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A Retrospective Analysis of the Patterns and Outcomes of Tile B and Tile C Pelvic Fractures in Cameroon

Open Journal of Orthopedics 2023年第4期13卷 157-167页

作者： Chunteng Theophile Nana Tsiagadigui Tsiagadigui Jean Gustave Ngo Yamben Marie-Ange Batchom Daudet Bombah Freddy Muluem Kenedy mokake divine ngomba Ekani Boukar Mahamat Ali Mahamat Takou Bougoue Andre Gaetan Simo Wambo Tagakou Mboula Christian Fotso Ndasi Henry Pius Fokam Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: Pelvic fractures constitute about 2% - 8% of all fractures. This incidence may rise up to 25% in poly-traumatised patients. These fractures have a high mortality rate due to the fact that they occur usually as a result of high energy trauma, and most of the injured are poly-traumatised with concomitant haemodynamic instability. The aim of this study is to describe the patterns of injury and complications of unstable pelvic fractures treated in a level III hospital in Cameroon. Methodology: This was a hospital based retrospective analysis of files of patients admitted and treated for unstable pelvic fractures at the Regional Hospital Limbe within a period of 10 years (from 1st of January 2009 to 31st of December 2018). Results: A total of 139 cases of pelvic fractures were identified, amongst which 77 were unstable;68 were finally analyzed. The ages ranged from 18 to 80 years with a mean of 39 ± 5 years. The age group from 20 - 40 years was most represented (58.88%, n = 40). There were 45 males and 23 females giving a sex-ratio of 2:1. Road traffic injuries accounted for most of the cases (73.53%, n = 50). Forty-five (66.2%) were classified Tile B and 23 (33.82%) were Tile C, and 15 cases were open fractures (22.06%). Associated lesions were recorded in 30 cases, fractures of the lower extremity being the most common (33.33%, n = 10). Most of the cases were definitively treated surgically (80.89%, n = 55). The most common complications were surgical site infections (23.64%, n = 13). Conclusion: Unstable pelvic fractures are relatively common. Young males in the age group 20 - 40 years are the most affected, and the most common cause of injury was road traffic accident. Surgical site infections, pressure ulcers, severe anaemia and thrombo-embolism are common complications.

关键词： Unstable Pelvic Fracture Patterns Complications Cameroon

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Management and Outcome of Urethral Strictures at Two Tertiary Health Facilities in Cameroon

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Open Journal of Urology 2024年第8期14卷 435-446页

作者： Martin divine mokake divine Enoru Eyongeta Ekani Mahamat Ekani Diana Nunga Theophile Chunteng Nana Ntungwetape Ngwane Mwambo Nalova Elroy Patrick Weledji Chichom Alain Mefire Marcellin Ngowe Ngowe Department of Surgery and Specialties Faculty of Health Sciences University of Buea Buea Cameroon Department of Surgery Regional Hospital Buea Buea Cameroon Department of Surgery Regional Hospital Limbe Limbe Cameroon Department of Surgery Douala General Hospital Douala Cameroon

Introduction and Objectives: Urethral stricture is a reduction in the caliber of the urethral lumen impeding the outflow of urine. It predominantly affects males. The disease burden is severe in our milieu where access to specialized care is limited. Our goal was therefore to assess the management and outcome of male urethral stricture at two tertiary hospitals in Douala, Cameroon. Materials and Methods: This was a hospital-based retrospective study of patients managed for urethral stricture over 5 years (January 1st, 2017 to December 31st, 2021) at the Douala General and Laquintinie Hospitals. Data on sociodemographic, clinical, paraclinical, and treatment options were extracted using pre-structured forms. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 28. Statistical significance was set at p-value Results: We exploited 130 medical records. The mean age of patients was 46.5 years. Dysuria and weak urine stream were the major presenting complaints (63.8% and 23.8% respectively). The etiology of urethral stricture was iatrogenic in 42.3% of cases. The strictures were mostly single (89.8%), and the bulbar urethra was most affected (46.9%). 28 patients had urinary tract infections and the most frequently isolated germ was E. coli in 29.6%. Direct visual internal urethrotomy (DVIU) was performed in 42.3% of cases. Surgery, especially excision and primary anastomosis (EPA) was done in 28.5% of cases. Major complications were wound infection, acute kidney injury (AKI), and urethrocutaneous fistulae affecting 3.1, 2.3, and 1.5% of cases respectively. The recurrence rate was 17% with a mortality rate of 0.08%. Conclusion: Urethral stricture is common in our adult male population. The cause is mainly iatrogenic and the bulbar urethra is most affected. Minimally invasive and open reconstruction are frequently used treatment options with significant recurrence rates in the long term.

