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Surgical Science 2018年第4期9卷 148-152页

作者： Dabo Aminata Diop thierno Madane Dembélé Bakary tientigui Coulibaly Mahamadoun Doumbia Arouna Manganémoustapha Issa Abdoul Hamidou Almeimoune traoré alhassane togo Adégné téguété Ibrahima Django Djibo Mahamane Diallo Gangaly Universal Resuscitation Service at Gabriel touré teaching Hospital Bamako Mali General Surgery Service of CHU Gabriel touré Bamako Mali Department of Obstetric Gynecologyof CHU Gabriel touré Bamako Mali

Intra-uterine manual aspiration is the recommended maneuver for abortive endo-uterine evacuation. It must be performed in a medical setting for therapeutic purposes, while respecting its contraindications and asepsis rules essential for its implementation. the ignorance of anatomical structures by the authors of clandestine abortions is marked by the presence of utero-adnexal lesions, digestive lesions and vesical lesions or evisceration by the vagina. Vaginal evisceration of the small bowel is a rare and serious complication of manual intrauterine aspirations and induced abortions. their late diagnosis and clandestine practice are responsible for unpredictable severe secondary complications and remain an important cause of morbidity and mortality. the development of a policy of continuous training of agents on the technique of manual intrauterine aspiration, broad information on contraceptive methods and a multidisciplinary, rapid and adequate management of complications will provide minimum morbidity and mortality. Conclusion: Abortion is a serious source of life-threatening complications.

关键词： Evisceration Abortion Surgery Mali

Benin Goitre in the General Surgery Department at teaching Hospital Gabriel touré

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Surgical Science 2022年第1期13卷 15-22页

作者： Madiassa Konate Amadou t.aore Moussa Samake Abdoulaye Diarra Boubacar Karembé Amadou Bah Boubacar Yoro Sidibé Kadiatou Doumbia tany Koné Amadou Maiga Zakari Saye Arouna Doumbia Ibrahim Diakite Bakary t. Dembelé alhassane t.aore Lassana Kante Adegné togo General Surgery at teaching of Gabriel toure Bamako Mali

Introduction: Goitre is an increase in the volume of the thyroid gland. Goiters may be congenital or acquired, diffuse or nodular, functional or non-functional, benign or malignant. Purpose: The objectives of this work were to study and determine the frequency of benign goitre in the general surgery department of CHU Gabriel Touré, and to study epidemiological, clinical and therapeutic aspects. Patients and Method: This was a retrospective and prospective study conducted in the general surgery department of CHU Gabriel Touré, from January 1999 to December 2019. Included in the study were all patients with benign goiter confirmed in histology, hospitalized and treated in the service. Patients with thyroid malignant tumours, strumite, thyroid tract cyst, cervical abscess and neck trauma were not retained. Socio-demographic, clinical, para-clinical, therapeutic and post-operative aspects were the study parameters. Word processing and tables were done with Microsoft Word and Excel 2016 software. Data analysis was performed with Epi info7 software, the statistical test used was the Khi2 test and a value of P 0.05 was considered statistically significant. Results:tyle="font-family:Verdana;"> A total of 253 patient files were collected. thyroidectomy represented 5.02% (253/5036) of surgical pr

关键词： Benign Goitre Epidemiological Clinical and therapeutic Aspects

Post Antibiotic Grade IV Anaphylaxis: A Case Report from the Emergency Department of Chu Donka

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Open Journal of Emergency Medicine 2023年第3期11卷 110-114页

作者： Amadou Yalla Camara Abdoulaye touré Ernest Ahounou Almamy Bangoura M’mah Lamine Camara thierno Sadou Diallo alhassane Barry Boubacar Atigou Dramé Joseph Donamou Medical and Surgical Emergency Department CHU-Donka National Hospital Conakry Guinea Anesthesia and Intensive Care Unit Ignace Deen National Hospital Conakry Guinea Department of Anaesthesia and Intensive Care Donka National Hospital Conakry Guinea Department of Anaesthesia and Intensive Care HKM National University Hospital Cotonou Benin

Anaphylaxis is a serious systemic reaction that is part of the general pattern of potentially fatal hypersensitivity reactions requiring immediate management. We report the case of a patient presenting to emergency with signs of malaria and pneumonia who was diagnosed with grade 4 anaphylaxis following antibiotic injection in the emergency department. the patient was 30 years old, with no previous history of anaphylaxis, and presented to the emergency department with fever, dry cough, headache and dizziness associated with prostration. Physical examination showed stable hemodynamics (BP = 110/80 mmHg, HR = 95 p/min,) and respiratory function with SpO2 = 98%, HR = 22 c/min and crepitus rales at the base of the lungs. the laboratory work-up carried out in the emergency department revealed a biological inflammatory syndrome associated with hyperleukocytosis of 11,260/mm3, a positive thick drop with GE(+) dp = 1183 t/microlitre;blood glucose = 0.83 g/l;Covid 19 RDt = (negative). A diagnosis of malaria and pneumonia was made and antibiotic therapy (ceftriaxone) and artesunate were indicated. During the injection of ceftriaxone 1 g, the patient became agitated, followed by cardiorespiratory arrest, confirming the diagnosis of stage 4 anaphylaxis. treatment consisted of stopping the ceftriaxone injection, external cardiac massage and ventilation, intravenous adrenaline and vascular filling, which enabled the patient to recover and stabilize. the diagnosis of anaphylaxis is clinical. Early administration of adrenaline is the mainstay of treatment.

