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Clinical and Anatomo-Pathological Study of Digestive Polyps at Point G Teaching Hospital

Open Journal of Gastroenterology 2023年第3期13卷 111-116页

作者： Sanra Déborah Sanogo Marcelle Paule Tayue Ganda Soumaré Ouatou Mallé abdoulaye Maiga Luc Sidibé Hourouma Sow Kadiatou Samaké Moussa Y. Dicko abdoulaye diarra Ilias Guindo Bakarou Kamaté Cheickh B. Traoré Hepatogastroenterology Department Point G University Hospital Bamako Mali Anatomical Pathology Department Point G University Hospital Bamako Mali Hepatogastroenterology Department Gabriel Touré University Hospital Bamako Mali CHU Bocar Sidy Sall Bamako Mali

Introduction: The aim of our study was to describe the aspects clinical and pathology of digestive polyps. Methods: This was a descriptive and analytical study with retrospective and prospective collection from January 2014 to September 2020, i.e. a duration of 72 months. Our study focused on all cases of non-cancerous digestive pathologies. The data were collected from registers, medical files and reports from the anatomy and pathological cytology department of the Point G University Hospital. All of this data was entered on an individual survey form. This sheet includes demographic data, qualitative and quantitative variables. Results: We conducted a study of 131 cases of digestive polyps. The frequency of digestive polyps was 3.65%. The mean age of our patients was 44.6 ± 21 years with extremes of 2 years and 79 years, with a male predominance and a sex ratio of 1.01. The biopsy was the type of sample most represented in 77.1%. The digestive polyps were located in stomach in 37.4%;the colon in 27.5% then the rectum 21.4%. The polyp sessile accounted for 65.6%. Histological examination revealed that adenomatous polyps were predominant in 77% of cases, followed by juvenile polyps in 9.2%, then hyperplastic polyps in 6.2%. Low grade dysplasia was found in adenomatous polyps in 61.53% and high grade found in 38.4%. Gastritis due to Helicobacter pylori (Hp) was found in 16% of cases. Conclusion: Digestive polyps are common in the general population. The prognosis is linked to the risk of neoplastic degeneration of adenomas.

关键词： Digestive Polyps Clinical Anatomopathology

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Digestive Surgical Emergencies at the Commune II Reference Health Centre in the District of Bamako

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Surgical Science 2022年第5期13卷 258-264页

作者： Idrissa Tounkara abdoulaye diarra Amadou Traore Boubacar Karembe Sayon Diakite Konimba Keita Oumar Ongoiba Madiassa Konate Seydou Sangare Bakary Coulibaly Bakary Tientigui Dembele Adegne Togo Reference Health Center of the Municipality II Bamako Mali Hospital-University Center of Kati Kati Mali University Hospital Gabriel Touré Bamako Mali Reference Health Center of the Municipality III Bamako Mali Timbuktu Regional Hospital Timbuktu Mali

We conducted a prospective descriptive study from January 1 to December 31, 2018 with the objectives of determining the frequency of digestive surgical emergencies, describing the clinical and para-clinical aspects of the management of digestive surgical emergencies, evaluating the therapeutic aspect of digestive surgical emergencies and analysing the post-operative follow-up of patients operated on in emergencies. We counted 120 patients operated on for digestive surgical emergencies, which corresponds to 5.80% of all consultations and 44.80% of all surgical interventions. The male sex was the most represented with a ratio of 1.80. The average age was 27.5 years. The majority of patients were from Bamako. Abdominal pain was the reason for consultation in 80% of cases. The diagnosis was essentially clinical and paraclinical in doubtful cases. These included ultrasound, unprepared abdomen and sometimes abdominal CT scans. Acute appendicitis was the most common pathology with 42.5%. General anaesthesia and spinal anaesthesia were used with 50% each. The majority of patients were operated on between 30 minutes and 12 hours after their admission to the department (71.7%). Acute peritonitis accounted for 67% of deaths from sepsis. The surgical technique was decided according to the pathology and the surgeon’s choice. The postoperative course was simple in the majority of cases. The prognosis is good when the management is early. The treatment is medical-surgical.

