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The Lithiasis of Choledoque: Epidemiological Aspects, Clinics and Therapeutiques in the Surgery Department “A” at the University Hospital Point G

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Surgical Science 2019年第8期10卷 281-286页

作者： O. Sacko S. Diallo L. Soumaré M. Camara S. Koumaré M. Sissoko S. Keita I. diarra M. Konaté M. Traoré G. Soumaré D. Dakouo M. Coulibaly H. Dicko Y. Dianessi A. Koita Z. Sanogo Department of Surgery “A” University Hospital of Point G Bamako Mali Department of Surgery “B” University Hospital of Point G Bamako Mali Department of Surgery Reference Center of Town 6 Bamako Mali Department of Gynecology-Obstetrics University Hospital of Point G Bamako Mali Department of Intensive Care University Hospital of Point G Bamako Mali

Considered as rare in Africa lithiasis of the main bile duct (MBD) is a potentially serious pathology, diagnosis is facilitated by imaging tests (ultra-sound, CT, MRI cholangiopancreatography). Its surgical management is improved by laparoscopy coupled with interventional endoscopy. However, laparotomy remains the only way in Mali. This was a 14-years retrospective and descriptive study (2010-2014). All patients with BPV lithiasis were included. We studied the field, antecedents, clinical, biological, radiological, therapeutic and outcome aspects. 40 cases of stones in the main bile duct were collected during the study period. The hospital frequency was 2.8 cases per year, the clinical signs dominated by the Charcot triad (pain, fever, jaundice) found in 40 cases (100%). The average age was 60 years, female represented 70% of cases. Ultrasonography was the most requested review in 40 cases (100%). The procedure performed was cholecystectomy associated with choledochotomy with calculation extraction in all patients (100% of cases). One case of biliary fistula and one case of wall abscess were observed. The mortality was 5% and the simple suited in 90% of the cases. The lithiasis of the main bile duct is an infrequent pathology in Mali and potentially serious. This diagnosis is assisted in our context by ultrasound and CT. Laparotomy remains the only route of entry in Mali.

关键词： Lithiasis of the CBD Surgery Cholodochotomy

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Tuberculosis in Children: Epidemio-Clinical Aspects in the Paediatric Department of the Gabriel TouréUniversity Hospital Center

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Open Journal of Pediatrics 2022年第2期12卷 376-388页

作者： Adama Dembélé Abdoul Aziz Diakité Mohamed Elmouloud Cissé Bassirou diarra Belco Maïga Issa Sanou Pierre Togo Abdoul Karim Doumbia Oumar Coulibaly Karamoko Sacko Djéneba Konaté Hawa Diall Lala Ndrainy Sidibé Bréhima Dégoga Fatoumata Léonie Diakité Guédiouma Dembélé Fatoumata Dicko Mariam Sylla Boubacar Togo Department of Paediatrics University Teaching Hospital of Gabriel Touré Bamako Mali University Clinical Research Center University of Sciences Techniques and Technologies of Bamako Bamako Mali Department of Pediatrics CHU Gabriel Touré Bamako Mali

Introduction: Globally, tuberculosis is the leading cause of death from a single infectious agent ahead of HIV/AIDS. Approximately 10 million people contracted TB in 2017, 10% of whom were children aged 0 - 15 years, or about 1 million with 250,000 deaths in 2016 (including children with HIV-associated TB). The signs of TB in children are not always specific and diagnosis remains difficult unlike in adults. According to a study conducted in 2011 in the paediatric department of the CHU-Gabriel Touré, only seventeen cases of all forms of tuberculosis were found, or approximately 0.2% of hospitalised children. The objective of our study was to investigate the epidemiological and clinical aspects of tuberculosis in children. Materials and Method: This was a prospective, cross-sectional and descriptive study that took place from 24 October 2017 to 23 October 2018, or 12 months in children aged 0-15 years. Data were collected from an individual medical record opened for each patient and an individual survey form established for each child. Results: During the study period, 40,434 children were consulted. Tuberculosis was suspected in 91 children, with a frequency of 0.22%. The age range of 1 to 4 years was 36.3% with a median age of 72 months. The sex ratio was 1.8. Chronic cough with 84.6% and malnutrition with 24.17% were the most frequent symptoms. Chest X-ray revealed bilateral pulmonary lesions in 52.7% and mediastinal adenopathy in 12.1%. TST was positive in 10.9% of patients, microscopy in 26.4%, Gene Xpert in 18.7%, and culture in 16.5%. The biological diagnosis of tuberculosis was retained in 48.4% of the patients, the pulmonary form represented 93.2%. The therapeutic regime (2RHZE/4RH) was used in 81.6% of cases and the evolution was favourable in 65.9% of patients. Conclusion: The diagnosis of tuberculosis in children remains difficult in our context. The clinical signs are not always specific, and further studies are needed to further elucidate this disease.

