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Small Bowel Obstruction Induced by Phytobezoar: A Case Report in Innocent Abdomen and Literature Review

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Surgical Science 2021年第6期12卷 187-195页

作者： Bréhima Traoré Djibril Traoré Modibo Coulibaly Oumar Guindo Abdoulaye Traoré Fodé Mory Keita Kiffery Ibrahim Keita Korotimi Mallé Pierre Coulibaly Aly Boubacar Diallo dramane cissé dramane Samaké Pierre A. Togo Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Anesthesia and Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclique des Armées de Kati Koulikoro Mali Department of Gynecology and Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery H&ocirc pital Régional de Sikasso Sikasso Mali Department of Medicine H&ocirc pital Sominé DOLO de Mopti Mopti Mali Faculty of Medicine and Odonto Stomatology University of Sciences Technics and Technologies de Bamako Bamako Mali

Introduction: Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. Herein, we report a case of small bowel obstruction (SBO) following excessive consumption of wild grapes with no previous abdomen medical or surgical history. Presentation of case: A 65-year-old male farmer presented with cessation of materials and gas associated with vomiting of food and then bilious. The abdomen was bloated and painful on palpation with a moving, painful mass in the left iliac fossa. The hypothesis of acute occlusion of the colon was retained and confirmed on the X-Ray which showed a dilation of small bowel with air-fluid levels. The diagnostic of acute SBO was retained. We performed urgently a median laparotomy. We found the dilation of the loops from the jejunum to the sigmoid colon with a compact mass at the sigmoid colon of 15 cm in length and 6 cm in diameter. We proceeded to crush the mass that was made up with wild grape seed fecal, and push it back to the rectum. The phytobezoar made up with wild grape seeds was extracted through the anus with the fingers after anal dilation. After extraction of the bezoar, the patient’s complaints completely subsided. Discussion: SBO is a frequent emergency surgical pathology. SBO induced by phytobezoar often occurs in patients with abdomen surgery history. However, it is particularly rare in virgin abdomen. Conclusion: This case report aims to raise awareness of phytobezoar as a cause of SBO in elderly even though without abdomen surgery history.

关键词： Small Bowel Obstruction Phytobezoars Innocent Abdomen

Small Bowel Obstruction: Epidemiological, Clinical and Therapeutic Aspects in the General Surgery Department of Hôpital SominéDOLO de Mopti

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Surgical Science 2021年第6期12卷 196-203页

作者： Bréhima Traoré Modibo Coulibaly Djibril Traoré Oumar Guindo Fodé Mory Keita Nouhoum Samassekou Abdoulaye Traoré Souleymane Sanogo Korotimi Mallé Kiffery Ibrahim Keita Pierre Coulibaly Aly Boubacar Diallo dramane cissé dramane Samaké Lassana Kanté Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclinique des armées Kati Mali Department of Anesthesia-Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Medical Imagery CHU Luxembourg Bamako Mali Department of Gynecology-Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery H&ocirc pital de Sikasso Sikasso Mali Department of Medicine H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery of CHU du Point-G Bamako Mali

Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. We report an observational study which aims to describe the epidemiological, clinical and therapeutic aspects of small bowel obstruction. This study was carried out in the General Surgery Department of Hôpital Sominé DOLO de Mopti from October 1, 2016 to October 1, 2018. A total of 114 patients were recorded for whom the diagnosis was related to an occlusion. The median age was 37 years with extremes ranging from 6 months to 90 years. Male sex was predominant with a sex-ratio of 1.8. The frequency of small bowel occlusions over all occlusions was 74.03%. The most encountered clinical signs were as followed: abdominal pain (100%), vomiting (88.6%), cessation of materials and gas (79.9%) and meteorism (62.3%). All patients underwent medical imaging, the most common of which was an abdomen without preparation X-ray (AWP). On the etiological level, the main causes found postoperatively were: flanges and adhesion (55.2%), strangulated hernias (28.0%), acute intussusception (6.1%), small bowel volvulus (3.5%) and small bowel tumor (1.6%). Releasing the bridles was the most common surgery process (28.0%). The morbidity of the immediate follow-up was (13.1%) and the mortality was (7.0%). This high mortality is due to ignorance of the signs of seriousness and the socio-cultural barrier (decision of the patriarch to agree to a surgical intervention), the late use of hospital facility and the limited financial capability of the patients.

