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

Open Journal of Obstetrics and Gynecology（妇产科期刊） 2023年第3期

作者： Alou samaké Sitapha Dembele Mamadou Keita Cheickna Sylla Dramane Haidara Mamadou Haidara Mamadou Diallo Moussa Konaté Mariam Maiga Mohamed Saydi Agmed Elméhdi Elansari Djibril Kassogué Seydou Zana Dao Hawa samaké Abdoulaye Nouhoun Coulibaly Brehima samaké Coulibaly Moussa Mariko Seydou Abdoulaye Cissé SémaKéita Siaka Amara Sanogo Seydou Fané

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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 Sidibé Layes Touré Ternan Traoré ousmane Dembelé Salif Traoré Moussa Kanté Mamadou Sangaré Kokoroba Sidibé Youssouf Diakité Mahamadou Coulibaly Moro Sidibé 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)

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

Sigmoide Volvulus on Pregnancy in the General Surgery Service of the Sikasso Hospital,Mali

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Surgical Science 2019年第7期10卷 229-234页

作者： A.Maiga T.Bathio M.Diassana I.Diakité A.Bah A.B.Diallo A.A.Traoré M.Diallo B.T.Dembélé B.Y.Sidibé O.H.Saadé M.Kanté M.Konaté S.Dembélé M.samaké A.Togo A.Traoré G.Diallo Service of General Surgery Teaching HospitalBamakoMali Service of General Surgery Hospital of SikassoSikassoMali Reference Heath Center of Commune VI BamakoMali

Sigmoid volvulus on pregnancy is a rare surgical emergency. We report two cases treated in the General Surgery Department of Sikasso Hospital between January 2009 and December 2017. The mean age was 34.8 years and the gestational age ranged from 28 to 30 weeks. The evolution time was 4 days. The 2 patients were referred to us by gynecologist-obstetricians. They were operated after a short-term resuscitation. Inoperative the volvulus of the sigmoid was alone in 1 case;he was associated with a hail volvulus in the other. The volvated loop was necrotic in 1 case (small and sigmoid). A patient benefited from the Hartmann operation associated with a small bowel resection with end-to-end anastomosis. Simple sigmoidal detorsion was performed in one patient. We did not register a maternal death. The follow-up was simple in the 2 patients who gave birth vaginally.

关键词： Sigmoid Volvulus Surgical Emergency Pregnancy

Study of Malaria in Patients Operated on at the Reference Health Center of Commune I Bamako

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Diagnosis and Therapeutic Aspects of the Ileo-Sigmoidian Node in the General Surgery Department of Gabriel Toure Chu

Surgical Science（外科学） 2023年第9期

作者： Tounkara Cheickna samaké hami.ou Koné Abdoulaye Maiga Boubacar Diarra Yaya Kayentao Kassoum Dolo Amadou Diallo Mouctar

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Surgical Science 2022年第1期13卷 23-27页

作者： Maïga Amadou Diakité Ibrahima Bah Amadou Diallo Aly Boubacar Traoré Bathio Moussa Diassana Sidibé Boubacar Yoro Koné Tani Doumbia Arouna Adama Traoré Amadou Saye Zakari Diallo Mamadou Konaté Moussa Saadé oumou Hélène Kanté Lassana Konaté Madiassa Dembélé Souleymane samaké Moussa Dembélé Bakary Tientigui Traoré Alhassane Togo Adégné General Surgery Department University Hospital Bamako Mali General Surgery Department Sikasso Hospital Sikasso Mali Reference Center of Commune VI Bamako Mali

Introduction: Emergency medico-surgical ileosigmoid node is a rare cause of intestinal obstruction. Diagnosis and treatment must be prompt. Objective: To determine the frequency of NIS, to describe the diagnostic aspects, therapeutic aspects and to analyze the postoperative effects. Methodology: Retrospective and prospective study from January 2006 to December 2020 including all patients operated on for ileosigmoid node confirmed by the intraoperative diagnosis at the CHU Gabriel Touré. Results: From January 2006 to December 2020 (15 years), 30 cases of ileo-sigmoid node were recorded in the service. During this period NIS accounted for 0.19% of surgeries. Abdominal pain was present in (100%) of cases, vomiting was present in 80% and cessation of materials and gas (57%). All of our patients underwent ASP and CT (1 case). All of our patients were operated on, and exploration revealed intestinal necrosis in 97%. The surgical procedures performed were colostomy according to HARTMANN (63%), anastomosis resection (16%), devolvulation (10%). Restoration of continuity was achieved in (73%). The postoperative consequences were straightforward in (80%). Morbidity was 17% including infection of the lining. Mortality was 3% (1 case). Conclusion:<