关键词： Grade 4 Anaphylaxis Adrenaline Antibiotics Emergencies

Stomach Cancer in the General Surgery Departement at the teaching Hospital Gabriel toure

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Surgical Science 2022年第4期13卷 188-197页

作者： Madiassa Konate Amadou t.aore Moussa Samake Abdoulaye Diarra Idrissa tounkara Boubacar Karembé Amadou Bah Boubacar Yoro Sidibé tany Koné Amadou Maiga Zakari Saye Sana Kouriba Arouna Doumbia Ibrahim Diakite Bakary t. Dembelé alhassane t.aore Lassana Kante Adegné togo General Surgery at teaching of Gabriel toure Bamako Mali

Introduction: Stomach cancer is a malignant tumor developed at the expense of the gastric wall. Gastric cancer is a common cancer occupying the 5th rank of cancers in the world, or 5.7% of all cancers. Purpose: to study epidemiological, diagnostic, therapeutic, and prognostic aspects of stomach cancer. Methodology: this was a retrospective and prospective study, which was carried out in the General Surgery Department at the teaching hospital Gabriel touré between January 1, 1999, and December 31, 2020, and all cases of stomach cancer were confirmed by histological examination. Result: We recorded 857 cases of stomach cancer or 40.1% of digestive cancers. the sex ratio was 1.6. the average age was 55 years ± 13 years. the main clinical signs were epigastralgia (98.6%), vomiting (93.34%), weight loss (96.03%), and anorexia (46.1%). It was adenocarcinoma (97.55%), and antropyloric location (78.64%). Patients were Stage IV (72.817%) cases. Among the 857 patients, 722 were operated on, accounting for 84.25% of the cases. Surgery was palliative in 60.66% and curative in 25.62%. Gastrectomy of 4/5 plus D2 type curage was the most performed in curative surgery. the median overall postoperative survival was 5 months. Conclusion: Stomach cancer is the most common digestive cancer in our department, the diagnosis is most often late, so palliative surgery occupies an important place.

关键词： Cancer Stomach Surgery Survival

Urinary Sphincter Disorders of Neurological Origin: Prognostic Aspects in the Neurology Department of the Ignace Deen National Hospital

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Open Journal of Urology 2023年第3期13卷 92-99页

作者： Mohamed Asmaou Bangoura Mohamed Lamine touré Mohamed traoré Aliou talibé Diallo Mamadou Oury Mané alhassane Fadiga Gouled Houssein Moussa Karinka Diawara Ibrahima Siré Diallo Cissé Fodé Abass Neurology Department CHU of Conakry Conakry Guinea

Introduction: Complications of Urinary sphincter disorders of neurological origin can be life threatening. the objective of this study was to describe the prognosis of urinary sphincter disorders during neurological conditions. Methods: this was a six-month analytical study conducted at the neurological unit of the Hôpital national Ignace Deen. Including patients with urinary sphincter disorders following a neurological condition;Chi-square, Fischer, and Student’s t-tests were used for variables with a p value less than 0.10 and then included in a logistic model with a significance level set at 0.05 and a 95% confidence interval. Results: We collected 1081 patients among whom, 324 presented, that is to say a frequency of 30%, which concerned subjects aged 57.3 ± 16.4 years with a slight female predominance 50.3%. Urinary incontinence (80.6%) was associated with complications such as urinary tract infection with a high proportion of cerebral damage (92.3%). HIV infection (P = 0.015), bedsores (P = 0.049), and inhalation pneumonia (P = 0.001) were the main poor prognostic factors. Conclusion: Urinary sphincter disorders are elements of poor prognosis, both vital and functional, concerning elderly subjects with a predominance of urinary incontinence. HIV infection, bedsores, pneumopathy are poor prognostic factors.