关键词： Urethral Stricture Management Outcomes

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Helicobacter Pylori Infections in Peptic Ulcer Perforations: A Retrospective Analysis in Two Referral Hospitals in Douala, Cameroon

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Surgical Science 2020年第10期11卷 298-311页

作者： Francois Adrien Morel Bokalli Chi Fru McWright Jerry Brown Njoh Aseneh Takere Maseoli Mbachan ngomba divine mokake Jules Clément Assob Nguedia Marcelin Ngowe Ngowe Department of Medicine Faculty of Health Sciences University of Buea Buea Cameroon Laquintinie Hospital Douala Cameroon Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Department of Biomedical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Surgery Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: Perforations are major complications of peptic ulcer disease and surgical emergencies with important mortality and morbidity. Helicobacter pylori (H. pylori) has been identified as one of the commonest factors associated with peptic ulcer disease. However, little is known about its implication in cases of perforations in Cameroon. We aimed to determine the frequency of Helicobacter pylori infections in cases of perforated peptic ulcers, describe clinical features and outcomes of these cases in Cameroon. Method: A hospital-based retrospective cross-sectional study was conducted through the review of patients’ records admitted for peptic ulcer perforations in Laquintinie and Douala General Hospitals over a period of 5 years (January 2014 - December 2018). We defined H. pylori infection as;positive result on tissue biopsy at time of surgery. We used SPSS version 23.0 to analyse data and set an alpha value at P = 0.05. Results: We reviewed 115 cases of peptic ulcer perforation, with a mean age of 40 years and sex ratio (M:F) of 5:1. All patients underwent emergency laparotomy, 48 (41%) cases had a biopsy report and the prevalence of H. pylori infection in these cases was 47.9 %. Smoking, alcohol consumption and Non-Steroidal Anti-inflammatory Drugs (NSAIDs) use, were not associated with peptic ulcer perforation. The morbidity was at 43.7% and mortality at 14%. Mortality was increasing with a higher Mannheim Peritonitis Index score (OR: 23.51, 95% CI: 4.197 - 143.003, P-value: 0.000). Conclusion: We observed a high prevalence of H. pylori infection in patients with peptic ulcer perforations. We recommend systematic H. pylori screening in cases of perforations and that larger studies should be carried out to evaluate the association of H. pylori infection with peptic ulcer perforation in Sub-Saharan Africa.

关键词： Perforated Peptic Ulcers Helicobacter pylori Infections Clinical Features Outcome

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The Epidemiological Profil of Digestive Cancers in Secondary and Tertiary Health Care Facilities in Cameroon

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Surgical Science 2022年第3期13卷 98-104页

作者： Yannick Ekani Boukar Mahamat Georges Bwelle Cyrille Chopkeng Freddy Bombah Fabrice Tietche Tim Guy Aristide Bang Eric Patrick Savom divine mokake Alain Chichom Arthur Essomba Marcellin Ngowe Maurice Aurelien Sosso Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Department of Surgery Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Digestive Surgery Unit Central Hospital of Yaounde Yaounde Cameroon Department of Surgery Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: Cancers have been a major public health problem in developing countries in recent years. The aim of this study was to determine the epidemiological profile of digestive cancers in secondary and tertiary health care facilities in Cameroon. Methodology: This was a cross sectional and descriptive study conducted over a period of 12 months in 14 health structures over the national territory. Included in our study were patients aged 15 and above with a histologically proven digestive cancer, patients with a clinical, biological and morphologic evidence of a digestive cancer. Socio-demographic (age, gender, region of origin, profession), clinical (symptoms on diagnosis, personal and family past history, consumption habits, tumour location) and paraclinical data were recorded on a pretested questionnaire. Data was analysed using SPSS version 20.0. Quantitative data was expressed as means with their corresponding standard deviations. Chi square was used for correlation between variables. A P value 0.05 was considered statistically significant. Results: Five hundred and eighty-two cases of digestive cancers were recorded out of 37,780 consultations/admissions during the study period giving a prevalence of 1.5% with a male predominance (58.1%). The mean age was 53.11 ± 17.26 years (15 - 99) with 33.8% of them below 45 years of age. Tumours were predominantly localized in the liver (43.5%) and colon (24.9%). Adenocarcinoma was the most common histological type in 44.5% of all cases. Alcohol consumption was found to be associated with colorectal cancer (p = 0.028) while tobacco consumption was found to be significantly associated with oesophageal cancer (p ≤ 0.001) and gastric cancer (p = 0.0047). Conclusion: A third of patients with digestive cancers were aged less than 45 years suggesting an early onset of these cancers in our setting. Relatively low prevalence with the liver being the most common site of localisation in our setting.

