Ce travail a pour objectif d’evaluer les resultats de l’embrochage centromedullaire elastique sta... more Ce travail a pour objectif d’evaluer les resultats de l’embrochage centromedullaire elastique stable (ECMES) dans les fractures diaphysaires du femur chez l’enfant. Il s’agissait d’une etude prospective qui s’est deroulee de Janvier 2013 a Decembre 2013 dans le service de Chirurgie Pediatrique du CHU Gabriel TOURE portant sur tous les enfants âges de 7 a 15ans et presentant une fracture diaphysaire du femur et dont le delai de consultation n’excedait pas 21 jours. En guise de resultat, nous avons opere 15 cas de fracture diaphysaire du femur soit 5% des fractures operees (300 cas). L’effectif etait compose de 8 filles contre 7 garcons soit un sexe ratio de 0,88. L’âge moyen de nos patients etait de 10,1 ans avec des extremes de 7 et 14 ans. L’etiologie la plus frequente etait les accidents de la voie publique (73,3%). Le choc etait direct dans 86,6%. Le femur droit etait atteint dans 53%. Le delai moyen de consultation etait de 6 heures. Le trait de fracture etait transverse dans 80% et oblique dans 20%. Le siege le plus frequent etait le 1/3 moyen de la diaphyse femorale. Le delai moyen de prise en charge etait de 3 jours. Nous avons procede a un embrochage centromedullaire elastique stable ascendant dans 86,6%. Les resultats ont ete evalues avec un recul moyen de 5 mois, ils etaient excellents dans 93,3% et un seul cas de raideur en extension de 10 degres. En conclusion, l’ECMES est une technique particulierement adaptee au traitement chirurgical des fractures diaphysaires du femur de l’enfant d’âge scolaire. Bien pratique, il donne de bons resultats. Le traitement orthopedique doit rester de regle mais ceci n’est plus aussi formel qu’avant. Mots cles: fracture, diaphyse femorale, grand enfant, ECMES English Abstract The objective of this work is to evaluate the results of stable elastic centro medullary insertion (ECMES) in diaphyseal femoral fractures in children. This was a prospective study that took place from January 2013 to December 2013 in the Department of Pediatric Surgery of CHU Gabriel TOURE, covering all children aged 7 to 15 years and presenting a diaphyseal fracture of the femur and whose consultation period did not exceed 21 days. We performed 15 cases of diaphyseal fracture of the femur or 5% of the fractures performed (300 cases). The number was 8 girls versus 7 boys, a sex ratio of 0.88. The average age of our patients was 10.1 years with extremes of 7 and 14 years. The most frequent etiology was road traffic accidents (73.3%). The shock was direct in 86.6%. The right femur was reached in 53%. The average time to consult was 6 hours. The fracture line was transverse in 80% and oblique in 20%. The most frequent seat was the middle 1/3 of the femoral diaphysis. The average waiting time was 3 days. We performed a stable elastic centro medullary insertion in 86.6%. The results were evaluated with an average follow-up of 5 months, excellent in 93.3% and a single case of stiffness in extension of 10 degrees. To conclude, stable elastic centro medullary insertion is a technique particularly adapted to the surgical treatment of diaphyseal fractures of the femur of the school-aged child. Well done, it gives good results. Orthopedic treatment must remain the rule, but this is no longer as formal as before. Keywords: fracture, femoral diaphysis, large child, ECMES
1024x768 RESUME : But. Etudier les peritonites aigues en milieu rural au Burkina Faso. Materiel e... more 1024x768 RESUME : But. Etudier les peritonites aigues en milieu rural au Burkina Faso. Materiel et methode : Etude transversale descriptive sur trois ans allant du 1 er janvier 2007 au 31 decembre 2009 des patients operes pour peritonite aigues generalisee dont le diagnostic a ete confirme en per operatoire au centre hospitalier regional de Dedougou. Resultats : En trois ans, 221 cas peritonites aigues generalisees ont ete operees. Ces peritonites ont represente 31,2% des urgences abdominales. L’âge moyen de nos patients etait de 24,34 ans avec des extremes de 1 an et de 79 ans. L’etiologie typhique venait en tete avec 42,5% suivie de l’etiologie appendiculaire 33% et la perforation d’ulcere gastroduodenale avec 6,8%. Les peritonites primitives representaient seulement 3,2%. On a note 40,2% de complications dont la suppuration parietale constituait 56,2%. La mortalite globale etait de 19%. Mots cles: Peritonite, chirurgie , etiologie, zone rurale, Burkina Faso Normal 0 21 false false false FR X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tableau Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}
Surgical site infections are frequent and responsible for significant morbidity in patients who u... more Surgical site infections are frequent and responsible for significant morbidity in patients who undergo digestive surgery. However, very little is known about the aspects of surgical site infections in sub-Saharan Africa. The purpose of this study was to assess the prevalence and identify risk factors of surgical site infections in patients who were treated in the Digestive Surgery Department of Tenkodogo Regional Hospital in Burkina Faso. From 1 January to 31 December 2016 we performed a descriptive study in the Department of Digestive Surgery of Tenkodogo Regional Hospital in Burkina Faso. All patients who underwent digestive tract surgery during this period were followed. Those patients whose post-operative surgical sites were complicated by infection were included in this study. Surgical site infection was diagnosed according to the CDC definition. Bacteriological sampling was performed in all included patients. In all, 964 patients underwent surgery during the study period. One...
