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Appendicular Peritonitis in the General Surgery Department of Gabriel TOURE CHU

Surgical Science 2022年第1期13卷 9-14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 Saadé Oumou Hélène Kanté Lassana konaté Madiassa Dembélé Souleymane Samaké Moussa Dembélé Bakary Tientigui Traoré Alhassane Togo Adégné Service de chirurgie générale H&#244pital de Sikasso Sikasso Mali Service de chirurgie générale CHU Gabriel Tour&#233 Bamako Mali

The appendicular peritonitis is complications of acute appendicitis which are characterized by the diffusion of the infectious process to the peritoneal cavity thus carrying out a generalized or located purulent peritonitis. It can appear from the start or follow the stage of appendicular abscess. Our objectives were to determine the frequency, to describe the clinic and para clinic aspects, to identify the principal germs and their sensitivities to antibiotics and to describe the operative continuations. Our prospective and descriptive study focused on patients treated for appendicular peritonitis, from January 1st to December 31st 2016, in the General Surgery Department of the Hospital of Sikasso. During the period of our study, 31 cases of appendicular peritonitis were collected, which

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Chronic Purulent Otorrhea in the South of the Sahara: Epidemiological, Clinical and Therapeutic Profiles about 135 Cases

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第4期11卷 219-226页

作者： Kassim Diarra N’faly konaté Youssou Sidibé Famagan Bah Boubacary Guindo Siaka Soumaoro Drissa Kaloga Bagayoko Fatogoma Issa koné Doumbia Kadidiatou Singare Mohamed amadou Keita Surgery Department University Hospital Gabriel Toure Bamako Mali Surgery Department CHU Mother-Child “Luxembourg” Bamako Mali Department of Anesthesia Resuscitation CHU Mother-Child “Luxembourg” Bamako Mali

Objective: To study the clinical and therapeutic epidemiological profile of chronic purulent otorrhea in the ENT and CCF departments of the Gabriel Touré university hospital. Materials and Method: This was a retrospective study from May 2019 to April 2021. We made an exhaustive sampling of all patients who consulted for chronic purulent otorrhea with a complete medical file. All ages were included (except from 0 to - 5 years), and all sexes combined. The data medium was the patient records and the department’s operating report register. The non-inclusion criteria were patients with incomplete files and patients who were less than 5 years old. Results: In total, we collected 135 cases. The average age of our patients was 29.27 years. The most represented age group was 16 to 25 years old. We noted a male predominance in 60.7%. The associated signs found were hearing loss, earache, tinnitus, ear pruritus, vertigo, headache and facial paralysis. The main pathology involved is chronic otitis media (CMO) in 55.5%, the most serious of which is dangerous chronic otitis (8.1%). All of our patients have received medical treatment. The treatment was surgical in 64% of patients after medical treatment. With the mean follow-up of 6 months, tinnitus and reperforation were the most common complications found in 6.2% and 3.1% respectively. Conclusion: Chronic purulent otorrhea is the most common ear discharge in ENT consultation. The main pathology involved is CMO, the most formidable of which is cholesteatoma. Medico-surgical treatment.

关键词： Chronic Otorrhea Cholesteatoma Myringoplasty Bamako

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Appendicular Abscess in General Surgery at the Bocar Sidi Sall University Hospital in Kati

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Surgical Science 2020年第12期11卷 479-485页

作者： Abdoulaye Diarra koniba Keita amadou Traoré Assitan koné Idrissa Tounkara Issa Traore Souleymane Thiam Fadima K. Tall Daouda Diallo Madiassa konate Aboubacar koné Deborah Sanra Sanogo Ismaël konare Alhassane Traoré Adégné Togo Department of General Surgery CHU of Kati Kati Mali General Surgery Department CHU Gabriel Touré Bamako Mali Department of Anesthesia and Resuscitation CHU of Kati Kati Mali Gastroenterology Department Point G Hospital Bamako Mali

