Introduction: Goiter is the most common endocrine disease in the world. The objective of our study is to assess and compare the morbidity linked to the surgical management of goiters and thyroid tumors in the general surgery department of the Niamey National Hospital. Result: We collected data on a prospective basis on 112 cases having undergone a thyroidectomy between March 2019 and April 2020. The female sex is predominant with 96.4%, i.e. a sex ratio of 0.037. The average age is 41.2 years with extremes ranging from 22 to 72 years old. The average duration of evolution of goiter is 7.5 years with extremes ranging from 5 months to 20 years old. The first reason for consultation is anterior cervical swelling. TSH testing confirmed euthyroidism in 107 patients (95.5%). Therapeutically, loboisthmectomy is the most performed procedure with 43.7%. The postoperative hormonal assessment revealed 32% hypothyroidism at 6 months, with a significant difference for cases of total thyroidectomy. The occurrence of postoperative hypocalcemia was significantly greater after total and subtotal thyroidectomy. There is no significant difference in terms of recurrent complications. Conclusion: Thyroidectomies must be performed after adequate preparation and information to the patient on possible postoperative complications, hence the need for close medical monitoring immediately and remotely.

Bakground: Anal and perianal sepsis is common anorectal disorders found in surgical practice. This study aims to report epidemiological aspects and outcomes of management of anal and perianal suppuration. Methods: This was a retrospective study from January 2011 to June 2016 at Niamey National Hospital. Patients operated on for anal and perianal suppuration of non-specific anorectal origin were included. Results: During the study period, we collected 141 cases of anal and perianal suppurations. The average age of our patients was 42±8.8 years. The sex ratio was 3.27 in favor of men. The origin of the patients was urban in 73.8% of the cases. The history of diabetes mellitus was found in 14.2% (n=20). Anal fistulas and anal abscesses (n=115) were simple in 46% (n=53) and complex in 54% (n=62). A fistulectomy with the placement of an elastic seton was performed for 41.13% of cases (n=58) and fistulotomy in 29.78%. The evolution of 6 months was marked by a recurrence in 10.63% (n = 15), the anal incontinence of gas at 9.21% (n=13). Deaths (n=4) were recorded in patients with Fournier's gangrene. Uncomplicated therapeutic success was 80.13% (n=113). Conclusion: The surgical treatment of anal fistula (the main cause of anal and perianal suppuration) aims to eradicate the suppuration and to preserve the anal continence. The fistulotomy done in the context of the management of a simple fistula gives a better outcome. Incontinence-related complications and relapses must impose thoroughness and patience in the surgical treatment of complex fistulas.

Introduction: Acute intussusception is a rare clinical entity in adults where it accounts for only 1-2% of intestinal obstructions. The authors wanted to report cases of acute intussusception in adult patients, their diagnostic aspects, their management, and their etiologies. Patients and European Scientific Journal November 2017 edition Vol.13, No.33 ISSN: 1857 -7881 (Print) e -ISSN 1857 266 Methods: This study is a retrospective study of the medical files of patients of both sexes. They include adults over 15 years of age, operated between January 2010 and December 2014, who were diagnosed with obstruction due to acute intestinal intussusception. Results: Six cases of adult intestinal intussusception were collected. The average age was 26.5 years. The sex ratio was 1 and there were so many men as women. Five out of six patients were unstable on admission. The diagnosis was made preoperative in two cases out of six, 33.3%. Ultrasound revealed a target sign in two cases. The ileo-ileal form was the most frequent (5 cases out of 6) or 83.3%. Also, there were two cases of intestinal necrosis out of six. Intestinal resection was performed in five cases or 83.33%. The cause of intussusception was found in four cases out of six or 66.7%. Here, a tumor was the cause in half of the cases. Immediate surgical follow-up was uncomplicated in all patients. Conclusion: Acute intestinal intussusception of the adult is a very rare condition. The preoperative diagnosis of acute intussusception of the adult remains delicate. The ileo-ileal form is more frequent than the ileo-colic form in adults. Treatment is always surgical in adults. Keywords: Acute intestinal intussusception, obstruction, adult, Niamey, Niger RésuméObjectifs: L'invagination intestinale aiguë est une entité clinique rare chez l'adulte où elle ne représente que 1 à 2% des occlusions intestinales. Les auteurs ont voulu rapporter les cas d'invagination intestinale aigüe de l'adulte, leurs aspects diagnostiques, leurs prises en charge et leurs étiologies. Patients et méthodes : Il s'agissait d'une étude rétrospective portant sur les dossiers de patients des deux sexes, adultes âgés de plus de 15 ans, opérés entre janvier 2010 et décembre 2014 dont le diagnostic d'occlusion sur invagination intestinale aigüe a été posé. Résultats : Six cas d'invagination intestinale aiguë de l'adulte avaient été colligés. L'âge moyen était de 26,5 ans. Le sexe ratio était de 1, il y'avait autant d'hommes que de femmes. Cinq patients sur 6 avaient été reçus eu urgence. Le diagnostic était posé en préopératoire dans deux cas sur six soit 33,33%. L'échographie avait montré une image en «cible » dans deux cas. La forme iléo-iléale a été la plus fréquente (5 cas sur 6) soit 83,34%. Il y avait deux cas de nécrose intestinale sur six. La résection intestinale avait été effectuée dans cinq cas, soit 83,34%. La cause d'invagination avait été retrouvée dans quatre cas sur six, soit 66,67%, dont une cause tumorale dans la moitié des cas. Les suites opératoires immédiates ont été simpl...