Objectif : Decrire les complications du DM dans le service de chirurgie generale du Centre Hospit... more Objectif : Decrire les complications du DM dans le service de chirurgie generale du Centre Hospitalier Universitaire Yalgado Ouedraogo. Patients et Methode: Il s’est agi d’une etude transversale descriptive sur 10 ans Resultats : Durant la periode d’etude, 11 cas ont ete colliges. L’incidence annuelle etait de 1,1 cas. Nous avons note une predominance masculine. L’âge moyen des patients etait de 29,82 ans. Le diagnostic preoperatoire etait dans huit cas une occlusion intestinale aigue, une appendicite aigue dans deux cas, une peritonite aigue generalisee dans un cas. Nous avons diagnostique en peroperatoire une occlusion intestinale dans 10 cas et un cas de perforation du DM. Tous les DM ont ete reseques. Tous nos patients avaient un DM situe a moins d’un metre de la jonction ileo-caecale. L’histologie realisee dans deux cas a conclu a une diverticulite. Les suites operatoires etaient simples dans neuf cas, compliquees dans deux cas. Un deces postoperatoire a ete enregistre. Conclus...
Background: Surgical site infections (SSIs) are responsible for substantial morbidity in patients... more Background: Surgical site infections (SSIs) are responsible for substantial morbidity in patients who undergo digestive surgery. However, very little is known about the aspects of SSIs in sub-Saharan Africa. Methods: The purpose of this study was to assess the prevalence and identify the risk factors of SSI in patients who were treated in the Department of Digestive Surgery of Tenkodogo Hospital in Burkina Faso. We performed a prospective study from January 1, 2016 to December 31, 2016. All patients who underwent digestive tract surgery during this period were included and followed. Patients whose post-operative surgical sites were complicated by infection were identified. Surgical site infection was diagnosed according to the U.S. Centers for Disease Control and Prevention (CDC) definition. Bacteriologic sampling was performed in all included patients. Results: A total 964 patients underwent surgery during the study period and were included in the study. Seven hundred thirty-seven were females (76.4%), and 227 were males. The mean age of the included patients was 47.5 years (standard deviation [SD] = 9 years). One hundred fourteen patients presented with SSI, the incidence of which was 11.8%. The incidence of SSI was substantially higher in females than in males (63.2 vs. 36.8%, p < 0.05). The incidence was also higher in patients living below the poverty line (71.1 vs. 28.9%, p < 0.05). Clinically, the incidence of SSI was higher in emergency surgery than in scheduled surgery (84.2 vs. 15.8%, p < 0.05). Contaminated or dirty surgery was more risky than clean surgery (p < 0.05). With respect to bacteria, the most commonly isolated microbes were Escherichia coli (66.7%) and Staphylococcus aureus (15%). Treatment mainly consisted of appropriate antibiotic therapy and local care. Three deaths were recorded for a mortality rate of 2.6%. Conclusions: Surgical site infections are frequent in sub-Saharan environments. The risk factors seem to be clinical and social.
Mots clés Cancer colorectal Adénocarcinome Traitement chirurgical Burkina Faso Résumé Le cancer c... more Mots clés Cancer colorectal Adénocarcinome Traitement chirurgical Burkina Faso Résumé Le cancer colorectal est le plus fréquent des cancers digestifs. Le but de ce travail était d'étudier la fréquence, les facteurs de risque, les modalités thérapeutiques et évolutives du cancer colorectal de l'adulte jeune au Burkina Faso. C'est une étude transversale descriptive sur dix ans menée dans deux hôpitaux régionaux du Burkina Faso. Elle a inclus tous les patients de 20 à 45 ans admis dans ces deux hôpitaux durant la période d'étude pour cancer colique ou rectal. Au total, 116 patients ont été inclus soit 39,2 % de l'ensemble des patients admis pour cancer colorectal durant la même période. La moyenne d'âge des patients inclus était de 35,4 ans. Il y avait 70 patients de sexe masculin (60,3 %). Sept patients présentaient un antécédent de maladie inflammatoire chronique de l'intestin et six autres présentaient un antécédent familial de cancer colique. Le délai moyen de consultation était de 6,2 mois. Dans 25 cas (19,9 %), le cancer a été découvert dans un contexte d'urgence abdominale. Quatre-vingt-douze patients (79,3 %) étaient diagnostiqués aux stades 3 ou 4. Le type histologique le plus fréquent était l'adénocarcinome avec 103 cas (88,9 %). Sur le plan thérapeutique, la chirurgie a été employée chez 87 patients (75 %) et la chimiothérapie chez 37 patients (31,9 %). Seize patients ont bénéficié d'une radiothérapie. La mortalité opératoire était de 4,6 %. La survie à cinq ans était de 17 %.En conclusion, le cancer colorectal de l'adulte jeune semble plus fréquent en milieu sub-saharien. La mortalité reste élevée du fait de l'arsenal thérapeutique limité.
Male breast cancer is a rare and less known disease. Therapeutic modalities affect survival. In B... more Male breast cancer is a rare and less known disease. Therapeutic modalities affect survival. In Burkina Faso, male breast cancers are diagnosed in everyday practice, but the prognosis at short-, middle-, and long-term remains unknown. The objective of this study is to study the diagnosis stages, therapeutic modalities, and 5-year survival in male breast cancer at the General Surgery Unit of Yalgado Ouedraogo University Hospital from 1990 to 2009. A cohort longitudinal study concerning cases of breast cancer diagnosed in man. Survival was assessed using the Kaplan-Meier method and survival curves were compared through the LogRank test. Fifty-one cases of male breast cancer were followed-up, i.e., 2.6% of all breast cancers. Stages III and IV represented 88% of cases. Eleven patients (21.6%) were at metastatic stage. Patients were operated in 60.8% of cases. The surgery included axillary dissection in 25 (80.6%) out of 31 cases. Lumpectomy was performed on 6.5% of patients (2 cases). ...