Introduction: Appendicular abscess is a progressive complication of acute appendicitis in which the spread of infection is contained by the greater omentum and the slender loops resulting in the formation of a true septate abscess of the large peritoneal cavity. Materials and Methods: This was a retrospective study from January 2010 to December 2019 carried out at the Bocar Sidi Sall University Hospital in Kati (CHU BSS in Kati) in general surgery. It concerned all patients operated on for appendicular abscess in the department. Results: 75 cases of appendicular abscess were collected, which represented 5.76% of surgical emergencies and 25% of acute appendicitis. The average age of the patients was 29 years. The male sex represented 67% of our patients with a sex ratio of 2. The average consultation time was 5 days. Abdominal pain was noted in all patients. It was localized in the right iliac fossa in 80% (n = 60) and diffuse in 2.7% of cases (n = 2). It was accompanied by nausea and vomiting in 93% of cases (n = 70), urinary disorders in 20% (n = 15), fever in 94% (n = 71), cessation of materials and gas in 1.33% (n = 1). Abdominal ultrasound was performed in 86% (n = 65). It made it possible to suggest a peri-appendicular effusion. Biological examination revealed a neutrophilic hyperleukocytosis greater than 20,000/mm3 in 47 patients, or 63%. All the patients were operated on by laparotomy (Marc Burney or midline subumbilical) under general anesthesia. The length of hospitalization was 6 days. We have not recorded any deaths. Morbidity was 8% (n = 6) represented by parietal suppuration. The postoperative course was straightforward in 92% of cases (n = 69). Conclusion: Appendicular abscess is a frequent medico-surgical emergency, the prognosis of which depends greatly on early diagnosis and adequate and immediate management.

关键词： Appendicular Abscess Surgery Kati Mali

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Volvulus of Colon Sigmoide in the General Surgery Department of Chu Gabriel Toure

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Surgical Science 2022年第1期13卷 46-52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: Sigmoid colon volvulus is a medico-surgical emergency which represents a common cause of colonic occlusion, it is characterized by strangulation of the sigmoid loop around its meso colic axis producing low mechanical occlusion [1]. Apart from this form conventionally described, the volvulus of the sigmoid colon can occur along an organoaxial axis. This form has been highlighted in the literature thanks to the diagnostic contribution of multi-detector scanners [2]. Objective: To determine the hospital frequency of sigmoid colon volvulus;to write the clinical and para-clinical aspects of sigmoid colon volvulus;write down the different treatments used for the management of sigmoid colon volvulus.

关键词： Sigmoid Volvulus General Surgery Department

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Necrotizing Fasciitis in the Sub-Saharan Zone: Analysis of an Exceptional Case and Review of the Literature

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第4期11卷 211-218页

作者： Kassim Diarra Nfaly konaté Yaya Dembélé Youssouf Sidibe Kalifa Coulibaly Drissa Kaloga Bagayoko Fatogoma Issa koné Siaka Soumaoro Boubacary Guindo Doumbia Kadidiatou Singaré Mohamed amadou Keita Gabriel Toure University Hospital Bamako Mali Army Polyclinic Bamako Mali Luxembourg Mother and Child Hospital Bamako Mali

Necrotizing fasciitis (FN) are severe, fulminant infection with necrosis of the skin and superficial fascia. The variability of the clinical picture and the severity of the condition make it a formidable condition. B.A, 16 years old, breeder, was admitted to ENT hospitalization for a large necrotic cervico-thoracic and dorsal ulceration of sudden onset following febrile odynophagia. ENT examination: large necrotic wound extending from the antero-posterior cervical region to the thoraco-abdominal and dorsal region, letting pus weld with trismus at 1.5 cm and a fistula of the anterior pillar of the right tonsil. Cytobacteriological examination of the pus isolated Staphylococcus aureus. We instituted a probabilistic antibiotic therapy readjusted afterward to the association amoxicillin clavulanic acid with the result of the antibiogram. Incision, drainage and surgical debridement of all necrotic tissues were performed, leading to extensive loss of skin substance. A daily local dressing was applied for 11 days, then replaced by honey for 51 days. On the 64th day, he was entrusted to the dermatology department for a skin graft where he stayed for 3 months. Conclusion: current name, necrotizing bacterial dermohypodermatitis. Surgery has a key role in treatment. Antibiotic therapy should be broad-spectrum.

关键词： Necrotizing Fasciitis Surgery Sequelae

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Reliability of Medical Imaging in the Pre-Therapeutic Assessment of Acute Intestinal Obstruction at the Centre Hospitalier Universitaire Du Point “G”.

