Background: Non-traumatic small bowel perforation is common condition in our income countries. This study aims to determine the pattern of non-traumatic intestinal perforation in our environment.Methods: The demographics, clinical features, relevant investigations, surgery performed and outcome of all the patients confirmed at surgery with intestinal perforation were collected for five years and the data analyzed using version 3.5.1 of Epi Info.Results: Out of the 69 cases involved in this study, there were 46 (66.7%) males and 23 (33.3%) females with a male/female ratio of 2; their mean age was 22.5±13.7 years (range 2 - 68 years). Young people in school constituted 23 (33,34%) of the cases and typhoid intestinal perforation was responsible for 64 (92.8%) cases while ischemic perforation as a result of postoperative flange, strangulated hernia and acute intussusception was responsible in 5 (7.2%) cases. The average duration before presentation in the hospital was 3 days while the average duration between presentation at the hospital and surgery was 2 days. The surgery offered was simple closure after freshening the edges in 35 (50.7%) cases, resection and anastomosis in 28 (40.5%) cases and resection with ileostomy in 6 (8.8 %) cases. The immediate postoperative course was uneventful in 64 (92.8%) case while the mortality was 10 (14.5%). The cause of death was not identified in 3 cases. The average hospital stay was 14.5±12.8 days with extremes of 7 and 55 days.Conclusions: NTIP is relatively common among the causes of widespread acute peritonitis in sub-Saharan Africa and its management remains difficult with high mortality.
L'objectif de cette étude était de déterminer la fréquence et les facteurs associés à la dénutrition chez les patients opérés en chirurgie viscérale en 2014. Il s'est agi d'une étude transversale, descriptive et analytique couvrant la période du 11septembre 2014 au 11 décembre 2014. La population d'étude était constituée des patients opérés en chirurgie viscérale au Centre National Hospitalier Universitaire Hubert Koutoucou MAGA de Cotonou. La dénutrition a été définie pour un indice de masse corporelle inférieur à 18,5 kg/m2. Au total 90 patients avaient été inclus dans l'étude, 57,78 % (52 patients) étaient de sexe masculin. La moyenne d'âge des patients était 55±6,32 ans. La dénutrition était observée chez 42 patients (46,67%). Les facteurs associés à la dénutrition chez les patients en postopératoire étaient : l'âge supérieur ou égal à 50 ans, les apports énergétique, protéique et hydrique faibles, la diarrhée, la présence de cancer, la chirurgie sur le tractus digestif, la chirurgie urgente, une perte de poids significative et l'hyperleucocytose. La dénutrition est fréquente chez les patients en postopératoire. Elle nécessite un dépistage et une prise en charge précoces.
Background: Fractures of the distal humerus represent 1.3% of fractures in Cotonou. Their treatment is often surgical. The aim of this work was to assess the results of their osteosynthesis in a disadvantaged environment.Methods: This retrospective study from 2001 to 2015 included 38 operated patients for distal humerus fracture with a minimum follow-up of 12 months. The average age was 33.6 years; the predominance was male (27 cases). The major etiology was traffic accidents (31 cases), According to the AO classification, the fractures were type A (10 cases), type B (02 cases) and type C (26 cases). The average time of surgery was 21 days. The Lecestre plate was the most used (29 cases). An iliac cortico-cancellous graft was used in 03 cases. The mean hospital stay was 20 days.Results: The mean follow-up was 37 months. Functionally, the mean Mayo elbow performance score (MEPS) score was 66.3 points. The results were excellent (08 cases), good (13 cases), average (10 cases) and bad (7 cases). The patients were satisfied or very satisfied in 29 cases. Radiographically, the reduction was anatomical in 34 cases. Anatomical reductions were obtained with Lecestre plates. Consolidation was achieved in 36 cases within an average of 9 weeks. As complications we noted: radial nerve paresis (03 cases); secondary displacement (02 cases); superficial infection of the operating site (02 cases), wire migration or screw retraction (05 cases), non-union (03 cases), malunion in varus (04 cases) and osteitis of the proximal ulna (01 case).Conclusions: Fractures of the distal humerus are infrequent. The anatomical and functional results despite little technical support provided and the long delay before surgery are quite good.
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