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The Evolutionary Profile of Patients Operated for Peptic Ulcer Perforation in Bujumbura

Surgical Science 2024年第1期15卷 7-18页

作者： Jean Claude mbonicura Prudence Bukuru Stanislas Harakandi Frank Ijeneza Révérien Ndayirorere François Nduwimana astère mbonicura Department of General and Gastro-Intestinal Surgery Centre Universitaire de Recherche en Santé Faculty of Medicine University of Burundi Bujumbura Burundi Department of Anesthesia-resuscitations Faculty of Health Sciences Hope Africa University Bujumbura Burundi Department of Anesthesia-resuscitation Centre Universitaire de Recherche en Santé Faculty of Medicine University of Burundi Bujumbura Burundi Department of Andro-Urology Centre Universitaire de Recherche en Santé Faculty of Medicine University of Burundi Bujumbura Burundi Department of Multi-Purpose Medicine Easter Grand Hospital Francilien Meaux France

Background: The evolutionary profile of patients operated for peptic ulcer perforation in Bujumbura. Perforated peptic ulcer is a serious complication of peptic ulcer with potential risk of grave complications. Aim: To study the early morbidity and mortality of surgery for peptic ulcer perforation in Bujumbura City Hall hospitals: Kamenge University Hospital Center (CHUK), Kamenge Military Hospital (HMK) and Prince Louis Rwagasore Clinic (CPLR). Patients and methods: This is a retrospective, descriptive and analytical study carried out in the three hospitals of Bujumbura over a period of three years from January 1, 2020 to December 31, 2022. It involved 57 cases (n = 57) of peptic ulcer perforation. results: The frequency of surgery for peptic ulcer perforation was 2.7% with a mean age of 43.6 years +/- 15.3 years and a male predominance with a sex ratio of 3.7. Eight percent of patients presented with shock, 24.5% were smokers, and 67.9% had taken non steroidal anti-inflammatory drugs. The mean hospital stay was 15.2 days with a standard deviation of 12.1. The morbidity rate was 30.2%, 32% were classified in grade IIIb of the Clavien-Dindo Surgical Complications Scale. There were 9 deaths (17%). Seven patients who underwent surgery and received late consultations died. Conclusion: Surgery for peptic ulcer perforation remains an intervention associated with a high rate of morbidity and mortality in Bujumbura. Surgery for peptic ulcer perforation remains a procedure associated with a high morbidity and mortality rate in Bujumbura. The time before consultation was the only factor associated with early morbidity and mortality of Surgery for peptic ulcer’s perforations.

关键词： Peritonitis Peptic Ulcer Perforation Complications

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Amniotic Band Syndrome at the Van Norman Clinic in Burundi: A Case Series

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Surgical Science 2024年第3期15卷 118-124页

作者： Alice Ndayishimiye Hélène Bukuru Déogratias Niyungeko Anne Marie Nikuze Sylvestre Bazikamwe Jean Claude mbonicura Gilbert Ndayizeye Department of Pediatrics Kamenge University Hospital Center Bujumbura Burundi Department of Obstetrics and Gynecology Kamenge University Hospital Center Bujumbura Burundi General Surgery Department Kamenge University Hospital Center Bujumbura Burundi Orthopaedy Department Kamenge University Hospital Center Bujumbura Burundi

Amniotic band syndrome is an acquired embryo-fetopathy. It is rare and is characterized by malformations mainly affecting the limbs but also the skull, face and thoraco-abdominal axis. Its etiopathogenesis remains poorly understood. Its diagnosis is essentially clinical and is classically based on the existence of signs such as furrows, amputations and pseudosyndactyly. To show the importance of antenatal diagnosis in resource-limited countries, we report the case of two newborns, one premature at 31 weeks and the other at term, in whom amniotic band syndrome was discovered incidentally at birth. It involved an amputation of the right leg for both cases. The premature baby was born in a context of neonatal sepsis and will succumb to the latter while the 2nd case was released from the hospital alive. Imaging examinations to search for probable congenital malformations could only be carried out for the 2nd case and no accessible congenital malformation had been identified. And as management of the disease, only psychological support to the parents was provided for the 2 cases. The antenatal discovery of a case of amniotic band syndrome in countries with low technical capacity such as Burundi should push clinicians to think in time about treatment options.