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Open Journal of Medical Imaging 2022年第3期12卷 147-156页

作者： Abdoulaye koné Mahamadou Daou Youssouf koné Moussa Traoré Moussa konaté Ouncoumba Diarra Ibrahima Coulibaly Youssouf Diawara amadou Doumbia Cheick Oumar Touré Kassim Sidibé Mody A. Camara Oumar Aba Ata Mahamadou Diallo Adama Diaman Keita Salia Coulibaly Zimogo Zié Sanogo Siaka Sidibe Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging Department of the University Hospital of Point G Bamako Mali Radiology Department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France Medical Imaging Department of GABRIEL TOURE Hospital Bamako Mali Radiology Department of CSREF Commune III Bamako Mali Medical Imaging Service Health Center of Ref Commune VI Bamako Mali Medical Imaging Service Health Center of Ref Commune IV Bamako Mali DCSSA Kati Mali Medical Imaging Department of Mali Hospital Bamako Mali Medical Imaging Department of Kati Hospital Bamako Mali Department of General Surgery of Point G University Hospital Bamako Mali

Introduction: Acute intestinal obstruction is a serious pathology, a surgical emergency for which medical imaging plays an important role in the management. We initiated this work in order to study the contribution of imaging in the diagnosis of acute intestinal obstruction at the Point-G University Hospital. Patients and Methods: This was a prospective, descriptive and analytical study of 96 patients collected at the radiology and medical imaging department of CHU Point-G from January 2018 to January 2019. Results: The age of our patients varied from 11 to 86 years, with an average of 36 years old. There was a male predominance of 64.6% against 35.4% for women, i.e., a sex ratio of 1.82. Previous surgery was found in 61.5% of our patients. The pain was present in all patients. An unprepared abdominal X-ray was performed in 89.6% of patients. Hydroaerobic levels were found in 96.5% of patients. Abdominopelvic CT scans were performed on 12 patients, all of whom were diagnosed with occlusion. These positive diagnostic findings were consistent with intraoperative findings in 92% of cases. The causes were dominated by bridges in 46 patients and tumors in 9 patients. Signs of severity on CT were dominated by signs of distress of the upstream bile ducts in 8.3%. Exactly 8% of our patients spontaneously resumed transit, 91% received surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients (83.3%) and poor with death in 16 patients (16.7%). Conclusion: Acute intestinal obstruction remains a serious pathology for which the X-ray of the PSA is often the only radiological examination performed in an emergency. However, abdominopelvic CT seems to us to be widely indicated thanks to its contribution both to the positive diagnosis and to the diagnosis of severity and etiology. However, this imaging technique is widely underused in our practice because of its high cost and lack of availability.

关键词： Medical Imaging Acute Intestinal Obstruction Abdominal CT Reliability

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

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Surgical Science 2022年第1期13卷 23-27页

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

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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

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Anatomical Variations of Recurrent Laryngeal Nerve: The Danger in Thyroid Surgery

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Surgical Science 2019年第1期10卷 11-15页

作者： Fatogoma Issa koné Siaka Soumaoro Naouma Cissé N’faly konaté Kassim Diarra Djibril Samaké Kadidiatou Singaré Kadidiatou Singaré Boubacary Guindo Samba Karim Timbo Mohamed amadou Keita Department of ENT—Head and Neck Surgery Gabriel Toure University Hospital Bamako Mali

Objectives: We report two types of anatomical variations of the recurrent laryngeal nerve in two patients. Through these two patients we wanted to highlight our surgical approach of the recurrent nerve in an unusual position and to describe the surgical implication of these almost rare variations. Case report: patient aged 28 and 58 admitted for goiter. They underwent a right lobisthmectomy. Both recurrences were approached retrograde. The anatomical variations of the nerve concerned the non-recurrent laryngeal nerve in the first patient. In the second patient there were three anatomical variations, namely an extra laryngeal bifurcation of the nerve, a pre-vascular position of the nerve and a branch connecting the vagus nerve and the recurrent nerve. No recurrence nerve injury was noted. Conclusion: The anatomical variations of the nerve are numerous. A careful dissection is a guarantee of a good prognosis.

关键词： Anatomical Variation Recurrent Laryngeal Nerve Surgery Mali

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