关键词： Surgical Emergencies Digestive Tract General Surgery CSRéf CII

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Strangulation of the Penis by a Ring in Children: About a Case

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Case Reports in Clinical Medicine 2023年第8期12卷 279-284页

作者： Klétigui Samuel Dembélé Korotimi Malle Issiaka diarra Mahamadou Keita Amara Dembele Mamadou Adama Diallo Karifala Haidara Mahamadou Coulibaly Moussa abdoulaye diarra Sadio Camara Siaka Konate Dramane Fomba Djibrila Kanthe Dramane Cisse Ousmane Abdoul Aziz Dicko Tominian Reference Health Center Tominian Mali Regional Directorate of Ségou Ségou Mali Commune I Reference Health center Bamako Mali General Surgery Department and Urology Department Nianakoro Fomba Hospital in Ségou Ségou Mali Koutiala Reference Health Center Koutiala Mali Bla Reference Health Center Bla Mali Kolondiéba Reference Health Center Kolondièba Mali Markala Reference Health Center Markala Mali Urology Department Somine DOLO Hospital in Mopti Mopti Mali

Strangulation of the penis by a ring is a rare but quite common event in children and is potentially serious. We found it important to report this case in order to share our experience on the management of penis rings. It was a 9-year-old child, with no particular medical-surgical history, nor any notion of known family defect, brought to the emergency room by his parents for intense pain in the penis associated with incessant crying. In front of which a clinical examination made it possible to conclude with penile strangulation by a metal ring. Our course of action was the ablation of the ring with non-medical forceps associated with local and general care. No complications were observed during treatment. The immediate consequences were simple and the patient was followed for 4 months.

关键词： Strangulation Penis Tominian

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Postoperative Occlusion of the Small Bowel with Flanges and/or Adhesions in General Surgery of Kati BSS CHU

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Surgical Science 2018年第9期9卷 293-299页

作者： abdoulaye diarra Koniba Keita Amadou Traore Assitan Koné Issa Traore Idrissa Tounkara abdoulaye Kante Fadima K.Tall Daouda Diallo Moustaph Issa Magané Madiassa Konate Aboubacar Koné Deborah Sanra Sanogo Ismael Konare Alhassane Traoré General Surgery Department KatiMali Anesthesia Service and Resuscitation Department KatiMali Gastroenterology Department KatiMali

Objectives were to determine the frequency, describe the epidemiological and clinical aspects, therapeutic and analyze the postoperative course. Methodology: This was a retrospective study that covered 08 years (January 2009-December 2017). Inclusion criteria: all patients operated for obstruction of the small bowel by hail and/or flanging. Exclusion criteria: other types of occlusion and non-operated patients. Result: We recorded a total of 162 cases of hail obstruction by adhesions and/or flanges at 2.87%. The average age was 32.04, the sex ratio was 1.2. The average consultation time was 4 days. Abdominal pain associated with stopping of material and gas was present in all our patients. X-ray of the abdomen without preparation carried out in all the patients made it possible to objectify in 150 patients (92.6%) of the hydro-hail levels. Inoperative occlusion of hail on flange was present in 80 patients (49.4%). Occlusion of the small bowel on flange and adhesion was present in 69 patients. Adhesion obstruction of hail accounted for 6.8% (11 cases). The most commonly used surgical technique was flange resection in 91 patients (56.2%). The follow-up was simple in 151 patients (93.2%). Mortality was 1.2% of cases, i.e. 2 deaths. The average duration of hospitalization was 6 days. Conclusion: Occlusion of the small bowel by flanging and/or adherence is a surgical emergency whose prognosis depends on early management.