Introduction: Thoracic wounds by firearms are frequent and severe. They may involve the patient's... more Introduction: Thoracic wounds by firearms are frequent and severe. They may involve the patient's prognosis. Objective: To study the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of the thoracic wounds by firearms. Material and method: This was a cross-sectional, descriptive study of all patients over the age of 15 who consulted in the university hospital-YO in the department of general and digestive surgery over a period of 5 years. Results: We collected 50 cases of thoracic wounds by firearms on 183 thoracic wounds with a prevalence of 27.3%. There were 48 men (96%). The average age was 30 years. The patients came from urban areas in 66% of cases; the informal sector accounted for 44% of the cases. The pistol was the most involved firearm (46.9%). The consultation period was less than 6 hours in 78% of patients. An unstable hemodynamic state was found in 42% (n = 21). A fluid and mixed pleural effusion syndrome was found in 46% and 26% of patients, respectively. Associated lesions were diaphragm involvement, and lesions of intra-abdominal hollow organs. Thoracic drainage was performed in 24 patients (48%) and was associated with a laparotomy in 8 patients. The average hospital stay was 7.5 days. Mortality was 14%. Conclusion: the thoracic wounds by firearms are frequent in civilian practice. The thoracic CT allows mapping of the lesions and thoracic drainage constitutes the essential part of surgical treatment. The fight against the proliferation of weapons deserves to be promoted.
Objective: The objective is to study the knowledge that albinos have on skin cancers, and their a... more Objective: The objective is to study the knowledge that albinos have on skin cancers, and their attitudes in terms of primary prevention and the screening practices for skin cancers in Burkina Faso. Methods: This is a cross-sectional and descriptive KAP study conducted from May 18 th to July 7 th 2015. It involved albinos aged at least 12 years. Their general knowledge, prevention attitudes and screening practices were considered. Results: All the responding albinos had already heard about skin cancers. Their main source of information was health workers (65.6%). They were showing at least two risk factors (99.2%) but only 68.3% affirmed having already undergone screening for skin cancer. Ignorance of the existence of screening was the main obstacle to it (16/26). The prevention means used was sun avoidance, the use of cream and protection clothing respectively in 84%, 41.5% and 51.2%. The skin lesions found were hyperpigmented macules (77.8%) then actinic keratosis (40.7%) and finally cheilitis (35.8%). We detected 4 cases of skin cancers confirmed by biopsy. Conclusion: Risk factors are frequent. Participation to screening is still insignificant. A lot is still to be done to extend the protection means. A good awareness-raising campaign and the accessibility to protection means remain for all, the best defense in the fight against skin cancers in albinos.
Introduction: Testicular seminoma is a highly lymphophilic germ cell tumor. It is the most common... more Introduction: Testicular seminoma is a highly lymphophilic germ cell tumor. It is the most common germ cell tumor in young adults. We are reporting one case of testicular seminoma complicated with an acute generalized peritonitis (AGP), in order to describe the circumstances of diagnosis and discuss about treatment. Observation: It involved a 39-year-old patient, admitted for vague abdominal pains that were evolving since 72 hours with a history of right orchiectomy because of testicular seminoma in 2011. The analysis revealed a peritoneal syndrome, a right inguinal lymphadenopathy of 10 cm diameter and an empty right scrotum. The exploration revealed fistulized necrotic retro-peritoneal lymphadenopathies in the peritoneal cavity and ileal perforation on contact with these lymphadenopathies. Necrosectomy and ileal resections were performed. After the operation, the scanner revealed a conglomeration of retro-peritoneal adenomegalies extending to the right femoral region associated with bilateral pleurisy. The β-HCG and the LDH were 8000 IU/L and 24,500 IU/L, respectively. The seminoma was ranked T3N3M1. The immediate post-operative care was uneventful. The patient was lost from sight for a month and was readmitted in a context of alteration of his general condition. He died before the end of the pre-chemotherapeutic assessment. Conclusion: Scrotal mass is the usual way of revelation of testicular seminoma. In poorly followed-up cases, exceptional complications such as peritonitis may occur and are direct consequences of poor prognosis.
Introduction: Transanal evisceration of small bowel is an extremely rare condition that can occur... more Introduction: Transanal evisceration of small bowel is an extremely rare condition that can occur spontaneously or after trauma. Objective: To report a case of Transanal evisceration of small bowel to describe the circumstances of occurrence and our therapeutic attitude. Observation: An 80year-old female patient was received at the visceral Emergency of University Hospital Yalgado Ouédraogo for the outcome of the small intestine by the anus with the waning of a defecation effort. The physical examination of the patient accustomed to evacuation purgation noted, eviscerated the small bowel through the anus, edematous but viable. The preoperative laboratory tests were normal. In emergency, under general anesthesia, a laparotomy was possible to objectify the incarceration of intestinal loops through linear perforation of 5 cenimeter from the anterior surface of the rectosigmoid hinge. We conducted an ileo-ileal resection anastomosis, a suture rectosigmoid breach and anal extraction of small bowel incarcerated measuring 200 centimeter. The evolution was simple. Conclusion: The weakening of the rectal mucosa by repeated purges has certainly been the contributory factor. The surgical treatment must be precocious to avoid extensive intestinal resection.