关键词： Child Clinic Epidemiology Gabriel Touré University Hospital Center Tuberculosis

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Appendicular Abscess in the Service of General Surgery at the Teaching Hospital Gabriel Toure, Bamako, Mali

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Surgical Science 2018年第8期9卷 281-285页

作者： Madiassa Konate Traore Amadou Coulibaly Yacaria Dembele Bakary Tiéntigui Karembe Boubacar Keita Soumaila Amadou Issa Mangane Moustaphissa Diop Thierno Madani Almeimoune Abdoul Hamidou Togo Adégné Pierre Kante Lassana Traore Alhassane Maiga Amadou Bah Amadou Sidibe Boubacaryoro Diamoutene Kolo Tolo Maimouna Samake Moussa Mounimezié diarra Diakite Ibrahim Diallo Gangaly FMOS Bamako Mali

Objectives: To determine hospital frequency and to write the diagnostic and therapeutic aspects of appendicular abscess in adults in the General Surgery Department of teaching Hospital Gabriel Touré from 2005 to 2017. Material and Methods: This was a retrospective study conducted from January 1, 2005 to December 31, 2017 in the General Surgery De-partment of Gabriel Touré University Hospital in all patients with appen-dicular abscess. Results: In 13 years, 1420 cases of acute appendicitis have been reported, including 105 cases of appendicular abscess (7.4%). Mean age of the patients was 32 years with extremes of 16 years and 70 years. Abdominal pain and fever were present in all patients. Pain sat in the right iliac fossa in 73.3% and was epigastric in 11.4%. In almost all cases abdominal defense was present (97.1%). There was generalized abdominal contracture in 2.8% of cases. Average duration of evolution was 27 days with extremes of 1 day and 60 days. Ultrasonography was performed in 42.6% of cases and found peri-appendicular effusion in 29 cases (27.6%). 90 incisions were made by incision of Mac Burney, 8 by median umbilical, 7 by midline above and below umbilical. The amount of fluid aspirated was greater than 100 cc in 47 patients. We performed an appendectomy with appendicular stump burying followed by washing plus drainage of the abdominal cavity in 65 patients. Morbidity rate was 14.3%. No deaths were recorded. Average duration of hospitalization was 6.5 days with extremes of 2 days and 26 days.

关键词： Appendicular Abscess Adult Appendectomy Mali

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Duodenal Duplication of Unusual Discovery:Case Report Chambery Hospital French

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Surgical Science 2018年第7期9卷 222-226页

作者： Konate Madiassa Traore Amadou Dembele Bakary Tientigui Karembe Boubacar Amadou Issa Mangane Moustaphissa Diop Thierno Madani Togo Adegnepierre Kante Lassana Traore Alhassane Bah Amadou Sidibe Boubacaryoro Diamoutene Kolo Samake Moussa Mounimezie diarra Diakite Ibrahim Coulibaly Yacaria Keita Soumaila Legros Jean Remy Mattia Stella Demane Sofia Al Naasan Irchid Diallo Gangaly Faculty of Medicine and Odonto-Stomatology BamakoMali

We report the case of a 33-year-old man having presented the episodes of abdominal pains since a few months in 2014. He was handled by the anal-gesic and the anti spasmodic by his regular doctor. Symptoms in started up again with renewed vigor in February, 2015. The physical examination was normal. The complementary examinations must be known by the ultrasound the scanner and the magnetic resonance imaging which were in favour of a mass under person suffering from a liver complaint the normal blood balance assessment. The patient was exclusively operated by the way of coelioscopy and the anatomopathology examination of the operating room ended has a duplication duodenal. The operating consequences were simple until one year.

