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The Polytraumatized in the Emergency Hosting Service and the Service of Resuscitation Gabriel TouréMali

Surgical Science 2018年第4期9卷 157-163页

作者： Diop Thierno Madane Magane Moustapha Issa Almeimoune Abdoulhamidou demb.lé AlajiSeidou Dabo Aminata Ouattara Kassoum demb.lé bakary tientigui Traoré Alhassane Togo Adegné Diango Mahamane Djibo Department Anesthesia-Intensive Care and Emergency Gabriel Toure University Hospital Bamako Mali Anesthesia Department Ophthalmological Institute West African University Hospital Bamako Mali General Surgery Department Gabriel Toure University Hospital Bamako Mali

Summary: Polytrauma is the leading cause of death in the under-40 population. They are accompanied by major morbidity with severe sequelae. The polytraumatized is defined as a serious trauma with several bodily injuries, at least one of which is life-threatening in the very short term. The initial hospital care must not barely delay and directly affect the prognosis. In developing countries, the absence of pre-hospital medicine means that mortality is still very high, which leads us to initiate this work, which aims to study the epidemiological and clinical aspects of polytrauma in emergency and in resuscitation of Gabriel Toure University Hospital. Material and Methods: This was a retrospective study that took place over a period of ten (10) months from February to November 2016. We included all patients received for polytrauma emergency hosting service. The data were collected using a surveycard. Results: During our study period, we collected a total of 200 polytraumatized cases out of a total of 16,141 patients admitted to the emergency hosting service, a prevalence of 1.3%. The age group of 20 - 29 years was the most represented with average age of 32.39 years. The male sex was predominant with 65% with a sex ratio of 1.9. The students were the most represented with 24%. The trauma occurred at 22.5% between 8:00 and 12:00 am, the public road was the main place of the trauma with 57.5% of the cases. Two-wheeled vehicles were involved in the accident in 68.9% of cases. The delay between trauma and admission was minus 6 hours in 70.5% of cases, 15.5% had a Glasgow lessthan 8% and 44.5% PAS Conclusion: The polytrauma is clinical situation putting the patients vital prognosis at stake. The haemorrhage is the origin of the student mortality. The installation of rigorous diagnostic system and a pre-hospital medicine will reduce the morbi-mortality.

关键词： Polytraumatized Emergency Resuscitation Bamako Mali

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Parietal Infiltration for Postoperative Analgesia

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Surgical Science 2023年第2期14卷 72-76页

作者： Kanté lassana Issiaka Diarra Idrissa Tounkara Maiga Amadou Traore Amadou Madiassa Konaté Ibrahima Diakite demb.lé bakary tientigui Alassane Traore Adegné Togo Faculty of Medicine and Odonto Stomatology (FMOS) General Surgery Department Gabriel Touré University Hospital Center Bamako Mali General Surgery Department of the Reference Health Center of Commune 1 of Bamako District Bamako Mali General Surgery Department of the Reference Health Center of Commune 2 of Bamako District Bamako Mali

The parietal component of pain occupies an important place in the management of postoperative analgesia. Parietal infiltration is a technique that fits into a concept of multimodal analgesia using several analgesic products simultaneously. This simple and reliable technique makes it possible to reduce the use of opioids and therefore their adverse effects;without increasing the risk of infection. It reduces the length of hospitalization.

关键词： Parietal Infiltration Analgesia Surgery

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Post-Traumatic Duodenal Rupture at the Fousseyni Daou Hospital in Kayes, Mali: A Case Report

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Surgical Science 2022年第6期13卷 300-306页

作者： Sangare Sidy Sogoba Gaoussou Traore lamine Issaga Kouyate Mamaye Katile Drissa Goita lassana demb.le Sadio Traore Allassane demb.lé bakary tientigui Traore Drissa Togo Adegné Department of General Surgery Fousseyni DAOU Hospital Kayes Mali Department of Paediatric Surgery Fousseyni DAOU Hospital Kayes Mali Department of Gastroenterology Fousseyni DAOU Hospital Kayes Mali Department of Anaesthesia and Resuscitation Fousseyni DAOU Hospital Kayes Mali Department of General Surgery Gabriel TOURE Hospital Bamako Mali Department of General Surgery Point G Hospital Bamako Mali

lesions resulting from duodenal involvement are rare. Their diagnosis and management remain difficult because of the topographic location of most of the duodenum in the retroperitoneum. We report a case of isolated duodenal rupture. At the time of the first operation, the duodenal lesion had gone unnoticed. During our management, we discovered a rupture of the lower knee of the second duodenum and we performed a triple anastomosis after the closure of the ends (proximal and distal). The immediate postoperative course was complicated by the death of the patient on the second day of surgery. Duodenal lesions have much mortality which is increased by the delay in diagnosis and management.