关键词： Ileosigmoid Node Digestive Surgery Bamako Mali

Liposarcoma of the Back:Case Report

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Surgical Science 2019年第4期10卷 141-145页

作者： A.Maiga I.Diakité A.Bah T.Bathio B.Diassana A.B.Diallo A.A.Traoré M.Diallo B.T.Dembélé Y.Sidibé O.H.Saadé M.Kanté M.Konaté S.Dembélé M.samaké A.Togo A.Traoré G.Diallo Service of General Surgery Teaching Hospital Gabriel TouréBamakoMali Service of General Surgery Hospital of SikassoSikassoMali Reference Heath Center of Commune VI BamakoMali

Liposarcoma is a particular form of soft tissue sarcoma. First described by Virchow in 1860, liposarcoma is a rare mesenchymal tumor [1]. It represents 14% to 18% of all malignant tumors of the soft tissues and constitutes the most frequent soft tissue sarcoma [2]. For the majority of authors, it affects adult after the fourth decade. Because of the unusual age, we report a case of largeliposarcoma of the dorsal surface of the trunk. The appearance of the operative part made us think of a possible malignancy. A 35-year-old man without a notable patient history was admitted for a mass of the back discovered three years before without any notion of trauma. The patient affirms the recent appearance of an induration motivating the consultation. There were no associated signs such rectorrhagia, hematemesis, emaciation, pain. The physical examination finds a patient in good general condition. Locally, there is a swelling of the right lateral part of the 1/3 middle part of the back. It is an oval swelling of 25 cm long axis. Any fat tumor having a size more than 5 cm must therefore receive special attention even before the fourth decade.

关键词： Liposarcoma Unusualage Malignancy

Breast Cancer in Young Women about 87 Cases in the General Surgery Department CHU Gabriel Touré

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Surgical Science 2022年第11期13卷 506-517页

作者： Maïga Amadou Saye Zakari Sidibé Boubacar Yoro Diakité Ibrahima Bah Amadou Diallo Mahamadou Diallo Aly Boubacar Traoré Bathio Moussa Diassana Koné Tani Doumbia Arouna Adama Traoré Amadou Diallo Mamadou Traoré Djibril Konaté Moussa Saadé oumou Hélène Kanté Lassana Konaté Madiassa Dembélé Souleymane samaké Moussa Keita Mory Dembélé Bakary Tientigui Traoré Alhassane Togo Adégné Department of General Surgery University Hospital Bamako Mali Department of General Surgery Sikasso Hospital Sikasso Mali Department of Orthopedic Traumatology University Hospital Bamako Mali Department of General Surgery University Hospital Bamako Mali Reference Center of Commune VI Bamako Mali General Surgery Department Mopti Hospital Mopti Mali

our objectives were to determine the frequency of breast cancer in young women, to determine the risk factors for breast cancer in young women, to detail the diagnostic process of the disease, to determine the different therapeutic strategies. This was a retrospective and descriptive study going from January 2005 to December 2021, a period of 17 years. The study involved 87 women with an average age of 33.2 years. Patients consulted 66 times or 75.9% for breast mass. The size of the tumor was greater than or equal to 5 cm in 62 patients;it was localized in the supero external quadrant 41 times or 47.1%. Molecular classification revealed the following results: Luminal A 21.4%;receptive (HER2) positive 28.6%, and triple negative 42.9%. Stage II was the most represented with 47.4%. Histology found infiltrating carcinoma of non-specific type in 76 patients. The treatment was mastectomy axillary dissection in 66 patients, quadrantectomy + axillary dissection in 6 cases (6.9%) associated with radiotherapy in 6 patients, chemotherapy was performed in 79 of our patients and hormone therapy in 10 patients. Conclusion: Breast cancer is frequent in our country. Patients generally consult us at a late stage. The possibility of determining certain receptors and carrying out certain non-surgical treatments on site would improve the prognosis.