关键词： Occlusions of the Small Intestine Etiology Surgical Treatment Hôpital Sominé DOLO de Mopti

Bladder Cancer: Epidemiological, Clinical and Histopathological Aspects at the University Hospital Point G, Mali

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Open Journal of Urology 2021年第10期11卷 343-350页

作者： Honoré Jean Gabriel Berthé dramane cissé Moussa Salifou Diallo Amadou Kassogué Alkadri Diarra Mamadou Tidiani Coulibaly Mamadou Lamine Diakité Modibo Coulibaly Mory Koné Université des Sciences des Techniques et des Technologies de Bamako Bamako Mali CHU du Point G Bamako Bamako Mali Hô pital Sominé DOLO de Mopti Mopti Mali CHU Kati Kati Mali CHU Luxembourg Bamako Mali CHU Gabriel TOURE Bamako Bamako Mali

Introduction: Bladder cancer is a new tissue formation most often of urothelial origin with potential for local, locoregional and distant invasion. Among its risk factors, urinary bilharzia is endemic in our study area. The aim of our study was to present the epidemiological, clinical and histopathological aspects of bladder cancer in our department. Patients and method: This was a descriptive cross-sectional study over a 12-month period from January 1 to December 31, 2019. The study took place in the urology department of the university hospital Point “G”. It included all patients hospitalized for bladder cancer. The epidemiological, clinical and histopathological characteristics have been sought and described. Results: A total of 74 patients were included in the study. Bladder cancer was the leading cause of cancer, accounting for 57.9% of all urological cancers. The mean age of the patients was 52.8 ± 16.25 years. A slight male predominance was observed with a sex-ratio of 1.2. Housewives were the most represented with 43.2% followed by farmers with 24.3%. Hematuria was the reason for consultation in 87.8% cases. The main risk factors found were urinary schistosomiasis (48.6%) and smoking (31.1%). These two factors were associated in 23.0% of cases. At diagnosis, 85.7% of patients were classified as T3 or T4 stage. Squamous cell carcinoma with 58.2% was the most common histological type followed by urothelial carcinoma in 26.0% of cases. Conclusion: Bladder cancer is very common of cancer in hospitalized patients in our department. Diagnosis is more often made at an advanced stage. The most common histological type is squamous cell carcinoma.

关键词： Bladder Cancer Epidemiology Clinic Histopathology

Penile Skin Flap Urethroplasty for Urethral Stenosis at SominéDOLO Hospital of Mopti (MALI)

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Open Journal of Urology 2021年第7期11卷 240-250页

作者： dramane cissé Honoré Jean Gabriel Berthé Abdoulaye Traoré Mamadou Lamine Diakité Modibo Coulibaly Mory Koné Djibril Traoré Bréhima Traoré Diamilatou Thiam Mamadou Tidiani Coulibaly Alkadri Diarra Amadou Kassogué Moussa Salifou Diallo Oumar Guindo Université des Sciences des Techniques et des Technologies de Bamako Bamako Mali Hô pital Sominé DOLO de Mopti Mopti Mali CHU du Point G Bamako Bamako Mali Direction Régionale de la Santé de Mopti Mopti Mali CHU Gabriel TOURE Bamako Bamako Mali CHU Luxembourg Bamako Mali CHU Kati Kati Mali

Introduction: Penile skin flap urethroplasty is a technique for replacing or enlarging an obstructed urethra. We aim to report our experience in the practice of this surgical technique. Patients and method: This was a prospective and descriptive study of penile skin flap urethroplasty indicated for urethral stenosis between January 2014 and December 2019. Results: A total of 21 penile skin flap urethroplasties for urethral stenosis were performed. The average age was 38.6 years old. The stenosis was of sclero-inflammatory origin in 15 cases (71.43%). It was of bulbo-perineal, penile, and penile-bulbar topography in about a third each. A history of urethral surgery was reported in 80.95% of the cases. The average length of the stenosis was 6.8 cm. Mundy circular skin flap urethroplasty about 15 cases (71.43%), and Quartey rectangular skin penile flap urethroplasty about 6 cases (28.57%) were the surgical techniques performed. The postoperative follow-up was favorable in 19 cases (90.48%). Two cases of urethral fistula (9.52%) underwent the 2nd urethroplasty. Urination at 1 year was satisfactory. No relapse has been reported to date. However, 4 patients (19.04%) reported asthenic ejaculation, and 1 patient (4.76%) a marked decrease in sexual pleasure. Conclusion: This surgical technique is effective in terms of voiding when the surgical indications are well chosen. The sexual aspect must be taken into account and the intervention only offered to those who really need it.