关键词： Digestive Cancer Secondary and Tertiary Health Care Facilities Cameroon

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Injury Patterns and Treatment Outcome of Road Traffic Crash Victims at the Emergency Department of the Regional Hospital Limbe, Cameroon

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Surgical Science 2022年第3期13卷 174-182页

作者： Mahamat Yannick Ekani Boukar Nana Teophile Chunteng Freddy Bombah Georges Bwelle Cyrille Chopkeng Guy Aristide Bang Eric Patrick Savom divine mokake Pius Fokam Alain Chichom Arthur Essomba Marcellin Ngowe Maurice Aurelien Sosso Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Surgery Unit Limbe Regional Hospital Limbe Cameroon Department of Surgery Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Surgery Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon

Background: Traumatic injuries constitute a leading cause of mortality and morbidity worldwide with a global burden that is on the rise. The aim of this study is to analyse preliminary data of the Limbe trauma registry, to describe the injury patterns and determine the outcome of care of the injured who were treated in the emergency department of the regional hospital Limbe in Cameroon. Methodology: This was a descriptive secondary analysis of prospective data collected on injury at Limbe Regional Hospital in two years, between October 2008 and October 2010. All cases of injury presenting to the emergency department of Limbe Regional Hospital were included in a prospective trauma registry. Data was collected with a pre-tested data entry form and included the age, sex, mechanism of injury, delay before arrival to hospital, body part injured, description of lesions and outcome at the emergency. Descriptive analyses were done using STATA 14. Comparisons between groups were evaluated using Chi-squared test or Kruskal-Wallis and p-values <0.05 were considered statistically significant. Results: A total of 2400 cases of injury were recorded during the study period with more males (68%) than females. The ages ranged from 0 to 90 years with a peak between 20 to 39 years. Road traffic crash was the most common cause of injury representing 60.81% of the population (n = 1434);other causes were burns, falls, domestic injuries, assaults, and labour accidents. The accidents mostly involved motor cycle alone (42.03%). Concerning the outcome of care at the emergency department, 88.73% (n = 1260) were discharged. Conclusion: The burden of road traffic injuries in south west Cameroon is high. Motorcycles are mostly involved alone or with pedestrians and/or cars.

关键词： Traumatic Injuries Limbe Regional Hospital Cameroon

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Prevalence, Aetiology, and Clinical Profile of Acute Abdomen in Pregnancy in Southwest Cameroon: A 5-Year Retrospective Study

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Surgical Science 2023年第1期14卷 1-9页