关键词： Breast Cancer Young Woman Receptors Diagnosis Prognosis Mali

Volvulus of Sigmoid Colon at Sikasso Hospital

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Surgical Science 2020年第2期11卷 15-24页

作者： A.Maiga T.Bathio M.Diassana I.Diakité M.B.Y.Sidibé T.Koné Z.Saye A.Bah A.B.Diallo A.A.Traoré M.Diallo B.T.Dembélé O.H.Saadé M.Kanté M.Konaté S.Dembélé M.samaké A.Togo A.Traoré Service of General Surgery Teaching HospitalBamakoMali Service of General Surgery Hospital of SikassoSikassoMali Reference Heath Center of Commune VI BamakoMali

The sigmoid volvulus is an acute strangulation of the colon by the twisting of the sigmoid loop around its mesenteric axis resulting in partial or complete obstruction of the colonic lumen. It is the most common intestinal volvulus and is an absolute medical and surgical emergency. Objectives: Determine the frequency of sigmoid colon volvulus, describe clinical and para-clinical signs, describe treatment, and determine morbidity and mortality. Methodology: This was a retrospective and prospective study performed in the General Surgery Department of Sikasso. This study concerned patients admitted and operated for sigmoid volvulus from January 1, 2014 to December 31, 2017. Retrospective Phase: We have created survey cards to study the following parameters: 1) The age and the sex;2) The clinical signs and associated defects;3) The radiological examinations, endoscopic;4) The established treatment whether medical, or surgical;5) The evolution and the postoperative consequences;6) The admission period. Prospective Phase: At the admission each patient to benefit: a complete interrogation, a complete physical examination, additional examinations including radio of the abdomen without preparation, the rate of hemoglobin and hematocrit, grouping/rhesus. Support: our data were collected from medical records and operating records of patients in the department. Results: We collected 54 cases of sigmoid volvulus (the annual frequency was 13.5 cases for year), which accounted for 58.1% of colonic occlusions 19.6% of intestinal occlusions and 5.9% of operative operations in emergency. The average age was 47.13 with extremes of 18 and 102 years, The sex ratio is 4.40% in favor of men. Abdominal pain, vomiting, stopping of materials and gases were present in 32 (59.3%) patients. Von Wahl’s triad was present in 36 patients (66.7%), the rectal ampoule empty in 92.6%. On the X-ray of the abdomen without preparation, 70.37% of the image was recorded as a double leg. The sigmoid was necr

关键词： Sigmoid Volvulus Surgical Emergency Sikasso Hospital

Giant Hernia with Incarceration

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Surgical Science 2021年第12期12卷 399-403页

作者： Amadou Maïga Amadou Bah Ibrahim Diakité Zakari Saye Boubacar Y. Sidibé Bathio Traoré Moussa Diassana Siaka Konaté Arouna A. Doumdia Tani Koné Aly B. Diallo Amadou A. Traoré Mamadou Diallo Bakary T. Dembélé oumou H. Saadé Moussa Kanté Madiassa Konaté Souleymane Dembélé Moussa samaké Moussa Konaté Lassana Kanté Alhassane Traoré Service de chirurgie générale h&#244pital universitaire Bamako Mali Service de chirurgie générale h&#244pital de Sikasso Sikasso Mali Centre de référence de la Commune VI Bamako Mali

Introduction: Giant hernias induce changes which reduce the quality of life of patients and make their surgical management complex. Adequate preoperative preparation of the patient guarantees good postoperative progress. It is necessary to avoid resorting to a technique of separation of the compartments during the cure. Here we report the case of a patient who benefited a successful cure using the Ramirez technique. Observation: We report the case of a 60-year-old patient admitted to an outpatient clinic for abdominal swelling evolving for 30 years without the notion of trauma gradually increasing in volume. The interrogation and physical examination led to the diagnosis of a giant white line hernia with incarceration. A preoperative assessment and a preanesthetic consultation were carried out. Intraoperatively, the cecum, transverse colon, sigmoid, jejunum and greater omentum were incarcerated in the bag. After adhesiolysis we proceeded to resect the bag and cure it using the Ramirez technique. The consequences were simple and the patient was discharged on day 4 after her dressing and was seen on day 15, 1 month, 3 months and 1 year. The patient benefited from the placement of an abdominal compression sheath for 3 months. Conclusion: Success in the management of prosthetic material in the absence of prosthetic material depends on good preoperative preparation and the mastery of certain surgical techniques.

关键词： Giant Hernia General Surgery CHU Gabriel Touré