关键词： Duplication Duodenal Hospital Chambéry French

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Contribution of Bone Scintigraphy in the Diagnosis of a Calcaneus Fatigue Fracture in a Case at the Nuclear Medicine Department of Idrissa Pouye General Hospital (HOGIP) in Dakar

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Open Journal of Medical Imaging 2020年第1期10卷 62-71页

作者： El-Hadji Amadou Lamine Bathily B. Ndong O. Diop M. S. Djigo K. Gueye A. Kokou G. Thiaw G. Mbaye L. A. D. Diouf M. Soumboundou A. R. Djiboune P. M. Sy O. Ndoye M. diarra M. Mbodj Nuclear Medicine Department General Hospital of Idrissa Pouye (HOGIP) Dakar Senegal Biophysical Laboratory FMPO Cheikh Anta Diop University (UCAD) Dakar Senegal Nuclear Medicine Department Hospital Dalal Jamm Dakar Senegal Biophysical Laboratory University of Lome Lome Togo Laboratory of Physical and Pharmaceutical Biophysics FMPO Cheikh Anta Diop University Dakar Senegal

Introduction: Fatigue fractures are secondary to excessive, unusual, repeated mechanical stress, occurring on healthy bone. Bone scintigraphy (BS) with 99mTc-HMDP is an excellent means of diagnosis. We report a case of stress fracture of the calcaneus with scintigraphic diagnosis, in a marathon runner. Patient and Methods: He is a 40-year-old athlete in overtraining with right calcaneal pain on running, intense at first, moderate in the middle and then persistent after exercise. The interrogation found no trauma to the right foot and the x-ray of the foot was without abnormality. The so 3 phases were performed following an injection of 564 MBq of 99mTc-HMDP, with a SPECT gamma camera. Results: Bone scintigraphy found in the early phase, hyper-perfusion and hyper-fixation of the right calcaneal region compared to its left counterpart and in the bone phase persistence of focal hyperfixation opposite the right calcaneus. This scintigraphic aspect of the right calcaneus in an overtrained marathon runner, in a painful context and in front of a normal X-ray, made us evoke a fracture of fatigue. A complementary CT scan performed two days after the BS was without abnormality. Conclusion: Fatigue fractures are micro-fractures generally not noticed on radiography and CT. BS due to its high sensitivity is an excellent or the best tool for the early diagnosis of stress fractures.

关键词： Fatigue Fracture Bone Scintigraphy Sports

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Complications Per and Post Operatory (CPPO) at the Gabriel Toure University Hospital in Bamako

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Surgical Science 2019年第8期10卷 287-296页

作者： M. Samaké S. B. Dembélé S. Konaté A. Traoré K. Madiassa A. diarra Z. Saye B. Tounkara A. Traoré I. Abdillahiiltireh B. T. Dembélé B. Y. Sidibé L. Kanté I. Diakité Adégné Togo G. Diallo Department of Surgery Hospital Gabriel Touré Bamako Mali

