We report the case of a 33-year-old man having presented the episodes of abdominal pains since a few months in 2014. He was handled by the analgesic and the anti spasmodic by his regular doctor. Symptoms in started up again with renewed vigor in February, 2015. The physical examination was normal. The complementary examinations must be known by the ultrasound the scanner and the magnetic resonance imaging which were in favour of a mass under person suffering from a liver complaint the normal blood balance assessment. The patient was exclusively operated by the way of coelioscopy and the anatomopathology examination of the operating room ended has a duplication duodenal. The operating consequences were simple until one year.
Summary: Polytrauma is the leading cause of death in the under-40 population. They are accompanied by major morbidity with severe sequelae. The polytraumatized is defined as a serious trauma with several bodily injuries, at least one of which is life-threatening in the very short term. The initial hospital care must not barely delay and directly affect the prognosis. In developing countries, the absence of pre-hospital medicine means that mortality is still very high, which leads us to initiate this work, which aims to study the epidemiological and clinical aspects of polytrauma in emergency and in resuscitation of Gabriel Toure University Hospital. Material and Methods: This was a retrospective study that took place over a period of ten (10) months from February to November 2016. We included all patients received for polytrauma emergency hosting service. The data were collected using a surveycard. Results: During our study period, we collected a total of 200 polytraumatized cases out of a total of 16,141 patients admitted to the emergency hosting service, a prevalence of 1.3%. The age group of 20 -29 years was the most represented with average age of 32.39 years. The male sex was predominant with 65% with a sex ratio of 1.9. The students were the most represented with 24%. The trauma occurred at 22.5% between 8:00 and 12:00 am, the public road was the main place of the trauma with 57.5% of the cases. Two-wheeled vehicles were involved in the accident in 68.9% of cases. The delay between trauma and admission was minus 6 hours in 70.5% of cases, 15.5% had a Glasgow lessthan 8% and 44.5% PAS < 90 mmHg. The polytrauma associated with a cranial + limb and cranial + abdominal were the 158 Surgical Science most represented with respectively 37.5% and 25%. The damage control suegery was performed in 79% of patients. The mortality was 31% and hemorrhagic shock was the most common etiology of these deaths with 51.6%. Conclusion: The polytrauma is clinical situation putting the patients vital prognosis at stake. The haemorrhage is the origin of the student mortality. The installation of rigorous diagnostic system and a pre-hospital medicine will reduce the morbi-mortality.
Objectives: To determine hospital frequency and to write the diagnostic and therapeutic aspects of appendicular abscess in adults in the General Surgery Department of teaching Hospital Gabriel Touré from 2005 to 2017. Material and Methods: This was a retrospective study conducted from January 1, 2005 to December 31, 2017 in the General Surgery Department of Gabriel Touré University Hospital in all patients with appendicular abscess. Results: In 13 years, 1420 cases of acute appendicitis have been reported, including 105 cases of appendicular abscess (7.4%). Mean age of the patients was 32 years with extremes of 16 years and 70 years. Abdominal pain and fever were present in all patients. Pain sat in the right iliac fossa in 73.3% and was epigastric in 11.4%. In almost all cases abdominal defense was present (97.1%). There was generalized abdominal contracture in 2.8% of cases. Average duration of evolution was 27 days with extremes of 1 day and 60 days. Ultrasonography was performed in 42.6% of cases and found peri-appendicular effusion in 29 cases (27.6%). 90 incisions were made by incision of Mac Burney, 8 by median umbilical, 7 by midline above and below umbilical. The amount of fluid aspirated was greater than 100 cc in 47 patients. We performed an appendectomy with appendicular stump burying followed by washing plus drainage of the abdominal cavity in 65 patients. Morbidity rate was 14.3%. No deaths were recorded. Average duration of hospitalization was 6.5 days with extremes of 2 days and 26 days.
Lower gastrointestinal bleeding (LGIB) is defined as bleeding from a source distal to the Ligament of Treitz. The primary step is to identify severe hemorrhages that may be life-threatening for patients (10% of cases of LGIB). The management depends on the severity of the bleeding, the diagnostic and therapeutic means of the patient's reception center. Patient with acute LGIB, in case of negativity of endoscopic and radiological examinations, can be a surgical indication with possibility of intraoperative colonoscopy. We report a case of urgent surgical management with intraoperative colonoscopy in a patient with severe acute LGIB.
The objectives were to determine the frequency of pain in cancer patients and its intensity in cancer pathologies and to evaluate the evolution of pain intensity after analgesic treatment; the effectiveness of its management study involved 121 cases of operated gastrointestinal cancers, which accounted for 85.82% (141) of operated cancers and 16.78% (721) of all operated patients; the average age of our patients was 49.93 years with extremes 17 and 78 years. Standard deviation: 15.75; with a sex ratio of 1.46. The majority of our patients had WHO III (54/121) or 44.6%; 46.3% (56/121) of patients were in stage IV of the TNM classification. The main digestive cancers were cancer of the esophagus 4 cases (3.3%); of the stomach 61 cases (50.4%); of the pancreas 7 cases (5.8%); of the liver 4 cases (3.3%); gall bladder 2 cases (1.6%); colon 33 cases (27.3%); rectum 6 cases (4.9%) and hail 4 cases (3.3%). The average pain intensities were 3 to 6 hour; 2 to 24 hour; 1.6 to 48 hour; and 1.2 to 72 hour. The majority of our patients had a treatment protocol involving nefopam, and paracetamol was 58%. The pain was exacerbated especially during exercise. Vomiting and vein burning were the main side effects encountered.
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