作者： Yannick Mahamat Ekani Boukar divine mokake Felix Adolphe Elong Terence Dze Enah Moussa Adam Adami Eric Patrick Savom Anutebeh Verdo Zisuh Guy Aristide Bang Alain Chichom Mefire Arthur Essomba Marcellin Ngowe Ngowe Maurice Aurelien Sosso Faculty of Health Sciences University of Buea Buea Cameroon Surgery Unit Buea Regional Hospital Buea Cameroon Gynaecology Unit Buea Regional Hospital Buea Cameroon Faculty of Human Health Sciences University of N’Djamena N’Djamena Tchad Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: Acute abdomen is one of the commonest reasons for presentation at the emergency department. The physiologic changes of pregnancy increase the chances of developing acute abdomen. The global incidence of acute abdomen in pregnancy range from 1 in 500 to 1 in 635 pregnant women. In 2018, a study in Azerbaijan reported a prevalence of 25%. However, to the best of our knowledge, very few studies have been carried out on this subject in Cameroon. Objectives: To determine the prevalence, assess the aetiologies, and review clinical profile of acute abdomen in pregnancy in the Southwest Cameroon. Methods: We conducted a 5-year retrospective study at the Obst/Gyn and Surgical units of Kumba, Buea, and Limbe Regional Hospitals. We included all files of pregnant women that were admitted for acute abdomen within the study period (1st Jan 2017 to 31st Dec 2021). Data was collected using a structured checklist adapted from previous studies. Descriptive statistics and statistical testing was done using SPSS version 25.0. Chi-square was used to compare categorical variables. p Results: Over 14,106 pregnant women were admitted to the aforementioned hospitals within the study period. 335 (2.4%) met our inclusion criteria. The patients’ age ranged from 17 to 43 years. The mean age was 27 years. Acute abdomen was more frequent (65%) in the first trimester. Ectopic pregnancy was the commonest obstetric aetiology while appendicitis was the commonest non obstetric surgical aetiology. Abdominal pain and tenderness were the most common presentation. Conclusion: The prevalence of acute abdomen in pregnancy in the Southwest Cameroon is 10 times higher than the global prevalence. Our study also confirmed the numerous aetiologies and varied clinical presentations of acute abdomen in pregnancy. Hence a wake-up call for primary care physicians.

关键词： Acute Abdomen Pregnancy Southwest Cameroon

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Prevalence, Management and Outcomes of Enterocutaneous Fistulas in Buea Regional Hospital and Laquintinie Hospital of Douala. A Five Years Retrospective Study

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Surgical Science 2023年第1期14卷 17-29页

作者： Yannick Mahamat Ekani Boukar divine mokake Ousmana Oumarou Chimene Cecile Biiga II Moussa Adam Adami Eric Patrick Savom Anutebeh Verdo Zisuh Guy Aristide Bang Alain Chichom Mefire Arthur Essomba Marcellin Ngowe Ngowe Maurice Aurelien Sosso Faculty of Health Sciences University of Buea Buea Cameroon Surgery unit Buea Regional Hospital Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Faculty of Human Health Sciences University of N’Djamena N’Djamena Tchad Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: An Enterocutaneous fistula (ECF) is an abnormal connection between the intestinal tracts or stomach and the skin. They are a major catastrophe to the patient and surgeons and still have a high incidence of morbidity and mortality which varies between 6% - 33%;their management remains a big challenge. These patients frequently face complications, and a well-organized multidisciplinary approach must be implemented in their management to improve outcomes. Objectives: Our study aims to assess the prevalence, management and outcomes of enterocutaneous fistulas in Buea regional hospital and Laquintinie hospital of Douala over the past 5 years. Methods: This was a hospital-based retrospective study in Buea regional hospital and Laquintinie hospital of Douala. Records of patients who had enterocutaneous fistulas within the period of 1st January 2017 to 31st December 2020 in the surgical departments. Data included demographics, pre-operative diagnosis, comorbidities, type of fistula, management modality and means, the indication of operative treatment, length of stay in the hospital and outcomes. Data was analysed using SPSSv26. Results: The study constituted 1343 medical records of which 83 medical records of patients with enterocutaneous fistulas, giving a prevalence of 6.2%, female predominance at 59% (n = 49), 42.2% (n = 35) were referred cases from the periphery for better management. A vast majority (96.4%) occurred as post-operative complications with appendectomy the most common indication (18.8%). High output fistulas were predominant (43.4%). 59% (n = 47) were managed medically, 6% (n = 5) received both conservative and surgical modalities while 35% (n = 5) were managed surgically. 64.1% (n = 50) were placed on enteral nutrition while 35.9% (n = 28) were placed on parenteral nutrition. Peritonitis/infection 50% (n = 18) was the commonest indication of surgical treatment, followed by failure of medical treatment 25% (n = 9) then hig

关键词： Enterocutaneous Fistula Prevalence Management Outcomes

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