Introduction: Despite the use of less invasive and increasingly effective techniques in order to reduce the morbi-mortality per and post-operative, the CPPO remain an important problem in surgery. Objectives: To determine the rate of per and post-operative complications, to describe the types of complications and to identify their risk factors. Methodology: This was a prospective study carried out from 04 April to 03 June 2016 in the surgical department of CHU-Gabriel TOURE. All patients aged 18 and over operated in the Surgical Department (General Surgery, Gynaecology and Obstetrics, Urology, Traumatology, Otolaryngology, Neurosurgery and Emergency Department), having been hospitalized at least for 24 hours after surgery, were retained. The method of sampling N=P(1-P)Za2/I2 was used;the minimum size necessary was 209 patients. We conducted invitations and the phone call to determine the occurrence of complications and survival of patients up to 30 days after surgery. Results: We counted 262 patients, of whom 142 (54.2%) were women and 120 (45.8%) were men with a sex ratio = 0.85. The average age was 41.48 years, with extremes of 18 and 86 years. We found 71 complications in 61 patients, an early CPPO rate of 23.28%. The various complications encountered were: urinary tract infections (26.76%), surgical site infections (28.17%), pulmonary infections (12.68%) and Deaths (21.13%). The occurrence of complications prolonged the hospital stay by 6 days and increased the average cost of care of 102,700 FCFA. According to Clavien Dindo’s classification, the severe postoperative complication in our series was 9.16% (grade III + IV + V). Factors favoring the occurrence of CPPO were age > 41 years old, ASA > II, the classes of Altemeier 3 and 4, NNISS score 1 and 2, diabetes and hemoglobin rate 8 g/dl. Conclusion: Complications per and post-operative (CPPO) are common in the department of Surgery of CHU-Gabriel TOURE and are dominated by post-operative infection. These compli

关键词： Post-Operative Complications Surgery

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Primitive Umbilical Endometriosis in a Young Woman at the District Health Center (CSREF) in Commune II in Bamako

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Surgical Science 2019年第3期10卷 89-93页

作者： Tounkara Idrissa diarra Abdoulaye Traoré Amadou Coulibaly B. Bakary Kanté Abdoulaye Dembélé Dabéré Ives Thiam Souleymane Ouattara Kassoum Kanté Lassana Konate Madiassa Koné Assitan Ongoiba Oumar Sangaré Modibo Dembélé Bakary Tiètiki Diakité Ibrahim Sidibé Yoro Bah Amadou Coulibaly Yakaria Togo Adégné Diallo Gangaly Chirurgie générale du Centre de santé de référence de la commune II de Bamako Mali Chirurgie générale du Centre Hospitalier Universitaire de Kati Mali Chirurgie générale Centre Hospitalier Universitaire Gabriel TOURE de Bamako Mali Chirurgie générale du Centre Hospitalier Universitaire du POINT G de Bamako Mali Hopital régional de Gao Mali Hopital régional de Tombouctou Mali

Umbilical endometriosis, also called Villar’s nodule, has rarely been described in the literature. It represents only 0.5% to 1% of all cases of endometriosis. We report a case in a 28-year-old nulligest, nulliparous woman who consulted at the CSREF CII in Bamako. The diagnosis was suspected with the presence of umbilical swelling with cyclic, painful, dark hemorrhage of firm consistency. We performed an omphalectomy with an uncomplicated postoperative course. She was released from the hospital three days post-surgery. Anatomo-pathological examination of the resected specimen confirmed the diagnosis of umbilical endometriosis.

关键词： Umbilical Endometriosis Young Woman Bamako Mali

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External Branch of the Superior Laryngeal Nerve: Anatomy and Operating Hurts

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International Journal of Otolaryngology and Head & Neck Surgery 2018年第6期7卷 388-395页

作者： Abdoulaye Kanté Babou Ba Youssouf Sidibé Drissa Ouattara Bréhima Bengaly Bréhima Coulibaly Drissa Traoré Mariam Daou Tata Touré Siaka Diallo Amady Diakalia Coulibaly Mamadou Alymami Keita Souleymane Sanogo Djibril Traoré Moustapha Issa Magané Ousmane Ibrahim Touré Idrissa Tounkara Abdoulaye diarra Bakary Keita Timbely Guidérè Birama Togola Nouhoum Ongoï ba Service of Surgery CHU Bamako Mali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology Bamako Mali ENT and Head and Neck Surgery Department CHU Mother-Child “Luxembourg” Bamako Mali Service of Neurology CHU Gabriel Touré Bamako Mali Department of Stomatology and Maxillofacial Surgery CHU-CNOS Bamako Mali Service of General Surgery CHU Gabriel Touré Bamako Mali Service of Anesthesia and Resuscitation CHU Gabriel Touré Bamako Mali