关键词： Emergency Duodenal Rupture Abdominal Contusion

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Fortuitous Discovery of a Case of Situs Inversus Totalis on Acute Intestinal Occlusion at the Fousseyni Daou Hospital in Kayes

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Surgical Science 2022年第12期13卷 551-560页

作者： Sangare Sidy Traore lamine Issaga Kouyate Mamaye Sogoba Gaoussou Katile Drissa Guindo Youssouf Traore Djibril Traore Allassane demb.lé bakary tientigui Togo Adégné Traore Drissa General Surgery Department of the Fousseyni DAOU Hospital Kayes Mali Pediatric Surgery Department at Fousseyni DAOU Hospital Kayes Mali Gastroenterology Department of the Fousseyni DAOU Hospital Kayes Mali Cardiology Department of the Fousseyni DAOU Hospital Kayes Mali General Surgery Department of the Somine DOlO Hospital Mopti Mali General Surgery Department of Gabriel TOURé Hospital Bamako Mali General Surgery Department of Point G Hospital Bamako Mali

Situs inversus is a rare congenital anomaly referring to the mirror image of the abdominal and thoracic viscera. It can be discovered routinely or on the occasion of a complication related or not to situs inversus. We report a case of Situs inversus discovered incidentally during surgery for acute intestinal obstruction caused by an iatrogenic uterine perforation.

关键词： Situs Inversus Incidental Finding Intestinal Obstruction Iatrogenic Uterine Perforation

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Ainhum (Or Dactylolysis Spontaneous) at the Fousseyni Daou Hospital in Kayes about a Case

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Surgical Science 2022年第8期13卷 367-373页

作者： Sangare Sidy Traore lamine Issaga Sogoba Gaoussou Kouyate Mamaye Katile Drissa Toure Hamidou Ababa Cisse Abdoulaye Traore Allassane demb.lé bakary tientigui Togo Adégné Traore Drissa General Surgery Department Fousseyni Daou Hospital Kayes Mali Pediatric Surgery Department Fousseyni Daou Hospital Kayes Mali Gastroenterology Department Fousseyni Daou Hospital Kayes Mali Dermato-Venereology Department Fousseyni Daou Hospital Kayes Mali General Surgery Department Gabriel Toure Hospital Bamako Mali General Surgery Department Point G Hospital Bamako Mali

Aïnhum or spontaneous dactylolysis is a progressive constriction of the digito-plantar fold of the fifth toe which leads after several years of evolution to a spontaneous amputation of the toe. Classically, a distinction is made between “true Aïnhum” of unknown cause, which affects only blacks and those of African (sub-Saharan) descent;“pseudo-Aïnhum”, which follows various causes such as an inflammatory flange or foreign body constriction;and finally, palmo-plantar keratoderma, of genetic origin, such as Vohwinkel disease. We report a case of Aïnhum received at stage III of the pathology and who benefited from an amputation of the fifth toe.

关键词： Aïnhum Spontaneous Dactylolysis Idiopathic Amputation

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Satisfaction of Patients Operated on and Hospitalized in the Surgery Department of the Referral Health Center of Commune I in the District of Bamako (Resource-limited Health District)

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Surgical Science 2024年第10期15卷 523-535页

作者： Diarra lassény Sanogo Modibo Konaté Moussa demb.lé Nouhoum Kollé Diallo Mamadou Diakité Ibrahima Kalil Tounkara Idrissa Samaké Alou Maiga Mariam M. S. Ag Med Elmehdi Elansari Keita Mamadou Touré Mamadou Karim demb.lé bakary tientigui Bamako Dermatology Hospital (HDB) Bamako Mali Reference Health Center of Commune I Bamako Mali Reference Health Center of Commune VI Bamako Mali Reference Health Center of Commune II Bamako Mali Department of General Surgery University Hospital Center Gabriel Tour Bamako Mali Department of General Surgery Faculty of Medicine and Odonto-Stomatology of Bamako University Hospital Center Gabriel Tour Bamako Mali