关键词： Urethral Stenosis Urethroplasty Pedicled Flap

Abdominal Trauma Management: About 62 Cases at the Department of General Surgery of Hôpital SominéDOLO de Mopti, Mali

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Surgical Science 2021年第6期12卷 204-210页

作者： Djibril Traoré Bréhima Traoré Fodé Mory Keita dramane cissé Modibo Coulibaly Mory Koné Abdoul Karim Djimdé Kiffery Ibrahim Korotimi Mallé Abdoulaye Traoré Oumar Guindo Mathias Diassana Pierre M. Coulibaly Bakary T. Dembélé Pierre A. Togo Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclinique des armées Kati Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Anesthesia and Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Gynecology and Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery CHU Gabriel Touré Bamako Mali

We undertook a prospective and descriptive observational study on abdominal trauma from February 1, 2016 to August 31, 2017. The aim of this work was to identify the typology and management of abdominal trauma cases in our surgery department. Overall, abdominal trauma represented 3.54% (62/1751) of all surgeries during the study period. Among the 62 cases, men accounted for 59 and women for 3. The sex ratio was 19.67. The mean age was 24 ± 15 years. Road accidents were the most represented with 43.5% of cases. The couple of signs, hypovolemic shock and abdominal pain and decrease on blood pressure were the prominent clinical symptoms with 100.0%, and 50.0% of cases, respectively. Abdominal ultrasound and abdominal x-ray without contrast were performed in 67.0% and 18.0% of cases, respectively. Abdominal trauma was divided into two entities: contusion 68% and wounds 32%. Medical treatment was sufficient in 23.00% of cases. Laparotomy as a surgical approach was performed in 77.0% of cases. Local hemostasis plus drainage (27.08%), splenectomy (25.00%), suture (14.58%), hemostasis by tamponade (8.33%) and colostomy (2.08%) were undertaken as surgical procedures when it came to deal with contusions. Debridement of wounds plus suture and hemostasis by tamponade was performed in 18.73% and 4.16 cases, respectively. The most observed lesions were those of the spleen with 27.42% and those of the small bowel with 24.19%. The postoperative follow-up was straightforward in 83.33% of cases. The overall mortality was 4.17%.

关键词： Trauma-Abdomen-Emergency-Hôpital Sominé DOLO de Mopti

Therapeutic Profile and Prognostic Factors of Patients Suffering from Upper Digestive Bleeding at Sikasso Regional Hospital

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Open Journal of Gastroenterology 2024年第9期14卷 300-312页

作者： Oumar Traoré Abdoul Salam Diarra dramane Touré Tawfiq Abu Amadou Boubeye Maïga Kadiatou cissé Saïdon Touré Mohomedine Touré Aboudou Dolo Youana Koné Madou Traoré Mamadou Togo Kalba Péliaba Mamadou Samaké Hamadoun Sangho Service of Internal Medicine Regional Hospital Sikasso Mali National Center for Scientific and Technological Research Bamako Mali Department of Pediatric Health Referral Center of Kalaban Coro Koulikoro Mali Private Practice for Family and Emergency Medicine Casablanca Morocco Service of Nephrology Regional Hospital Sikasso Mali Department of Infectious Disease Regional Hospital Sikasso Mali Service de Mdecine Interne CHU Gabriel Tour Bamako Mali Service dHpato-Gastro-Entrologie CHU Gabriel Tour Bamako Mali Department of Public Health Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali

Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.

关键词： Digestive Hemorrhage Digestive Endoscopy Treatment Outcome

Microbiological Assessment and Antimicrobials’ Use in an Infectious Diseases Department in Mali

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Advances in Microbiology 2021年第8期11卷 384-398页

作者： Mikaila Kaboré Issa Konaté Yacouba cissoko Ibrehima Guindo Bintou Coulibaly Meli Hermine Aboubacar Alassane Oumar Mariam Soumaré Assetou Fofana Abdoulaye Zaré Mohamed Aly cissé dramane Sogoba Omar Magassouba Hama Hamidou Issa Fodé Kouyaté Sounkalo Dao Infectious Diseases Department Point “G” University Teaching Hospital Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Laboratory and Biomedical Research Department National Institute of Public Health Bamako Mali Faculty of Pharmacy University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Laboratory of Biomedical Analysis University Teaching Hospital of Kati Kati Mali Serefo Program University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali

The use of antimicrobials without microbiological proof is frequent and contributes to the emergence of resistance. The aim was to identify the organisms isolated during laboratory examinations and the type of antimicrobials consumed by patients hospitalized to Infectious Diseases’ Clinic. This is a cross-sectional and analytical study, carried out from January 1 to December 31, 2017 in the Infectious Diseases Department of Point “G” Teaching Hospital in Mali. All biological specimens from patients during the study period were analyzed. In total, 322 patients benefited from microbiological test, with a mean age of 40.9 ± 12.2 years (range 15 and 74 years) with a sex ratio of 0.93. Only 5.6% of patients were HIV negative. In all participants, a total of 658 microbiological specimen were taken, 224 (34.0%) identified at least one pathogen including bacteria in more than a half of the cases (58.5%). On the report of bacteriological analysis, the most frequently identified organisms were Mycobacterium tuberculosis (42.2%) mainly in sputum;Escherichia coli (24.2%) and Klebsiella pneumoniae (7.8%) commonly in urine and Gardnerella vaginalis (7.0%) exclusively in vaginal secretions. Candida albicans (5/8) and Cryptococcus neoformans (3/8) were the most common fungi while Plasmodium falciparum (96.4%) represented the parasite frequently found in blood. From a therapeutic standpoint, 1143 antimicrobials were prescribed to 322 admitted patients, i.e. 3.55 anti-infectives per patient. Antibiotics (excluding tuberculosis drugs), antiparasitics and antifungals represented respectively 46.2%;18.8% and 15.1% of anti-infectives. Antibiotic therapy was effective in 274 (85.1%) patients and among them, only 76 (27.7%) cases were based on microbiological evidence. Antibiotics are the most widely used antimicrobials in an infectious disease department. Empiric treatments are common but must be minimized by the search for microbiol

