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Acute Intussusception of the Adult in Burkina Faso, a Tropical Area: Our Experience about 30 Cases

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Surgical Science 2018年第6期9卷 189-196页

作者： zida maurice Ouangré Edgar Ouedraogo Souleymane Doamba Rodrigue Kafando Roch Justin Zan Abdoulaye Traoré Si Simon Department of Visceral Surgery Teaching Hospital Yalgado Ouedraogo Ouagadougou Burkina Faso Department of General Surgery Teaching Hospital of Ouahigouya Ouahigouya Burkina Faso

Objective: To describe the etiological, clinical and therapeutic aspects of adults’ intussusception at Yalgado Ouedraogo University Hospital in Ouagadougou (CHU-YO), Burkina Faso. Patients and method: This descriptive cross-sectional study was conducted between May 2011 and April 2016 at CHU-YO. All patients with 16 years of age and older operated on for intussusception were included. Results: Thirty patients were identified, 15 men and as many women. Their average age was 37.3 years. A higher frequency was noted between 30 and 39 years. The installation of the symptomatology was insidious in 22 cases and brutal in 8 cases. The reasons for consultation were abdominal pain (30 cases), vomiting (19 cases), intestinal transit stop (18 cases) and rectorrhagia (9 cases). Physical examination noted an abdominal mass in 11 cases and a localized abdominal tenderness in 7 cases. An intussusception coil was identified on ultrasound in 9 cases. All patients underwent surgery under general anesthesia and the approach was laparotomy. Intraoperatively, the intussusception was ileocolic in 15 cases;a right hemi-colectomy was performed. It was colo-colic intussusception in 10 cases and the treatment thus consisted of a left hemi-colectomy. In other 5 cases, intussusception was ileal, requiring ileal resection. The average hospital stay was 11.7 days. Pathologically, the examination was normal in 2 cases. A colic tumor was found in 14 cases and an ileum tumor in 6 cases. In the other 8 cases, it was an inflammatory aspect of the intestine. Conclusion: In tropical Burkina Faso, adult intussusception often occurs on an intestinal tumor. The symptomatology is atypical.

关键词： Acute Intestinal Intussusception Adult Intestinal Tumor Burkina Faso

Incisional Hernias: Risk Factors and Treatment in a Context of Limited Resources

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Surgical Science 2017年第10期8卷 451-456页

作者： Souleymane Ouedraogo Salam Ouedraogo Jean-Luc Kambire Mamadou Windsouri Mamadou T. Traore maurice zida , Si Simon Traore Department of Surgery University Ouaga 1 Pr Joseph Ki Zerbo Ouagadougou Burkina Faso Department of General and Digestive Surgery University Ouaga 1 Pr Joseph Ki Zerbo Ouagadougou Burkina Faso

Background: The purpose of this study was to describe the etiologic factors and therapeutic modalities of incisional hernias in the department of surgery at the regional hospital of Tenkodogo, in Burkina Faso. Methods: It is a cross sectional study covering the period from 2010 to 2012. Sampling was comprehensive, including all the patients operated for incisional hernias during this period. Results: Fifty-four patients were included. Their average age was 22.3 years. There were 35 (64.8%) males and 19 (35.2%) female patients. We counted 28 large-size incisional hernias, 14 medium-size incisional hernias and 12 incisional hernias of small size. The average time from the first surgery to the diagnosis of incisional hernias was 8 months. Generalized acute peritonitis (44.4%) and acute intestinal obstructions (22.2%) were the main indications of initial surgical interventions. Vertical midline incisions have been involved in 37 cases (68.5%). Therapeutically, two surgical techniques have been used: open suture repair and open mesh repair. Forty-two patients (77.8%) were treated by open suture repair. Twelve patients (22.2%) benefited from open mesh repair. Post-operative complications were noted in 2 patients. Nine patients (16.7%) presented a recurrence after 12 months. Conclusion: In the rural area of Burkina Faso, incisional hernias occur in young patients. Emergencies with abdominal Infections are the main operative indications. Prostheses are relatively high cost and less accessible. The recidivism rate is high.