Purpose: Our purpose was to describe the anatomy of the external branch of the upper laryngeal nerve and to estimate the frequency of nerves at risk during the total thyroidectomies sub. Methodology: We realized in the CHU Point G in Bamako a forward-looking study over a period going from September 1st, 2016 till December 31st, 2017. All the patients operated by thyroidectomies subtotals for mild goiters were included to whom a systematic location of the external branch of the superior laryngeal nerve in the space avascular of Reeve was realized. Cancers and other thyroid pathologies were not included. Results: We counted and operated 120 cases of mild goiters. The external branch of the superior laryngeal nerve was seen and dissected in 80.8%;it was not seen in 19.2%. According to the classification of Cernea: the type 2 was found in 80.8% of the cases with him under typical 2b in 47.5% and under type 2a in 40 (33.3%). The global frequency of lesion of the external branch of the upper laryngeal nerve was 10.8% at 9 patients among whom 6 who presented a BENLS of Type Ni. Conclusion: The external branch of the upper laryngeal nerve of type 2 presents a risk of wound because the surgeon treats the upper pedicle at the level of the critical centimeter place over the upper pole of the thyroid. The identification of the nerve during the thyroid surgery is the solution of choice.

关键词： External Branch of the Laryngeal Superior Nerve Anatomy Thyroid Surgery

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COVID-19 and the Vascular Elderly Subject: Illustration of Therapeutic Management with Corticosteroids in an Elderly Diabetic Patient with COVID-19

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Open Journal of Clinical Diagnostics 2024年第1期14卷 1-6页

作者： Ibrahima Amadou Dembele Abrar-Ahmad Zulfiqar Romuald Nounga Nyanke Sékou Landoure Stéphane Loique Djeugoue Adama Sinayoko Nouhoum Kone Paul Antoni Amadou Nouroudine Rosunee Ahsveen Yacouba Koné Aoua diarra Tania Mekuiko Ngeupi Mamadou Cissoko Mamadou Mallé Keïta Kaly Djibril Sy Djénébou Traoré Didier Mukéba Tshialala Assétou Soukho Kaya Emmanuel Andres Internal Medicine Department Medical Clinic B University Hospital Center of Strasbourg Strasbourg France Internal Medicine Department University Hospital Center Point G Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali Faculty of Medicine Pharmacy and Public Health University of Mbuji-Mayi Democratic Republic of Congo

Introduction: The severity of Sars-Cov-2 infection is associated with the development of acute respiratory distress syndrome (ARDS). The progression to ARDS appears to be driven by a major inflammatory mechanism potentially sensitive to corticosteroids. Observation: This article describes the case of an elderly patient was admitted to emergency departments for intense asthenia, accompanied by motor diarrhoea, dyspnoea with desaturation in ambient air, in a context of strong suspicion of infection linked to COVID-19. The article also reviews the existing literature on the diagnosis and treatment of this severe form of the disease. Conclusion: Corticosteroids, and in particular dexamethasone, have been shown to be effective in the management of patients with COVID-19, an oxygen-releasing disease.

关键词： COVID-19 Diabetes Mellitus Elderly person Corticosteroids Internal Medicine

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Torsion of Ovarian Tumor in the Elderly: About a Case

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Surgical Science 2020年第4期11卷 69-73页

作者： Amadou Bah Ibrahima Diakite Amadou Maiga Boubacar Yoro Sidibe Madiassa Konaté Zakari Saye Boureima Kelly Tany Koné Siaka Konate Arouna A. Doumbia Bathio Traore Boubacar Karembe Mohamed Lamine Diakite Amadou A. Traoré Abdoulaye diarra Moustapha Issa Mangane Abdoul Hamidou Almeimoune Bakary T. Dembélé Alhassane Traoré Lassana Kanté Adégné Pierre Togo General Surgery Department University Hospital of Gabriel Touré Bamako Mali Anesthesia and Reanimation Department University Hospital of Gabriel Touré Bamako Mali.

We report a case of torsion of an ovarian tumor in a 68-year-old woman with no medical and surgical history. The diagnosis was made in front of an intermittently painful pelvic mass. The treatment consisted of a left annexectomy;the anatomopathological examination revealed a fibro-inflammatory and hemorrhagic cyst. Postoperative results were simple with a 12-month follow-up.

关键词： Tumor Ovary Cyst Surgery

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