关键词： Antimicrobial Microbiology Infectious Diseases Mali

Influence of Age on the Clinical and Prognostic Features of Tetanus in Mali

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International Journal of Clinical Medicine 2021年第3期12卷 77-86页

作者： Mikaï la Kaboré Issa Konaté Yacouba cissoko Jean Paul Dembélé Mariam Soumaré Assetou Fofana dramane Sogoba Oumar Magassouba Hermine Méli Abdoulaye Zaré Mohamed Aly cissé Bintou Coulibaly Hama Hamidou Issa Fodé Kouyaté Japhet Dembélé Sounkalo Dao Infectious Diseases Department Point “G” University Teaching Hospital Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Serefo Program University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali

Background: The regression of post-vaccination immunity with age exposes elderly subjects to certain infectious diseases, in particular tetanus. The aim was to compare the clinical and prognostic features of tetanus according to the age of patients. Methodology: Analytical study of the files of patients hospitalized for tetanus in the Infectious Diseases Department at Point “G” University Teaching Hospital from 2013 to 2019 with retrospective collection. According to age, three groups of patients were formed: group I (Results: In total, 202 cases of tetanus were recorded or 7.3% of admissions. The mean age was 41.9 ± 15.6 years (range, 6 and 85 years) with a sex ratio of 19.2. According to the age grouping, group II was predominant (79.2%) followed by group III (14.9%) with respective mean ages of 39.2 ± 10.6 and 67.3 ± 6.5 and sex ratio of 39 and 29. Workers (33.3%), farmers (25.8%), traders (19.7%) and drivers (7.1%) represented the most important occupations most at risk. Clinically, bad general condition (p Conclusion: Tetanus is more prevalent in men. Complications and mortality increase with age. It is important to include booster immunization of adults in existing national programs in order to reduce disease-related morbidity and mortality in this age group.

关键词： Tetanus Elderly Clinical Prognosis Mali

Neuropsychic Disorders Unmasking the Coexistence of Fahr Syndrome and Neuromeningeal Cryptococcosis

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Case Reports in Clinical Medicine 2020年第11期9卷 329-334页

作者： Mikaila Kaboré Issa Konaté Yacouba cissoko Souleymane P. Coulibaly Jean-Paul Dembélé Assetou Fofana Mariam Soumaré Hermine Méli dramane Sogoba Oumar Magassouba Adama Sissoko Mohamed Aly cissé Abdoulaye Zaré Bintou Coulibaly Fodé Kouyaté Moïse Nguemeni Sounkalo Dao Infectious Diseases Department Point “G” University Teaching Hospital Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Psychiatry Department Point “G” University Teaching Hospital Bamako Mali Neurology Department Point “G” University Teaching Hospital Bamako Mali Serefo Program University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali

Background: Fahr syndrome associates a set of neuropsychiatric manifestations with bilateral calcifications in the basal ganglia and phosphocalcic disorders. Neuromeningeal cryptococcosis can be present in its manifestations, neuropsychic disorders with or without meningeal signs. The objective was to describe a rare association between Fahr syndrome and neuromeningeal cryptococcosis which can be expressed by the same clinical symptomatology in the context of co-infection with the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV). Presentation: A 37-year-old patient without pathological history, who presented behavioral disorders that led to a fight with those around her and a psychiatric consultation. Then, she was hospitalized in the infectious diseases Department upon discovery of her HIV status and viral hepatitis B. She was logorrheic with behavioral disturbances and subsequently presented with tonic-clonic convulsions. Laboratory tests and imaging have concomitantly discovered Fahr syndrome due to pseudohypoparathyroidism and neuromeningeal cryptococcosis. The correct management of these two pathologies enabled stabilization of the patient’s clinical condition with regular monitoring for HIV-HBV coinfection. Conclusion: Farh syndrome and neuromeningeal cryptococcosis are two different entities but sometimes similar symptoms and risk factors. Treatment of metabolic disorders combined with anticryptococcal therapy improved the prognosis.

关键词： Neuropsychic Disorders Neuromeningeal Cryptococcosis Fahr Syndrome Pseudohypoparathyroidism HIV