关键词： Postoperative Occlusion Hail Bridle/Adherence Mali

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Acute Appendicities in the Reference Health Center of Municipality II of Bamako District

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Surgical Science 2022年第5期13卷 251-257页

作者： Idrissa Tounkara Boubacar Karembe Sayon Diakite abdoulaye diarra Amadou Traore Konimba Keita Oumar Ongoiba Madiassa Konate Moussa L. Coulibaly Bakary Coulibaly Bakary Tientigui Dembele Adegne Togo Reference Health Center of the Municipality II Bamako Mali Reference Health Center of the Municipality III Bamako Mali University Hospital of Kati Kati Mali University Hospital Gabriel Touré Bamako Mali Timbuktu Regional Hospital Timbuktu Mali

This was a prospective study from January 2019 to December 2019 in the reference health center of municipality II of the Bamako district. During this period, we operated on 73 patients for acute appendicitis, including 51 men and 22 women, for a sex ratio of 1.7. The average age was 25.5 with extremes of 1 and 40 years. Abdominal pain was the main reason for consultation. The physical signs were dominated by the positivity of the Blumberg sign in 97.3% of the cases, the defense of the right iliac fossa in 79.5%, and the Rovsing sign in 61.6% of the cases. This physical examination made it possible to make the diagnosis in the majority of cases. In the face of some doubtful cases, we requested an abdominal ultrasound. Locoregional anesthesia was the most used anesthesia technique at 72.6%. The classic anterograde appendectomy with stump burial by Mac Burney was the most commonly used technique, respectively. The postoperative consequences were straightforward in 87.6%. Anatomopathology examination was performed on 69 surgical specimens and 4 appendectomy specimens were not subjected to an anatomo-pathological examination. Phlegmonous appendicitis was the most common at 63% of cases. Appendicitis remains the most common surgical emergency in a community setting. The early diagnosis and the speed of treatment guarantee improvements in the prognosis. The treatment is mainly surgical.

关键词： Acute Appendicitis Clinical Aspects Appendectomy Postoperative Effects

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Ectopic Pregnancy Combined with Intra-Uterine Pregnancy with a Full-Term Live Baby: A Case Report and Review of Literature

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Case Reports in Clinical Medicine 2019年第1期8卷 29-34页

作者： Mamadou Almamy Keita Daouda Camara abdoulaye Kanté Assitan Koné abdoulaye diarra Bréhima Coulibaly Zoseph Koné Seydou Fané Cheick Fantamady Camara Assitan Traoré Bakary Danfaga Moussa Sogoba Ismaila Simaga Bakary Keita Moussa Konaré Jules Sangala Drissa Traoré Nouhoum Ongoiba General Surgery Service of the Kati-Mali Reference Health Centre Kati Mali Gynecology and Obstetrics Service of the Kati-Mali Reference Health Centre Kati Mali Service of Surgery “B” of CHU Point G Bamako Mali Service of Anesthesia and Resuscitation of Reference Health Centre Kati Mali Service of Gynecology and Obstetrics of CHU-Gabriel Touré Faculty of Medicine and Odontostomatology Bamako Mali Service of Anesthesia and Resuscitation of CHU-Gabriel Touré Bamako Mali

Heterotopic pregnancy is no more a medical breakthrough. It combines intrauterine pregnancy and extra-uterine pregnancy regardless of location. We report a case of intra-uterine pregnancy associated with a ruptured abdominal ectopic pregnancy located on the pelvic colon in a 29-year-old patient, third gestation, primigravida, having a live baby and a prior history of two abortions. She has blood group O negative of Rhesus. It has been diagnosed at the stage of the rupture of ectopic pregnancy. An emergency laparotomy performed under blood transfusion has revealed heavy hemoperitoneum (1100 ml), a ruptured abdominal extra-uterine localized on the pelvic under blood transfusion and a bulging uterus. We have proceeded with the aspiration of hemoperitoneum, the ablation of the extra-uterine pregnancy and the hemostasis of the section part. The post-operative follow-up has been easy. The intra-uterine pregnancy has developed normally and has given birth to a full-term live, and healthy baby.