Background: Vulvar cancer is a rare gynaecological cancer. In Burkina Faso, the diagnosis of vulv... more Background: Vulvar cancer is a rare gynaecological cancer. In Burkina Faso, the diagnosis of vulvar cancers is delayed and the prognosis is poor. However, no specific study on vulvar cancers has been conducted at the moment. This work aimed to study the characteristics of these cancers. Methods: This is a prospective study on histologically confirmed primary cancers of the vulva diagnosed between 1st January 2013 and 30th June 2015. The demographic and clinical aspects were studied at the Yalgado Ouedraogo University Hospital of Ouagadougou (CHU-YO). Results: We noticed 21 cases of vulvar cancers within 30 months, ranking it as the 4th most common gynaecological cancer. The average age of the patients was 55 years (standard deviation +/− 6.3) and the median age was 57 years. Scars resulting from female circumcision, menopause (n = 20) and HIV infection were noticed in 19 cases and 6 cases respectively. The average time from first symptoms to first consultation was 29 months. Pain and ulceration were the main reasons for consultation. The clinical picture was chiefly an ulcero-granulating tumour. There was squamous cell carcinoma in 20 cases and basal carcinoma in 1 case. Fifteen patients were at stage III or IV, where of three patients had metastatic disease. We noticed vitiligo in 9 vulvar cancer cases. Conclusion: The cancer of the vulva is rare. Women are of menopausal age, are mostly circumcised and HIV-infection is common. A majority of patients sought consultation at advanced stage of disease, and diagnosis was belatedly made. Pain and ulceration were the main reasons for consultation. The sensitization of the population, education for self-examination would allow earlier diagnosis.
Les garrots de prélèvement, un drame chez le nourrisson: à propos de 3 cas Tourniquets, a drama i... more Les garrots de prélèvement, un drame chez le nourrisson: à propos de 3 cas Tourniquets, a drama in the infant: about 3 cases
Le diverticule de Meckel (DM) est la persistance partielle du canal omphalomésentérique. Ses comp... more Le diverticule de Meckel (DM) est la persistance partielle du canal omphalomésentérique. Ses complications sont rares. Le diagnostic est le plus souvent per opératoire. L'objectif a été de décrire les complications du diverticule de Meckel chez l'adulte dans le service de chirurgie générale et digestive du CHU Yalgado Ouédraogo. Il s'est agi d'une étude transversale descriptive sur 10 ans (janvier 2004-décembre 2013) portant sur les dossiers des patients âgés de plus de 15 ans ayant présenté un DM compliqué. Durant la période d'étude, 11 cas ont été colligés. L'incidence annuelle a été de 11 cas. Nous avons noté une prédominance masculine avec un sex-ratio de 4,5. L'âge moyen des patients était de 29,8 ans. Le diagnostic préopératoire a été dans huit cas une occlusion intestinale aiguë, une appendicite aiguë dans deux cas, une péritonite aiguë généralisée dans un cas. Il a été diagnostiqué en peropératoire une occlusion intestinale dans neuf cas; une diverticulite dans un cas et un cas de perforation du DM. Tous les DM avaient été réséqués dont huit résections segmentaires iléales emportant le DM et trois résections cunéiformes. Tous les DM étaient situés à moins d'un mètre de la jonction iléo-caecale. L'histologie réalisée dans deux cas avait conclu à une diverticulite. Les suites opératoires ont été simples dans neuf cas, compliquées dans deux cas dont une éventration et un décès. Les complications du diverticule de Meckel sont rares. Le diagnostic préopératoire est difficile. Le traitement est essentiellement chirurgical.
Objective: Describe the epidemiological characteristics of GI cancers in elderly patients in the ... more Objective: Describe the epidemiological characteristics of GI cancers in elderly patients in the GI Surgery Unit of the Yalgado Ouedraogo University Hospital ‘(CHU -YO)’. Materials and methods: We conducted between January 1st 2006 and December 31st 2013, a cross-sectional study on the epidemiological characteristics of primary GI cancers in elderly patients. The average age of the Burkinabe population is 21.8 years and those under 15 years represent 47% of the population. Considering life expectancy in our country (54 years) and physiological age, all the patients having a chronological age equal or above 60 years were included. Results: Within 7 years, 276 cases of primary GI cancers were diagnosed in elderly patients. This represented 45.9% of all GI cancers. Sex ratio male/female was 3. The average age of patients was 63 years. The over 80 years were only 4% of the cases in our series. Comorbidities were noted in 24% of the cases. High blood pressure was the most common comorbid...
Le mélanome est une tumeur maligne développée aux dépens des mélanocytes. Ses caractéristiques ép... more Le mélanome est une tumeur maligne développée aux dépens des mélanocytes. Ses caractéristiques épidémiologiques restent peu étudiées dans les populations africaines. D'où le but de cette étude. Il s'est agit d'une étude rétrospective descriptive de janvier 2009 à décembre 2012 et prospective en 2013. Pour la partie rétrospective, nous avons inclus tous les patients atteints de mélanome confirmé par l'examen histopathologique et ayant un dossier clinique exploitable. Pour la partie prospective, nous avons inclus tous les cas de mélanomes recensés en 2013. Les variables étudiées étaient les caractéristiques sociodémographiques, anatomocliniques et thérapeutiques. Au total 19 patients étaient inclus, avec un âge médian de 53,42 ans et 10 patients de sexe féminin. La durée moyenne d'évolution de la maladie était de 3,7 ans. Les lésions étaient surtout ulcero-bourgeonnantes (13), hyperpigmentées (15), et siégeaient sur les plantes (14). Le type et acro-lentigineux était le plus fréquent (13). L'indice de Clarck a été mesuré dans 3 cas, l'indice de Breslow dans aucun cas. Les métastases étaient présentes chez 10 patients. Le traitement était surtout chirurgical. Les 11 patients inclus de manière retrospective étaient ont été perdus de vue. Un décès était noté parmi les 8 patients inclus de manière prospective. Le retard à la consultation semblait être le principal facteur de mauvais pronostic dans notre contexte. Une sensibilisation de la population et du personnel de santé sur les signes précoces de la maladie, permettrait probablement de réduire la morbidité.