Purpose: To evaluate the results of thyroidectomy in the Oto-RhinoLaryngology and Neck Surgery office of the National Hospital of Niamey in Niger. Materials and methods: we analyzed the epidemiological aspects, the indications, the technics and the evolution of thyroidectomy through a retrospective and descriptive study conducted from January 2010 to December 2015. Results: Thyroidectomy represents 8, 51% (n = 236/2773) of the ENT operative activities and an average of 47.2 cases per year for 5 years. Among the patients, there were 15 men and 221 women, a sex ratio of 0.17. The mean age was 37.25 years (extreme 22 and 61 years). The operative indications are dominated by multinodular goiter euthyroid (43.22%), thyroid nodules (39.40%), hyperthyroidism (goiter and Basedow) and substernal goiters, respectively, representing 8.90% and 6.35%. The gestures performed were subtotal thyroidectomy in 56 cases (23.73%), complete thyroidectomy in 85 cases (36.02%) and lobo-isthmectomy in 95 cases (40.25%). The recurrent nerve was searched in 235 cases (99%) and found in 215 cases (91, 10%). It was found 1 case (0.42%) of splitting of the left nerve recurrent. 2 cases (0.84%) of immediate postoperative hemorrhage was recorded. Morbidity was 0.29% with 4 cases of definitive unilateral recurrent paralysis and 3 cases of transient hypoparathyroidism. No mortality was encountered. Conclusion: The thyroidectomy is a frequent intervention in the ENT and Neck Surgery office of the National Hospital of Niamey. Multinodular goiter remains the first surgical indication. Recurrent and hypoparathyroid morbidity was very low.

Introduction: Arterial aneurysms affect 7 to 8% of people over 65 in the West and are the 2nd leading cause of death in these countries. In Africa this frequency is poorly evaluated. The objective of this work is to report the management of arterial aneurysms at the National Hospital of Niamey (HNN). Patients and methods: This was a retrospective, descriptive study over a period of eight (8) years from January 2009 to December 2016, performed in the surgical departments of the National Hospital of Niamey. Included in the study were patients of both sexes, hospitalized and / or operated for arterial aneurysm. Not included were patients treated for arterial aneurysm with incomplete records or those concerning the neurosurgical sphere. Results: During the study period, 17,748 patients were hospitalized in the general surgery departments, including 16 patients for arterial aneurysm, or 0.09% of surgical pathologies. There were 13 men (81.25%) and 3 women (18.75%), or a sex ratio of 4.33. The average age was 55.75 years with extremes ranging from 25 years old to 90 years old. The circumstances of discovery of the aneurysms were swelling of the antero-internal aspect of the thigh in 7 cases (43.75%), abdominal mass 6 cases (37.50%), then 2 cases (12.50%) of chest pain and incidental discovery in 1cas (6.25%). The most common risk factor was high blood pressure with 43.75% (7 cases). The aneurysm sat on the femoral artery in 43.75% (n = 7), of which 6 on the deep femoral and 1 on the superficial femoral, on the infrarenal aorta in 31.25% (n = 5), on thoracic aorta 12.50% (n = 2), on the iliac artery 12.50% (n = 2). For the diagnosis the angioscanner is realized in all the patients and in addition Doppler ultrasound in 43, 75% of cases. Twelve (12) patients benefited from curative surgical intervention by prosthetic graft by PTFE in 58.33% of cases and by Dacron in 41.66%. The average stay was 29.75 days and the immediate operative followup was complicated by thrombosis in 12.5% and parietal suppurations in 6.25%. We recorded two (2) deaths, ie 12.5% among non-operated patients. Conclusion: Arterial aneurysms are rare diseases at the HNN. Conventional surgery is the treatment performed in our patients. The postoperative course was simple in most cases.