关键词： Heterotopic Pregnancy Diagnosis Maternal and Fetus Prognostic

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Vaginal Caesarean Section: A Review of Indications in Mali

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Open Journal of Obstetrics and Gynecology 2023年第6期13卷 1068-1074页

作者： Famakan Kane Soumaila Diallo Soumana Boire Alima Sidibe Jean Martin Zino Baba Bah Sadio Camara Lassina Ibringo Moussa abdoulaye diarra Bourama Lassina Dembele Mahamadou Diassana Tidiane Traore Centre de Santé de Référence de Bla Ségou Mali Centre de Santé de Référence de Niono Ségou Mali Centre de Santé de Référence de Kayes Kayes Mali Clinique la Conception Thiès Sénégal Hô pital Sominé Dolo de Mopti Mopti Mali Hô pital Fousseyni Daou de Kayes Kayes Mali Hô pital Niankoro Fomba de Ségou Ségou Mali

Introduction: The vaginal caesarean described since the 19th century remains unknown to many practitioners. The publications available on the subject are rare. The objective of this review is to report the experience of our team in Mali on vaginal cesarean section. Materials and Methods: This is a documentary review of a series of 5 cases on the practice of vaginal caesarean section at the Sominé Dolo Hospital and Reference Health Center of the Sanitary District of Bla in Mali between 2005 and 2022. Results: We performed a vaginal caesarean section on 5 patients in this series. The indications were retroplacental hematoma in 2/5 cases including 1 with a live fetus, eclampsia crisis in 1/5 cases, dystocia on uterine prolapse in 1/5 cases and beating cord prolapse in 1/5 cases. In the 5 cases, the pregnancy was not at term. In 3/5 cases, cesarean section was indicated to save the non-term fetus with a very low possibility of success by classic cesarean section and in 2/5 cases for maternal rescue with fetal death in utero. 2 live newborns were released in satisfactory condition, 1 died after 6 hours of life. Antibiotic therapy was not necessary in the majority of cases. The average length of hospitalization was 3 days. Conclusion: The circumstances of the realization of the vaginal cesarean section in our series of studies remain frequent in the practice of modern obstetrics. The short duration of hospitalization and the low use of antibiotics can contribute to the reduction of the medical cost of caesarean section in low-income countries, such as Mali.

关键词： Vaginal Cesarean Indications Mali

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Clinical and Therapeutic Aspects of Inguinal Hernia at the Reference Health Centre of Commune II of the District of Bamako

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Surgical Science 2022年第5期13卷 265-271页

作者： Idrissa Tounkara Boubacar Karembe Souleymane Thiam Sayon Diakite abdoulaye diarra Amadou Traore Konimba Keita Oumar Ongoiba Moussa Sanogo Moussa L. Coulibaly Bakary Tientigui Dembele Adégné Togo Reference Health Center of Commune II Bamako Mali Commune III Reference Health Centre Bamako Mali University Hospital Center of Gao Gao Mali University Hospital Center of Kati Kati Mali University Hospital of Gabriel Touré Bamako Mali Regional Hospital of Tombouctou Tombouctou Mali

Objective: To study the diagnostic and therapeutic aspects of uncomplicated inguinal hernias in the general surgery unit of CSRéf CII. Method: This was a prospective, descriptive, single-centre study from 1 January 2016 to 31 December 2016 of 84 patients operated on for inguinal hernias in the general surgery unit of CSRéf CII. Results: Inguinal hernia accounted for 8% of surgical consultations and hernia repair accounted for 30.22% of surgical procedures. Hernia repair accounted for 30.22% of surgical procedures. The male sex was the most represented with a ratio of 7.40. The average age of our patients was 43.19 years. Recurrence occurred in 10% of cases. The right side was most affected in 71.43% of cases, 19.05% on the left side in;it was bilateral in 09.52%. Local anaesthesia was used in 67.86% of our patients, general anaesthesia in 13.09% of cases and locoregional anaesthesia in 19.05% of cases. The hernia was external oblique in 75% of cases. Shouldice’s technique was the most used with 88%;Bassini’s technique was used in 7% and Mac Vay’s in 5% of cases. The postoperative course was simple in 96.43% of cases, with an early postoperative morbidity rate of 3.57%, one case of wall abscess and two cases of parietal haematoma. No deaths were observed during our study. Conclusion: The new methods of tension-free cure should be used more and more by our users in our facilities.