关键词： Amniotic Band Syndrome Embryo-Fetopathies Antenatal Diagnosis Limbs

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Morbidity and Mortality of Emergency Hernia Surgery in Children in Bujumbura: Analysis of Favourable Factors

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Surgical Science 2023年第12期14卷 738-747页

作者： Jean Claude mbonicura Prudence Bukuru Paul Banderembako Révérien Ndayirorere Guy Darcy Nibogora Jean Marie Nizeyimana Stève Nkurunziza General and Gastro-Intestinal Surgery Universitary Center for Health Research Faculty of Medicine University of Burundi Bujumbura Burundi Association Burundaise de Chirurgie (ABUC) Bujumbura Burundi Faculty of Health Sciences Department of Anesthesia-Resuscistation Hope Africa University Bujumbura Burundi Department of Anesthesia-resuscistation Prince Louis Rwagasore Clinic Bujumbura Burundi Andro-Urology Universitary Center for Health Research Faculty of Medicine University of Burundi Bujumbura Burundi

Background: Management of emergency hernias surgery should include certain complications most often up after 30 days of the operation. Aim: To analyze the factors contributing to morbidity and mortality after 30 days of emergency hernia surgery in children in the surgical departments of 8 Bujumbura hospitals. Patients and Methods: This is a prospective study over a period of one year which included all hernias operated on in emergency from January 1, 2022 to February 29, 2023. results: During the period, 282 patients (children) were admitted to the operating theatre for abdominal parietal hernias, of which 46 were admitted for emergency hernia surgery. Males accounted for 86.96% (40), sex ratio 6.6. The average age was 3.4 years. The persistence of the peritoneo-vaginal canal represented 52.17% of cases. Inguino-scrotal hernia was prevalent (43.48%). The main complication was strangulation (80.43%). Morbidity accounted for 1.3% of complications (infection, residual pain, testicular atrophy, hernia recurrence). No deaths were found. Altemeier stage and gender were statistically related to morbi-mortality of emergency hernia surgery in adults at 30 days post-op (p = 0.0260 and p = 0.0212 respectively). Conclusion: Abdominal parietal hernias are common in children, dominated by groin hernias. The high frequency of strangulation calls for awareness of cold hernia repairs.

关键词： Hernia Strangulation Herniorrhaphy Morbidity Mortality Early

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Morbidity and Mortality of Emergency Hernia Surgery in Adults in Bujumbura: Analysis of Favourable Factors

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Surgical Science 2023年第12期14卷 758-769页

作者： Stève Nkurunziza Prudence Bukuru Stany Harakandi Paul Banderembako Révérien Ndayirorere Guy Darcy Nibogora Jean Marie Nizeyimana Jean Claude mbonicura General and Gastro-Intestinal Surgery Universitary Center for Health Research Faculty of Medicine University of Burundi Bujumbura Burundi Faculty of Health Sciences Department of Anesthesia-Resuscitation Hope Africa University Bujumbura Burundi Department of Anesthesia-resuscistation Prince Louis Rwagasore Clinic Bujumbura Burundi Department of Anesthesia-resuscitation Universitary Center for Health Research Faculty of Medicine University of Burundi Bujumbura Burundi Andro-Urology Universitary Center for Health Research Faculty of Medicine University of Burundi Bujumbura Burundi Association Burundaise de Chirurgie (ABUC) Bujumbura Burundi

Background: Abdominal parietal hernia, a temporary or permanent exit of viscera through an anatomically pre-existing zone of weakness, is a frequent pathology in surgery. So, the management of emergency hernias surgery should include some complications most often up after 30 days of the operation. Aim: To analyze the factors contributing to morbidity and mortality after 30 days of emergency hernia surgery in adults in the surgical departments of Bujumbura hospitals. Methodology: This is a prospective study over a period of one year that included all hernias operated on in emergency from January 2022 to February 2023. results: During the period, 251 patients were admitted to the operating room for abdominal parietal hernias, including 49 for emergency hernia surgery. There were 43 men (87.76%) and 6 women (12.24%), i.e. a sex ratio of 7.1. The average age was 49.6 years, with extremes of 18 and 84 years. The occupation of strength (farmer, labourer, mechanic, mason, mason’s helper) represented 75.51% of the cases. Inguino-scrotal hernia was preponderant (65.31%) followed by inguinal hernia (25.58%), umbilical hernia (4.08%);femoral hernia represented 4.08%. Hernial strangulation represented 89.80% and engorged hernia 10.20%. Morbidity was minor, 2.04% of complications (suppuration, hematoma, urinary retention). No deaths were found. Altemeir stage and occupation were statistically related to morbi-mortality of emergency hernia surgery in adults at 30 days postoperative (p = 0.0028 and p = 0.0284 respectively). Conclusion: Abdominal parietal hernias are frequent, dominated by groin hernias. The high frequency of strangulation calls for awareness of cold hernia cures.

关键词： Hernia Strangulation Herniorrhaphy Morbidity Mortality Early

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