of a hollow organ of the digestive sphere results in peritonitis, which in this case is the consequence of an infection of the peritoneal cavity by spreading of the digestive contents. The aim of the work was to describe the epidemiological, clinical and therapeutic aspects of traumatic digestive perforation. Patients and method: The study was retrospective and descriptive from January 1, 2016 to December 31, 2020, in the general surgery department of the hospital of Sikasso (Mali). Patients operated for traumatic digestive perforation were included. Results: The clinical records of 42 patients were collected. Traumatic digestive perforations represented 12.3% of patients hospitalized for abdominal trauma. The average age of the patients was 26.6 years, with a sex ratio of 6:1. The most frequent etiology was road traffic accidents with 38% of patients. The average delay of consultation was 5 days. Abdominal pain was present in 38 patients, vomiting in 17 patients. On physical examination, the most frequent signs were abdominal contracture in 61.9% of patients, and disappearance of pre-hepatic dullness in 54.7% of patients. On rectal examination, the douglas was bulging and painful in 21 patients. X-ray of the abdomen without preparation showed pneumoperitoneum in 54.1% of patients. Excision, suture and peritoneal lavage were performed in 31 patients. The postoperative course was marked by parietal suppurations in 5 patients, a digestive fistula in 2 patients and 4 cases of death (9.5%). Conclusion: Traumatic digestive perforation is a frequent pathology in surgery. Road acci

关键词： Perforation Digestive Traumatic Sikasso (Mali)

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Basedowian Orbitopathy Without Thyreotoxicosis : A Case Report from Sikasso Hospital

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Open Journal of Ophthalmology 2023年第3期13卷 273-279页

作者： Cheickna Nomoko Adama Dembele moro sidib. Karim Diarra Moussa sidib. Niamé Touré Moussa Abdou Touré Oulematou Soucko Ousmane Fané Daouda Goita Oumar Diallo Djonny Jonas Dembele Mamadou Adama Togo Kadiatou Ba Koita Abdoulaye Nouhoum Coulibaly Cheick Fantamady Tounkara Nouhoum Touré Abdoulaye Konaté Abdoulaye Napo Nana Kadidia Fofana Regional Hospital of Sikasso Sikasso Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Referral Health Center for Commune 3 in the District of Bamako Bamako Mali African Tropical Ophthalmology Institute Bamako Mali Referral Health Center for Commune 4 in the District of Bamako Bamako Mali

Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.

关键词： Euthyroidism Basedowian Orbitopathy Orbital-Cerebral MRI Corticoster-oid Therapy

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Meningioma of the Optical Nerves in a Case at the Hospitalier Center of Saint Denis in Ile de France

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Open Journal of Ophthalmology 2023年第1期13卷 23-29页

作者： Adama Dembele moro sidib. Ibrahim Conaré Mamadou Kolé sidib. Larcheveque Florence Seror Julien Abdoulaye Napo Daouda Goita Oumar Diallo Djonny Jonas Dembele Mamadou Adama Togo Kadiatou Ba Koita Abdoulaye Nouhoum Coulibaly Cheick Fantamady Tounkara Nouhoum Touré Abdoulaye Konaté Jeannette Traore Sanoussi Bamani Lamine Traoré Japhet Popanou Théra Regional Hospital of Sikasso Sikasso Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali African Tropical Ophthalmology Institute Bamako Mali Hospital Center Saint Denis France

Summary: Optic nerve tumors are rare tumors, representing 3% - 5% of intracranial tumors developing mainly along the optic nerve and/or the chiasm. Optic nerve meningiomas are histologically benign tumors whose severity is linked to diagnostic and especially therapeutic difficulties. The Optic nerve meningioma is the second leading cause of optic nerve tumor after glioma. Observation: We report the case of a 49-year-old woman from South Asia, who consults an ophthalmology department for progressive visual loss in her right eye for about a year with her glasses and would like to renew her optical correction. Having no particular medical history apart from left unilateral blindness is known for approximately 15 years. Magnetic Resonance Imaging (IRM) cerebral found a tissue mass with a clear outline and polylobules on the left temporo-peduncular. Through this case, we describe the circumstances of discovery of the disease, the clinical characteristics, as well as our diagnostic approach. Conclusion: In the majority of cases, these are benign tumours, the circumstances of which are discovered in multiple ways. A mostly unilateral and non-improvable loss of visual acuity must attract our attention. Renewing glasses may be the reason for discovering the disease. Today Magnetic Resonance Imaging (IRM) remains an important and capital examination for the diagnosis and monitoring of this pathology.

关键词： Meningioma Optic Nerve Decreased Visual Acuity IRM

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