关键词： Incisional Hernia Abdominal Wall Closure Surgical Treatment Burkina Faso

Thoracic Wounds by Firearm at the University Hospital Yalgado Ouedraogo (YO)

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Open Journal of Thoracic Surgery 2017年第2期7卷 23-28页

作者： Edgar Ouangré maurice zida Moussa Bazongo Elie Yamba Sawadogo Aristide Sam Rock Kafando Nayi Zongo Si Simon Traoré Department of General and Digestive Surgery University Hospital-Yalgado Ouédraogo Ouagadougou Burkina Faso

Introduction: Thoracic wounds by firearms are frequent and severe. They may involve the patient’s prognosis. Objective: To study the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of the thoracic wounds by firearms. Material and method: This was a cross-sectional, descriptive study of all patients over the age of 15 who consulted in the university hospital-YO in the department of general and digestive surgery over a period of 5 years. Results: We collected 50 cases of thoracic wounds by firearms on 183 thoracic wounds with a prevalence of 27.3%. There were 48 men (96%). The average age was 30 years. The patients came from urban areas in 66% of cases;the informal sector accounted for 44% of the cases. The pistol was the most involved firearm (46.9%). The consultation period was less than 6 hours in 78% of patients. An unstable hemodynamic state was found in 42% (n = 21). A fluid and mixed pleural effusion syndrome was found in 46% and 26% of patients, respectively. Associated lesions were diaphragm involvement, and lesions of intra-abdominal hollow organs. Thoracic drainage was performed in 24 patients (48%) and was associated with a laparotomy in 8 patients. The average hospital stay was 7.5 days. Mortality was 14%. Conclusion: the thoracic wounds by firearms are frequent in civilian practice. The thoracic CT allows mapping of the lesions and thoracic drainage constitutes the essential part of surgical treatment. The fight against the proliferation of weapons deserves to be promoted.

关键词： Wounds Thorax Firearm Drainage Burkina Faso

Epidemiological, Etiological, Therapeutic and Evolutionary Aspects of Acute Surgical Abdomens Operated at the University Hospital of Bobo-Dioulasso

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Surgical Science 2018年第1期9卷 1-7页

作者： Cyprien Zaré Hermann Belemlilga Edgard Ouangre maurice zida Bakary Gustave Sanon Drissa Barro Nassirou Yabre Si Simon Traore Department of General and Digestive Surgery of the University Hospital Center Souro Sanou Bobo-Dioulasso Burkina Faso Service of General and Visceral Surgery CHUYO Ouagadougou Burkina Faso

Surgical acute abdomens represent a significant proportion of surgical emergencies in terms of frequency, morbidity and mortality. The aim of our study was to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of acute surgical abdomens operated in the surgical emergency department of the Centre Hospitalier Universitaire Souro Sanou (CHUSS). This was a retrospective descriptive study of 426 cases of surgical acute abdomens operated in the CHUSS surgical emergency department from 1 January to 31 December 2015. These 426 cases accounted for 24.14% of the emergency interventions carried out in the CHUSS surgical emergency department. These were 314 (73.7%) men and 112 (26.3%) women with an average age of 30 years. Among the causes, there were 187 (43.9%) cases of acute generalized peritonitis, 71 (16.7%) cases of acute intestinal occlusions, 49 (11.5%) cases of acute appendicitis, 38 (9.4%) cases of strangulated parietal hernias, 16 (3.8%) cases of abdominal contusions, and 15 (3.5%) cases of penetrating wounds of the abdomen. The appendectomy was the most performed gesture with 112 (26.3%) cases. The time to surgery was greater than 48 hours in 29 (6.8%) cases. Complications were observed in 68 (16%) cases with 35 (8.2%) cases of parietal infections, 18 (4.2%) cases of postoperative peritonitis. The death occurred in 37 (8.7%) patients. The average hospital stay was 8.7 days. Improving the prognosis of acute surgical abdomens requires early diagnosis and treatment, as well as better postoperative follow-up.

关键词： Surgical Emergencies Abdomen Bobo-Dioulasso

Child Abdominal Trauma Due to Attack of Cattles While Working on Farms in Burkina Faso

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Surgical Science 2017年第11期8卷 481-487页

作者： Souleymane Ouedraogo Cyprien Zaré maurice zida Julien T. Savadogo Mamadou Windsouri Edgar Ouangre Emile Bandre Simon S. Traore Department of Surgery University Ouaga 1 Pr Joseph Ki Zerbo Ouagadougou Burkina Faso Department of Surgery University of Nazi Bony Bobo-Dioulasso Burkina Faso Department of Surgery University Ouaga Pr Joseph Ki Zerbo Ouagadougou Burkina Faso