Background: Typhoid fever is endemic in sub-Saharan Africa. Inadequate management often leads to ... more Background: Typhoid fever is endemic in sub-Saharan Africa. Inadequate management often leads to complications, which are mainly surgical. Surgical complications are fraught with heavy mortality. Objective: To describe the surgical and digestive complications of typhoid fever in the Surgical Department of Tenkodogo Regional Hospital in Central-Eastern Burkina Faso. Methods: This was a descriptive study performed in the digestive surgery department of Tenkodogo Regional Hospital. It covered the period from January 2014 to December 2018. The records of all patients who were admitted for a surgical complication of typhoid fever were included. Results: Two hundred and ninety-five patients were treated for a surgical complication of typhoid fever. There were 184 male patients (62.4%) and 111 female patients. Their average age was 15.7 years. The reported complications were peritonitis by ileal perforation with 212 cases (71.2%), acute cholecystitis with 45 cases (13.8%), primary biliary ...
Background: The purpose of this retrospective study is to determine the epidemiologic, clinic, th... more Background: The purpose of this retrospective study is to determine the epidemiologic, clinic, therapeutic and evolutive aspects of acute appendicitis in children. Patients and Methods: We conducted a retrospective study over six years between January 1st 2005 and December 31st 2010 at the Training Paediatric Hospital Charles de Gaulle of Ouagadougou on 367 children from 0 to14 years old admitted for acute appendicitis and who benefited appendicectomy. The data have been constituted from emergency admission register, surgery protocols, hospitalized patient register, consultations register. Results: A total of 367 children were involved in the study. Acute appendicitis of children was frequent and represented 27% of non traumatic abdominal pain and 10.8% of digestive surgical interventions. Ages between 11 and 14 years old were most frequently seen (55.3%). The male-to-female ratio was 2.2. Eighty three (83.9%) of patients got treatment before their admission at surgical emergency de...
Ce travail a pour objectif d’evaluer les resultats de l’embrochage centromedullaire elastique sta... more Ce travail a pour objectif d’evaluer les resultats de l’embrochage centromedullaire elastique stable (ECMES) dans les fractures diaphysaires du femur chez l’enfant. Il s’agissait d’une etude prospective qui s’est deroulee de Janvier 2013 a Decembre 2013 dans le service de Chirurgie Pediatrique du CHU Gabriel TOURE portant sur tous les enfants âges de 7 a 15ans et presentant une fracture diaphysaire du femur et dont le delai de consultation n’excedait pas 21 jours. En guise de resultat, nous avons opere 15 cas de fracture diaphysaire du femur soit 5% des fractures operees (300 cas). L’effectif etait compose de 8 filles contre 7 garcons soit un sexe ratio de 0,88. L’âge moyen de nos patients etait de 10,1 ans avec des extremes de 7 et 14 ans. L’etiologie la plus frequente etait les accidents de la voie publique (73,3%). Le choc etait direct dans 86,6%. Le femur droit etait atteint dans 53%. Le delai moyen de consultation etait de 6 heures. Le trait de fracture etait transverse dans 80% et oblique dans 20%. Le siege le plus frequent etait le 1/3 moyen de la diaphyse femorale. Le delai moyen de prise en charge etait de 3 jours. Nous avons procede a un embrochage centromedullaire elastique stable ascendant dans 86,6%. Les resultats ont ete evalues avec un recul moyen de 5 mois, ils etaient excellents dans 93,3% et un seul cas de raideur en extension de 10 degres. En conclusion, l’ECMES est une technique particulierement adaptee au traitement chirurgical des fractures diaphysaires du femur de l’enfant d’âge scolaire. Bien pratique, il donne de bons resultats. Le traitement orthopedique doit rester de regle mais ceci n’est plus aussi formel qu’avant. Mots cles: fracture, diaphyse femorale, grand enfant, ECMES English Abstract The objective of this work is to evaluate the results of stable elastic centro medullary insertion (ECMES) in diaphyseal femoral fractures in children. This was a prospective study that took place from January 2013 to December 2013 in the Department of Pediatric Surgery of CHU Gabriel TOURE, covering all children aged 7 to 15 years and presenting a diaphyseal fracture of the femur and whose consultation period did not exceed 21 days. We performed 15 cases of diaphyseal fracture of the femur or 5% of the fractures performed (300 cases). The number was 8 girls versus 7 boys, a sex ratio of 0.88. The average age of our patients was 10.1 years with extremes of 7 and 14 years. The most frequent etiology was road traffic accidents (73.3%). The shock was direct in 86.6%. The right femur was reached in 53%. The average time to consult was 6 hours. The fracture line was transverse in 80% and oblique in 20%. The most frequent seat was the middle 1/3 of the femoral diaphysis. The average waiting time was 3 days. We performed a stable elastic centro medullary insertion in 86.6%. The results were evaluated with an average follow-up of 5 months, excellent in 93.3% and a single case of stiffness in extension of 10 degrees. To conclude, stable elastic centro medullary insertion is a technique particularly adapted to the surgical treatment of diaphyseal fractures of the femur of the school-aged child. Well done, it gives good results. Orthopedic treatment must remain the rule, but this is no longer as formal as before. Keywords: fracture, femoral diaphysis, large child, ECMES
1024x768 RESUME : But. Etudier les peritonites aigues en milieu rural au Burkina Faso. Materiel e... more 1024x768 RESUME : But. Etudier les peritonites aigues en milieu rural au Burkina Faso. Materiel et methode : Etude transversale descriptive sur trois ans allant du 1 er janvier 2007 au 31 decembre 2009 des patients operes pour peritonite aigues generalisee dont le diagnostic a ete confirme en per operatoire au centre hospitalier regional de Dedougou. Resultats : En trois ans, 221 cas peritonites aigues generalisees ont ete operees. Ces peritonites ont represente 31,2% des urgences abdominales. L’âge moyen de nos patients etait de 24,34 ans avec des extremes de 1 an et de 79 ans. L’etiologie typhique venait en tete avec 42,5% suivie de l’etiologie appendiculaire 33% et la perforation d’ulcere gastroduodenale avec 6,8%. Les peritonites primitives representaient seulement 3,2%. On a note 40,2% de complications dont la suppuration parietale constituait 56,2%. La mortalite globale etait de 19%. Mots cles: Peritonite, chirurgie , etiologie, zone rurale, Burkina Faso Normal 0 21 false false false FR X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tableau Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}
Surgical site infections are frequent and responsible for significant morbidity in patients who u... more Surgical site infections are frequent and responsible for significant morbidity in patients who undergo digestive surgery. However, very little is known about the aspects of surgical site infections in sub-Saharan Africa. The purpose of this study was to assess the prevalence and identify risk factors of surgical site infections in patients who were treated in the Digestive Surgery Department of Tenkodogo Regional Hospital in Burkina Faso. From 1 January to 31 December 2016 we performed a descriptive study in the Department of Digestive Surgery of Tenkodogo Regional Hospital in Burkina Faso. All patients who underwent digestive tract surgery during this period were followed. Those patients whose post-operative surgical sites were complicated by infection were included in this study. Surgical site infection was diagnosed according to the CDC definition. Bacteriological sampling was performed in all included patients. In all, 964 patients underwent surgery during the study period. One...