关键词： Urinary Sphincter Disorders Incontinence Retention Neurology

torsion of Ovarian tumor in the Elderly: About a Case

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Surgical Science 2020年第4期11卷 69-73页

作者： Amadou Bah Ibrahima Diakite Amadou Maiga Boubacar Yoro Sidibe Madiassa Konaté Zakari Saye Boureima Kelly tany Koné Siaka Konate Arouna A. Doumbia Bathio t.aore Boubacar Karembe Mohamed Lamine Diakite Amadou A. traoré Abdoulaye Diarra Moustapha Issa Mangane Abdoul Hamidou Almeimoune Bakary t. Dembélé alhassane traoré Lassana Kanté Adégné Pierre togo General Surgery Department University Hospital of Gabriel Touré Bamako Mali Anesthesia and Reanimation Department University Hospital of Gabriel Touré Bamako Mali

We report a case of torsion of an ovarian tumor in a 68-year-old woman with no medical and surgical history. the diagnosis was made in front of an intermittently painful pelvic mass. the treatment consisted of a left annexectomy;the anatomopathological examination revealed a fibro-inflammatory and hemorrhagic cyst. Postoperative results were simple with a 12-month follow-up.

关键词： tumor Ovary Cyst Surgery

Giant Hernia with Incarceration

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Surgical Science 2021年第12期12卷 399-403页

作者： Amadou Maïga Amadou Bah Ibrahim Diakité Zakari Saye Boubacar Y. Sidibé Bathio traoré Moussa Diassana Siaka Konaté Arouna A. Doumdia tani Koné Aly B. Diallo Amadou A. traoré Mamadou Diallo Bakary t. Dembélé Oumou H. Saadé Moussa Kanté Madiassa Konaté Souleymane Dembélé Moussa Samaké Moussa Konaté Lassana Kanté alhassane traoré Service de chirurgie générale h&#244pital universitaire Bamako Mali Service de chirurgie générale h&#244pital de Sikasso Sikasso Mali Centre de référence de la Commune VI Bamako Mali

Introduction: Giant hernias induce changes which reduce the quality of life of patients and make their surgical management complex. Adequate preoperative preparation of the patient guarantees good postoperative progress. It is necessary to avoid resorting to a technique of separation of the compartments during the cure. Here we report the case of a patient who benefited a successful cure using the Ramirez technique. Observation: We report the case of a 60-year-old patient admitted to an outpatient clinic for abdominal swelling evolving for 30 years without the notion of trauma gradually increasing in volume. The interrogation and physical examination led to the diagnosis of a giant white line hernia with incarceration. A preoperative assessment and a preanesthetic consultation were carried out. Intraoperatively, the cecum, transverse colon, sigmoid, jejunum and greater omentum were incarcerated in the bag. After adhesiolysis we proceeded to resect the bag and cure it using the Ramirez technique. The consequences were simple and the patient was discharged on day 4 after her dressing and was seen on day 15, 1 month, 3 months and 1 year. The patient benefited from the placement of an abdominal compression sheath for 3 months. Conclusion: tyle="font-family:Verdana;">Success in the management of prosthetic material in the absence of prosthetic material depends on good preoperative preparation and the mastery of certain surgical techniques.

关键词： Giant Hernia General Surgery CHU Gabriel touré

Abdominoperineal Resection in Rectal Cancer in General Surgery Department at Gabriel toure University Hospital

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Surgical Science 2019年第1期10卷 16-23页

作者： Amadou t.aore Abdoulaye Diarra Madiassa Konate Souleymane thiam Soumaila Keita tani Kone Boubacar Karembe Assitan Kone Boubacar Sidibe Amadou Bah Amadou Maiga Ibrahim Diakite Bakary tientigui Dembele alhassane t.aore Adegne togo Lassana Kante Moussa Samake Moustapha Issa Mangane thierno Madane Diop Mamadou Salia Diarra Adama Diakite Gangaly Diallo Gabriel toure University Hospital BamakoMali

the objectives: Were to determine the hospital frequency of abdominoperineal resection (APR);to determine mortality and morbidity rates and to assess oncologic outcomes. Method and patients: We performed a retrospective study between 2008 and 2013 in general surgery department at Gabriel toure University Hospital (UH) which included all patients admitted for rectal cancer confirmed by pathological examination, and having undergone an APR. Results: We have collected 17 cases which accounted for 65.38% of curative resections of rectal cancer. the sex-ratio was 0.89 and the averageage was 49.53 years. the average tumor distance from the anal verge was 4.59 ± 1.7 cm. All patients had adenocarcinoma of the rectum. the histopathologic grade was well in 7 cases, moderate and poor in 5 cases each. According to the pathologic tNM classification, 13 patients were classified t4, 14 patients N+. APR was associated with hysterectomy and partial colpectomy in 4 cases. the average duration of interventions was 202.06 ± 25.68 minutes. the average duration of hospitalization was 18.24 ± 04.89 days. the postoperative mortality and morbidity rates were 5.88% and 29.42%, respectively. Local recurrence was observed in 6 patients and liver metastasis in 2 patients. the overall survival rate was 37.5% at 2 years and 18.75% at 5 years. Conclusion: APR still occupies an important place in our practice. Our results could be improved by the recent introduction of neoadjuvant radio chemotherapy in Mali.

关键词： Abdominoperineal Cancer Mali Rectum Resection Surgery