关键词： Inguinal Hernias Strangulation Management CSRéf CII

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Rare Case of Acute Peritonitis by Perforation of an Appendicular Schistosomiasis at the CHU BSS in Kati

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Surgical Science 2020年第12期11卷 385-392页

作者： Koniba Keita abdoulaye diarra Sidiki Keita Oulématou Coulibaly Assitan Koné Salia Coulibaly Amadou Traoré Idrissa Tounkara Lamine Soumaré Mamadou Diallo Bourama Togola Drissa Traoré Pierre A. Togo Department of General Surgery CHU BSS Kati Mali Department of General Surgery CHU Point-G Bamako Mali Reference health center of the commune VI of the district of Bamako Bamako Mali Medical Imaging Department CHU BSS Kati Mali General Surgery Department CHU Gabriel Touré Bamako Mali

Perforation of a pseudo appendicular tumor of bilharzial origin (bilharzia) is a rare etiology of acute peritonitis. His diagnosis is histopathological. The existence of comorbid malaria and surgical pathology is frequent in having a positive thick drop with Schistosoma mansoni eggs in his stool. After 3 months, the patient is doing well. In conclusion, we recommend the histopathological analysis of the surgical specimen after appendectomy and the detection of haematozoa for malaria in any case of fever in a surgical environment.

关键词： Acute Peritonitis Bilharzia Ileocecal Appendix

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Practice of Upper Gastrointestinal Endoscopy at the Mother-Child Hospital in Bamako/MALI: About 465 Cases

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Open Journal of Gastroenterology 2020年第11期10卷 295-300页

作者： Sanra Déborah Sanogo Moussa Y. Dicko Ganda Soumaré Kadiatou Doumbia Hourouma Sow Makan S. Tounkara Youssouf Kassambara Hamadoun Guindo A. Maiga A. Kondé abdoulaye diarra Ilias Guindo Drissa Katilé Ouatou Mallé Anselme Konate Moussa T. diarra Bougouzié Sanogo Moussa Y. Maiga Gastroenterology Department Point G University Hospital Bamako Mali Gastroenterology Department Gabriel Touré University Hospital Bamako Mali Surgery Department BSS University Hospital Bamako Mali Gastroenterology Department Mother-Child Hospital Bamako Mali

Introduction: Upper gastrointestinal (GI) endoscopy is an examination that involves exploring the upper part of the digestive tract using an endoscope. Our study was aimed to evaluate the practice of Upper GI endoscopy at the mother-child hospital in Mali. Patients and Methods: This was a descriptive retrospective study on reports of Upper GI endoscopy results in the digestive endoscopy unit at the mother-child hospital in Bamako from January to December 2018. Results: Endoscopy was performed in 465 patients including 231 males and 234 females. The sex ratio was 0.98. Patients were aged 46.69 years old on average with the extremes of 8 and 90 years old. Epigastralgia was the main referral in 50.5%. Endoscopy was normal in 24.7%. The main diagnostics were duodenogastric reflux in 32.5% and gastritis in 14.4%. Conclusion: The practice of Upper GI endoscopy at the mother-child hospital in Mali has allowed the exploration of the upper digestive tract to contribute to the diagnosis of esogastroduodenal lesions.

关键词： Upper GI Endoscopy Indications Mother-Child Hospital Mali

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