Objectif : Decrire les complications du DM dans le service de chirurgie generale du Centre Hospit... more Objectif : Decrire les complications du DM dans le service de chirurgie generale du Centre Hospitalier Universitaire Yalgado Ouedraogo. Patients et Methode: Il s’est agi d’une etude transversale descriptive sur 10 ans Resultats : Durant la periode d’etude, 11 cas ont ete colliges. L’incidence annuelle etait de 1,1 cas. Nous avons note une predominance masculine. L’âge moyen des patients etait de 29,82 ans. Le diagnostic preoperatoire etait dans huit cas une occlusion intestinale aigue, une appendicite aigue dans deux cas, une peritonite aigue generalisee dans un cas. Nous avons diagnostique en peroperatoire une occlusion intestinale dans 10 cas et un cas de perforation du DM. Tous les DM ont ete reseques. Tous nos patients avaient un DM situe a moins d’un metre de la jonction ileo-caecale. L’histologie realisee dans deux cas a conclu a une diverticulite. Les suites operatoires etaient simples dans neuf cas, compliquees dans deux cas. Un deces postoperatoire a ete enregistre. Conclus...
Background: Surgical site infections (SSIs) are responsible for substantial morbidity in patients... more Background: Surgical site infections (SSIs) are responsible for substantial morbidity in patients who undergo digestive surgery. However, very little is known about the aspects of SSIs in sub-Saharan Africa. Methods: The purpose of this study was to assess the prevalence and identify the risk factors of SSI in patients who were treated in the Department of Digestive Surgery of Tenkodogo Hospital in Burkina Faso. We performed a prospective study from January 1, 2016 to December 31, 2016. All patients who underwent digestive tract surgery during this period were included and followed. Patients whose post-operative surgical sites were complicated by infection were identified. Surgical site infection was diagnosed according to the U.S. Centers for Disease Control and Prevention (CDC) definition. Bacteriologic sampling was performed in all included patients. Results: A total 964 patients underwent surgery during the study period and were included in the study. Seven hundred thirty-seven were females (76.4%), and 227 were males. The mean age of the included patients was 47.5 years (standard deviation [SD] = 9 years). One hundred fourteen patients presented with SSI, the incidence of which was 11.8%. The incidence of SSI was substantially higher in females than in males (63.2 vs. 36.8%, p < 0.05). The incidence was also higher in patients living below the poverty line (71.1 vs. 28.9%, p < 0.05). Clinically, the incidence of SSI was higher in emergency surgery than in scheduled surgery (84.2 vs. 15.8%, p < 0.05). Contaminated or dirty surgery was more risky than clean surgery (p < 0.05). With respect to bacteria, the most commonly isolated microbes were Escherichia coli (66.7%) and Staphylococcus aureus (15%). Treatment mainly consisted of appropriate antibiotic therapy and local care. Three deaths were recorded for a mortality rate of 2.6%. Conclusions: Surgical site infections are frequent in sub-Saharan environments. The risk factors seem to be clinical and social.
Mots clés Cancer colorectal Adénocarcinome Traitement chirurgical Burkina Faso Résumé Le cancer c... more Mots clés Cancer colorectal Adénocarcinome Traitement chirurgical Burkina Faso Résumé Le cancer colorectal est le plus fréquent des cancers digestifs. Le but de ce travail était d'étudier la fréquence, les facteurs de risque, les modalités thérapeutiques et évolutives du cancer colorectal de l'adulte jeune au Burkina Faso. C'est une étude transversale descriptive sur dix ans menée dans deux hôpitaux régionaux du Burkina Faso. Elle a inclus tous les patients de 20 à 45 ans admis dans ces deux hôpitaux durant la période d'étude pour cancer colique ou rectal. Au total, 116 patients ont été inclus soit 39,2 % de l'ensemble des patients admis pour cancer colorectal durant la même période. La moyenne d'âge des patients inclus était de 35,4 ans. Il y avait 70 patients de sexe masculin (60,3 %). Sept patients présentaient un antécédent de maladie inflammatoire chronique de l'intestin et six autres présentaient un antécédent familial de cancer colique. Le délai moyen de consultation était de 6,2 mois. Dans 25 cas (19,9 %), le cancer a été découvert dans un contexte d'urgence abdominale. Quatre-vingt-douze patients (79,3 %) étaient diagnostiqués aux stades 3 ou 4. Le type histologique le plus fréquent était l'adénocarcinome avec 103 cas (88,9 %). Sur le plan thérapeutique, la chirurgie a été employée chez 87 patients (75 %) et la chimiothérapie chez 37 patients (31,9 %). Seize patients ont bénéficié d'une radiothérapie. La mortalité opératoire était de 4,6 %. La survie à cinq ans était de 17 %.En conclusion, le cancer colorectal de l'adulte jeune semble plus fréquent en milieu sub-saharien. La mortalité reste élevée du fait de l'arsenal thérapeutique limité.