Introduction: Cattle are strong animals very often used in agriculture in rural Africa. Unpredictable in their behavior, they regularly inflict injuries to farmers, some of whom are children in rural Africa. Objective: The purpose of this study was to describe the clinical, therapeutic and evolutionary aspects of abdominal trauma caused by bovidae to children on farms in Burkina Faso. Patients and Method: This is a descriptive study covering the period from January 2014 through December 2016 and was conducted in the General Surgery Unit of the Tenkodogo Regional Hospital in Burkina Faso. It included all patients under the age of 17, victims of abdominal trauma by cattle on farms. Result: A total of 68 patients were identified, which is 3% of all patients under 17 admitted to the service during the same period. The average age of patients was 10.5 years, with a standard variation of 3.6 years. The majority (73.5%) of the patients were boys. The main lesional mechanisms found were horn strokes (88.2%). We noted 35 eviscerations without visceral perforation, 15 intestinal perforations, 6 hepatic wounds and 5 splenic wounds. In 7 cases, there were non-penetrating wounds. All patients underwent surgical intervention under anesthesia. The average length of hospital was 6 days. Two deaths were recorded, making a mortality rate of 3%. Conclusion: Abdominal traumas of the child by attack of cattle are frequent during farm works in rural Burkina Faso. The injuries are sometimes serious. Wearing protective equipment for children should be considered during farm work.

关键词： Abdominal Trauma Cattle Children Field Work Surgery

Gastric Adenocarcinoma Treatment in Africa: Surgery Alone or Perioperative Chemotherapy?

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Journal of Cancer Therapy 2017年第7期8卷 653-662页

作者： Nayi Zongo Bagué Abdoul Halim Ouangré Edgar Bagré Sidpawalmde Carine zida maurice Boukoungou Gilbert Sanou Adama Lompo Olga Mélanie Traoré Si Simon Ahmadou Dem General and Digestive Surgery Yalgado Ouédraogo University Hospital Ouagadougou Burkina Faso Oncology Institute Joliot Curie of Dakar Dakar Senegal General and Digestive Surgery Department University Hospital Center Blaise COMPAORE Ouagadougou Burkina Faso Pathological Anatomy and Forensic Unit Yalgado Ouédraogo University Hospital Ouagadougou Burkina Faso

Aim: Evaluate the impact of MAGIC trial on gastric adenocarcinoma’s management in Africa. Method and methodology: It was about a review of literature on therapeutic aspects of gastric adenocarcinoma in the African area. We have taken a census of 21 articles including 2792 patients published between 1980 and 2013. We have distinguished articles published before 2006 (group 1) from those published after 2006 (group 2) to better understand therapeutic changes after that perioperative chemotherapy has become a standard in gastric adenocarcinoma’s management. Results: Surgery remains in Africa the first and practically the only treatment weapon in gastric adenocarcinoma: 46% to 92% people in the 1st group and 65% to 100% people in the 2nd group underwent surgical procedures. Perioperative chemotherapy takes longer to be part of therapeutic habits (0.18%). Factors related to patients such alteration of general state with a WHO performance status superior to 2 in 72% of cases, the lack of financial accessibility to anticancerous drugs explains partly the non-use of perioperative chemotherapy. This is also due to factors peculiar to our sanitation structures which don’t have enough cancer specialists. So we noticed that MAGIC trial is simply ignored in certain studies. The lack of adoption of perioperative chemotherapy explains with delayed diagnosis the low survival of patients in the African area. Conclusion: MAGIC trial practically has no effect on therapeutic behavior yet comparatively to gastric adenocarcinoma in Africa. The insurance particularly relies on surgery only until now. However, it might enable us to improve gastric adenocarcinoma’s survival rates.

关键词： Adenocarcinoma Stomach Surgery Perioperative Chemotherapy Africa

Transanal Evisceration of Small Bowel about One Case at the University Hospital Yalgado Ouédraogo of Ouagadougou

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Surgical Science 2016年第7期7卷 291-294页

作者： Adama Sanou Moussa Bazongo Edgar Ouangré maurice zida Gilbert Patindé Bonkoungou Rodrique Namékinsba Doamba Sylvain Wendmi Karfo Elie Yamba Sawadogo Nayi Zongo Si Simon Traoré Division of General and Digestive Surgery University Hospital Blaise Compaoré Ouagadougou Burkina Faso Division of General and Digestive Surgery University Hospital Yalgado Ouédraogo Ouagadougou Burkina Faso

Introduction: Transanal evisceration of small bowel is an extremely rare condition that can occur spontaneously or after trauma. Objective: To report a case of Transanal evisceration of small bowel to describe the circumstances of occurrence and our therapeutic attitude. Observation: An 80-year-old female patient was received at the visceral Emergency of University Hospital Yalgado Ouédraogo for the outcome of the small intestine by the anus with the waning of a defecation effort. The physical examination of the patient accustomed to evacuation purgation noted, eviscerated the small bowel through the anus, edematous but viable. The preoperative laboratory tests were normal. In emergency, under general anesthesia, a laparotomy was possible to objectify the incarceration of intestinal loops through linear perforation of 5 cenimeter from the anterior surface of the rectosigmoid hinge. We conducted an ileo-ileal resection anastomosis, a suture rectosigmoid breach and anal extraction of small bowel incarcerated measuring 200 centimeter. The evolution was simple. Conclusion: The weakening of the rectal mucosa by repeated purges has certainly been the contributory factor. The surgical treatment must be precocious to avoid extensive intestinal resection.