Introduction: Evaluating the quality of care offered is a reliable indicator of the effectiveness of a health system. Developing countries are still lagging behind in implementing these principles. This work aims to evaluate the satisfaction of patients operated on and hospitalized in the surgery department at the municipality’s reference health center over a period of 6 months (June 2020 to December 2020). Materials and Methods: This is a quantitative, qualitative, transversal and evaluative study over a period of 6 months based on a self-administered questionnaire to patients who underwent surgery and were hospitalized in the surgery department of the reference health center of commune I upon leaving their hospitalization. The questions are structured around welcome, respect and privacy, care, accommodation conditions as well as overall satisfaction. Results: The survey included 260 patients, 60.8% of whom were male. The 31 - 40 year old age group was in the majority and the majority had completed primary education (42.3%). Married patients were the majority, i.e. 60.4% of cases. Patients were not insured in 66.5% of cases. Almost all of the patients surveyed found that the welcome, care, waiting time, respect and privacy were satisfactory. On the other hand, patients found the rooms and beds uncomfortable. Conclusion: The satisfaction survey reveals worrying data regarding the comfort of patients who must challenge caregivers in healthcare structures. Decision-makers should find useful information there to improve the quality of care.

关键词： Quality of Care Satisfaction Surgery CSRéf CI

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Operating Site Infections at General Surgery Department of Gabriel Toure Training Hospital

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Surgical Science 2015年第2期6卷 59-64页

作者： bakary tientigui demb.lé Alhassane Traoré Adégné Togo lassana Kanté Ibrahim Diakité Bourama Diarra Amadou Traoré Madiassa Konaté Boubacar Karembé Yacaria Coulibaly Mamby Keita Souleymane Diallo Souleymane Diallo Gangaly Diallo Faculty of Medicine and Odonto-Stomatology Bamako Mali Department of General Surgery CHU Gabriel Touré Bamako Mali Department of Biology and laboratory CHU Gabriel Touré Bamako Mali

The operating site infections constitute the major postoperative issue in surgery. Our objectives were to determine the hospital frequency, the risk factors, the involved germs as well as the cost generated by the operating site infections. Method: Our three months prospective survey run from September the 1st to November the 30th 2013 has included all department patients being operated on and hospitalized. The criteria have been set by CDC d’Atlanta. Results: 374 files were involved, among them 229 (61.2%) were emergencies and 145 (38.8%) were scheduled. The average age was 41 (extremes 7 and 95 standard deviation 17.46), the sex ratio 1.67. The infective risk according to Altmeier has found 17.5% type 1, 25.1% type 2, 11.2% type 3 and 46.3% type 4;according to NNISS, 96 (25.7) were NNISS 0;94 (51.9%) NNISS 1;80 (21.4%) NNISS 2;and 4 (1.1%) NNISS. In the Altmeier class I have not got antibiotic before infection signs appearances. Our overall rate of operating site infections was 7.9% (29 cases), with 24 (82.8%) emergency cases. According to Altmeier’s class of infective risk, the rate of operating site infections was 1.54% making 1 out of 65 type I patients;4.3% making 4 out of 93 type II patients;11.9% making 5 out of 42 type III patients;10.9% making 19 out of 174 type IV patients. According to NNISS, the infective risk has been assessed and was 2.08% for score 0, we have got 8.25% score 1, and 12.5% for score 2, and 25% for score 3. The bacteriology has been dominated by Escherichia colii(51.7), Proteus mirabilisi(13.8), and Klebsiella pneumoniaei(10.34). The germs have been resistant to the combination Amoxicillin-clavulanic Acid between 50% and 87% of cases. The most active antibiotics on the germs have been Cephalosporin, Polypeptides, and aminoglycosides. The hospital stay has been delayed to 12 days on average by operating site infections, making 2.5 times greater than those uninfected. The infection has increased the cost of management around 600 Euro.