Male breast cancer is a rare and less known disease. Therapeutic modalities affect survival. In B... more Male breast cancer is a rare and less known disease. Therapeutic modalities affect survival. In Burkina Faso, male breast cancers are diagnosed in everyday practice, but the prognosis at short-, middle-, and long-term remains unknown. The objective of this study is to study the diagnosis stages, therapeutic modalities, and 5-year survival in male breast cancer at the General Surgery Unit of Yalgado Ouedraogo University Hospital from 1990 to 2009. A cohort longitudinal study concerning cases of breast cancer diagnosed in man. Survival was assessed using the Kaplan-Meier method and survival curves were compared through the LogRank test. Fifty-one cases of male breast cancer were followed-up, i.e., 2.6% of all breast cancers. Stages III and IV represented 88% of cases. Eleven patients (21.6%) were at metastatic stage. Patients were operated in 60.8% of cases. The surgery included axillary dissection in 25 (80.6%) out of 31 cases. Lumpectomy was performed on 6.5% of patients (2 cases). ...
Introduction: Thoracic wounds by firearms are frequent and severe. They may involve the patient's... more Introduction: Thoracic wounds by firearms are frequent and severe. They may involve the patient's prognosis. Objective: To study the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of the thoracic wounds by firearms. Material and method: This was a cross-sectional, descriptive study of all patients over the age of 15 who consulted in the university hospital-YO in the department of general and digestive surgery over a period of 5 years. Results: We collected 50 cases of thoracic wounds by firearms on 183 thoracic wounds with a prevalence of 27.3%. There were 48 men (96%). The average age was 30 years. The patients came from urban areas in 66% of cases; the informal sector accounted for 44% of the cases. The pistol was the most involved firearm (46.9%). The consultation period was less than 6 hours in 78% of patients. An unstable hemodynamic state was found in 42% (n = 21). A fluid and mixed pleural effusion syndrome was found in 46% and 26% of patients, respectively. Associated lesions were diaphragm involvement, and lesions of intra-abdominal hollow organs. Thoracic drainage was performed in 24 patients (48%) and was associated with a laparotomy in 8 patients. The average hospital stay was 7.5 days. Mortality was 14%. Conclusion: the thoracic wounds by firearms are frequent in civilian practice. The thoracic CT allows mapping of the lesions and thoracic drainage constitutes the essential part of surgical treatment. The fight against the proliferation of weapons deserves to be promoted.
Objective: The objective is to study the knowledge that albinos have on skin cancers, and their a... more Objective: The objective is to study the knowledge that albinos have on skin cancers, and their attitudes in terms of primary prevention and the screening practices for skin cancers in Burkina Faso. Methods: This is a cross-sectional and descriptive KAP study conducted from May 18 th to July 7 th 2015. It involved albinos aged at least 12 years. Their general knowledge, prevention attitudes and screening practices were considered. Results: All the responding albinos had already heard about skin cancers. Their main source of information was health workers (65.6%). They were showing at least two risk factors (99.2%) but only 68.3% affirmed having already undergone screening for skin cancer. Ignorance of the existence of screening was the main obstacle to it (16/26). The prevention means used was sun avoidance, the use of cream and protection clothing respectively in 84%, 41.5% and 51.2%. The skin lesions found were hyperpigmented macules (77.8%) then actinic keratosis (40.7%) and finally cheilitis (35.8%). We detected 4 cases of skin cancers confirmed by biopsy. Conclusion: Risk factors are frequent. Participation to screening is still insignificant. A lot is still to be done to extend the protection means. A good awareness-raising campaign and the accessibility to protection means remain for all, the best defense in the fight against skin cancers in albinos.
Introduction: Testicular seminoma is a highly lymphophilic germ cell tumor. It is the most common... more Introduction: Testicular seminoma is a highly lymphophilic germ cell tumor. It is the most common germ cell tumor in young adults. We are reporting one case of testicular seminoma complicated with an acute generalized peritonitis (AGP), in order to describe the circumstances of diagnosis and discuss about treatment. Observation: It involved a 39-year-old patient, admitted for vague abdominal pains that were evolving since 72 hours with a history of right orchiectomy because of testicular seminoma in 2011. The analysis revealed a peritoneal syndrome, a right inguinal lymphadenopathy of 10 cm diameter and an empty right scrotum. The exploration revealed fistulized necrotic retro-peritoneal lymphadenopathies in the peritoneal cavity and ileal perforation on contact with these lymphadenopathies. Necrosectomy and ileal resections were performed. After the operation, the scanner revealed a conglomeration of retro-peritoneal adenomegalies extending to the right femoral region associated with bilateral pleurisy. The β-HCG and the LDH were 8000 IU/L and 24,500 IU/L, respectively. The seminoma was ranked T3N3M1. The immediate post-operative care was uneventful. The patient was lost from sight for a month and was readmitted in a context of alteration of his general condition. He died before the end of the pre-chemotherapeutic assessment. Conclusion: Scrotal mass is the usual way of revelation of testicular seminoma. In poorly followed-up cases, exceptional complications such as peritonitis may occur and are direct consequences of poor prognosis.