关键词： Evisceration Transanal Small Bowel Rectum Sigmoid

Testicular Seminoma and Peritonitis about One Case at the Yalgado Ouedraogo University Hospital of Ouagadougou

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Open Journal of Urology 2015年第12期5卷 220-223页

作者： Nayi Zongo Moussa Bazongo Mamadou Windsouri Mousa Kaboré Edgar Ouangré maurice zida Aimé Sosthène Ouédraogo Aboubacar Hirrhum Bambara Augustin Tozoula Bambara Si Simon Traore Ahmadou Dem Division of General Surgery Yalgado Ouédraogo University Hospital Ouagadougou Burkina Faso Division of Pathologic Anatomy Yalgado Ouédraogo University Hospital Ouagadougou Burkina Faso Oncology Institue Joliot Curie Dakar Senegal

Introduction: Testicular seminoma is a highly lymphophilic germ cell tumor. It is the most common germ cell tumor in young adults. We are reporting one case of testicular seminoma complicated with an acute generalized peritonitis (AGP), in order to describe the circumstances of diagnosis and discuss about treatment. Observation: It involved a 39-year-old patient, admitted for vague abdominal pains that were evolving since 72 hours with a history of right orchiectomy because of testicular seminoma in 2011. The analysis revealed a peritoneal syndrome, a right inguinal lymphadenopathy of 10 cm diameter and an empty right scrotum. The exploration revealed fistulized necrotic retro-peritoneal lymphadenopathies in the peritoneal cavity and ileal perforation on contact with these lymphadenopathies. Necrosectomy and ileal resections were performed. After the operation, the scanner revealed a conglomeration of retro-peritoneal adenomegalies extending to the right femoral region associated with bilateral pleurisy. The β-HCG and the LDH were 8000 IU/L and 24,500 IU/L, respectively. The seminoma was ranked T3N3M1. The immediate post-operative care was uneventful. The patient was lost from sight for a month and was readmitted in a context of alteration of his general condition. He died before the end of the pre-chemotherapeutic assessment. Conclusion: Scrotal mass is the usual way of revelation of testicular seminoma. In poorly followed-up cases, exceptional complications such as peritonitis may occur and are direct consequences of poor prognosis.

关键词： Seminoma Testicle Peritonitis Treatment Prognosis

Survey on the Knowledge, Attitudes, Primary Prevention Practices and Screening of Skin Cancers in Albinos in Burkina Faso

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Journal of Cancer Therapy 2016年第11期7卷 812-823页

作者： Smaila Ouédraogo Nayi Zongo Nina Korsaga-Somé Seraphine Marie Suzanne Kaboré Edgar Ouangré maurice zida A. S. Ouédraogo Aboubacar Hierrum Bambara Augustin Touzoula Bambara Si Simon Traoré Pascal Niamba Adama Traoré Ahmadou Dem Public Health Yalgado Ouédraogo University Hospital Ouagadougou Burkina Faso General and Digestive Surgery Yalgado Ouédraogo University Hospital Ouagadougou Burkina Faso Dermatology and Venerology Yalgado Ouédraogo University Hospital Ouagadougou Burkina Faso Pathological Anatomy and Forensic Unit Yalgado Ouédraogo University Hospital Ouagadougou Burkina Faso Oncology Institute Joliot Curie of Dakar Dakar Senegal

The objective is to study the knowledge that albinos have on skin cancers, and their attitudes in terms of primary prevention and the screening practices for skin cancers in Burkina Faso. Methods: This is a cross-sectional and descriptive KAP study conducted from May 18th to July 7th 2015. It involved albinos aged at least 12 years. Their general knowledge, prevention attitudes and screening practices were considered. Results: All the responding albinos had already heard about skin cancers. Their main source of information was health workers (65.6%). They were showing at least two risk factors (99.2%) but only 68.3% affirmed having already undergone screening for skin cancer. Ignorance of the existence of screening was the main obstacle to it (16/26). The prevention means used was sun avoidance, the use of cream and protection clothing respectively in 84%, 41.5% and 51.2%. The skin lesions found were hyperpigmented macules (77.8%) then actinic keratosis (40.7%) and finally cheilitis (35.8%). We detected 4 cases of skin cancers confirmed by biopsy. Conclusion: Risk factors are frequent. Participation to screening is still insignificant. A lot is still to be done to extend the protection means. A good awareness-raising campaign and the accessibility to protection means remain for all, the best defense in the fight against skin cancers in albinos.

关键词： Albinos Screening Prevention Skin Cancers