关键词： Infections Operating Sites Bamako

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Post-Operative Peritonitis: Diagnostic Problems, Morbidity and Mortality in Developing Countries

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Surgical Science 2014年第8期5卷 363-367页

作者： Alhassane Traoré bakary tientigui demb.lé Adégné Togo lassana Kanté Madiassa Konaté Ibrahima Diakité Simo Notue Fabienne laurence Boubacar Karembé Abdoulaye Diarra Amadou Traoré Mahamane Djibo Diango Gangaly Diallo Department of General Surgery CHU Gabriel Touré Bamako Mali Faculty of Medicine and Odonto-Stomatology Bamako Mali

Goal: To study the diagnostic difficulties and post-operative morbidity and mortality of peritonitis. Patients and Methods: Retrospective study about the records of adult patients operated on between 1999 and 2013 whose diagnosis of post-operative peritonitis was made. Results: We achieved 23,573 lanterns and recorded 148 cases of postoperative peritonitis or 0.62%. The medium age was 37.1 ± 17.7 years and the sex ratio was 1.2. The delay between the initial intervention and reoperation was less than 5 days. Factors occurrence of postoperative peritonitis were those related to the initial surgery: septic context 70.8%, emergency surgery 81.1% under the seat mesocolic 25% and 20.3% initial surgical technique. The diagnosis was made preoperatively in 62.2% (n = 92). Ultrasound has found an effusion in 29.7% (n = 44). Cytobactériologic review identified germs in 85.1% (n = 126) and sterile in 12.9% of patients (n = 22). The most frequent etiologies were: 22.9% anastigmatic leak (n = 34), the phoenix abscess in 17.6% (n = 26), iatrogenic perforation 13.5% (n = 20) and digestive fistula 25% (n = 37). Other causes were the stoical necrosis 12.2% (n = 18) and evisceration 8.8% (n = 13). We performed a digestive stoma in 61% (n = 89), a closure of the abdomen bolsters in 8.8% (n = 13), a suture in iatrogenic perforation in 13.5% (n = 20) and washing with drainage in patients with phoenix abscess in 17.6% (n = 26). Morbidity was 22.3% and 53.4% mortality. Conclusion: The diagnosis of post-operative peritonitis is difficult in a developing country. Morbidity and mortality is high. Improved diagnostic tools are needed.

关键词： Peritonitis Postoperative Morbidity and Mortality Surgery

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Perception and Management of Hemorroid Disease at the CSREF of the Commune Bamako Mali

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Surgical Science 2024年第2期15卷 89-97页

作者： Tounkara Cheickna Diarra Mohamed Hassimy Diarra Issaka Sanogo Keita bakary demb.le bakary tientigui Traore Alhassane Togo Pierre Adégné lassana Kante Department of General Surgery The Cs Ref of Commune I of Bamako Bamako Mali Department of General Surgery The Gabriel TOURE University Hospital in Bamako Bamako Mali

This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the Bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of Bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at Cs Ref CI. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.

关键词： Hemorrhoidal Disease Caregivers Traditional Therapists Patients Surgery CS Ref CI

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Bilharzia Appendicitis: Incidence in a Commune in Mali, about 3CAS

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Surgical Science 2024年第5期15卷 321-329页

作者： Souleymane Bingue demb.lé Yely Dianessy Moussa Samake Abdou Guiré Siaka Konaté Ousmane Sy Boubacar Yoro Sidibé Amadou Maïga Thiorno Nadio Boubacar Karembe Amaguiré Saye Sirama Diarra Dorcas Sodjiné Yede Issiaka Diarra Ibrahima Maiga Mahamane Dicko Moussa Konaté Aliou Bina Diarra bakary tientigui demb.lé General Surgery Department of the District Hospital of Commune IV of Bamako Bamako Mali Kolondié ba Reference Health Centre Sikasso Mali Epidemiology and Clinical Research Bamako Mali General Surgery Department of Gabriel Touré University Hospital Bamako Mali Ophthalmology Department of the District Hospital of Commune IV of Bamako Bamako Mali Gynecology and Obstetrics Department of the District Hospital of Commune IV of Bamako Bamako Mali Commune I of the District of Bamako Reference Health Centre Bamako Mali Imaging Department of the District Hospital of Commune IV of Bamako Bamako Mali Commune VI of the District of Bamako Reference Health Centre Bamako Mali Anotomy-Pathology Department of the G Point University Hospital Bamako Mali

Appendicitis bilharzia is a very rare condition and we report 3 cases of this pathology that sense clinical and biological similarities with bacterial appendicitis. The etiological diagnosis was exclusively histopathological, this allowed to highlight eggs of Schistosome in the appendicular wall in the three patients. The surgical treatment was supplemented by a specific medical treatment based on praziquantel. The surgical suites were simple for 2 patients, complicated by superficial parietal suppuration in a patient.

关键词： Bilharzial Appendicitis Endemic Histopathology Specific Antiparasitic Treatment

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