Introduction: Transanal evisceration of small bowel is an extremely rare condition that can occur... more Introduction: Transanal evisceration of small bowel is an extremely rare condition that can occur spontaneously or after trauma. Objective: To report a case of Transanal evisceration of small bowel to describe the circumstances of occurrence and our therapeutic attitude. Observation: An 80year-old female patient was received at the visceral Emergency of University Hospital Yalgado Ouédraogo for the outcome of the small intestine by the anus with the waning of a defecation effort. The physical examination of the patient accustomed to evacuation purgation noted, eviscerated the small bowel through the anus, edematous but viable. The preoperative laboratory tests were normal. In emergency, under general anesthesia, a laparotomy was possible to objectify the incarceration of intestinal loops through linear perforation of 5 cenimeter from the anterior surface of the rectosigmoid hinge. We conducted an ileo-ileal resection anastomosis, a suture rectosigmoid breach and anal extraction of small bowel incarcerated measuring 200 centimeter. The evolution was simple. Conclusion: The weakening of the rectal mucosa by repeated purges has certainly been the contributory factor. The surgical treatment must be precocious to avoid extensive intestinal resection.
Background: Vulvar cancer is a rare gynaecological cancer. In Burkina Faso, the diagnosis of vulv... more Background: Vulvar cancer is a rare gynaecological cancer. In Burkina Faso, the diagnosis of vulvar cancers is delayed and the prognosis is poor. However, no specific study on vulvar cancers has been conducted at the moment. This work aimed to study the characteristics of these cancers. Methods: This is a prospective study on histologically confirmed primary cancers of the vulva diagnosed between 1st January 2013 and 30th June 2015. The demographic and clinical aspects were studied at the Yalgado Ouedraogo University Hospital of Ouagadougou (CHU-YO). Results: We noticed 21 cases of vulvar cancers within 30 months, ranking it as the 4th most common gynaecological cancer. The average age of the patients was 55 years (standard deviation +/− 6.3) and the median age was 57 years. Scars resulting from female circumcision, menopause (n = 20) and HIV infection were noticed in 19 cases and 6 cases respectively. The average time from first symptoms to first consultation was 29 months. Pain and ulceration were the main reasons for consultation. The clinical picture was chiefly an ulcero-granulating tumour. There was squamous cell carcinoma in 20 cases and basal carcinoma in 1 case. Fifteen patients were at stage III or IV, where of three patients had metastatic disease. We noticed vitiligo in 9 vulvar cancer cases. Conclusion: The cancer of the vulva is rare. Women are of menopausal age, are mostly circumcised and HIV-infection is common. A majority of patients sought consultation at advanced stage of disease, and diagnosis was belatedly made. Pain and ulceration were the main reasons for consultation. The sensitization of the population, education for self-examination would allow earlier diagnosis.
Les garrots de prélèvement, un drame chez le nourrisson: à propos de 3 cas Tourniquets, a drama i... more Les garrots de prélèvement, un drame chez le nourrisson: à propos de 3 cas Tourniquets, a drama in the infant: about 3 cases
Le diverticule de Meckel (DM) est la persistance partielle du canal omphalomésentérique. Ses comp... more Le diverticule de Meckel (DM) est la persistance partielle du canal omphalomésentérique. Ses complications sont rares. Le diagnostic est le plus souvent per opératoire. L'objectif a été de décrire les complications du diverticule de Meckel chez l'adulte dans le service de chirurgie générale et digestive du CHU Yalgado Ouédraogo. Il s'est agi d'une étude transversale descriptive sur 10 ans (janvier 2004-décembre 2013) portant sur les dossiers des patients âgés de plus de 15 ans ayant présenté un DM compliqué. Durant la période d'étude, 11 cas ont été colligés. L'incidence annuelle a été de 11 cas. Nous avons noté une prédominance masculine avec un sex-ratio de 4,5. L'âge moyen des patients était de 29,8 ans. Le diagnostic préopératoire a été dans huit cas une occlusion intestinale aiguë, une appendicite aiguë dans deux cas, une péritonite aiguë généralisée dans un cas. Il a été diagnostiqué en peropératoire une occlusion intestinale dans neuf cas; une diverticulite dans un cas et un cas de perforation du DM. Tous les DM avaient été réséqués dont huit résections segmentaires iléales emportant le DM et trois résections cunéiformes. Tous les DM étaient situés à moins d'un mètre de la jonction iléo-caecale. L'histologie réalisée dans deux cas avait conclu à une diverticulite. Les suites opératoires ont été simples dans neuf cas, compliquées dans deux cas dont une éventration et un décès. Les complications du diverticule de Meckel sont rares. Le diagnostic préopératoire est difficile. Le traitement est essentiellement chirurgical.
Objective: Describe the epidemiological characteristics of GI cancers in elderly patients in the ... more Objective: Describe the epidemiological characteristics of GI cancers in elderly patients in the GI Surgery Unit of the Yalgado Ouedraogo University Hospital ‘(CHU -YO)’. Materials and methods: We conducted between January 1st 2006 and December 31st 2013, a cross-sectional study on the epidemiological characteristics of primary GI cancers in elderly patients. The average age of the Burkinabe population is 21.8 years and those under 15 years represent 47% of the population. Considering life expectancy in our country (54 years) and physiological age, all the patients having a chronological age equal or above 60 years were included. Results: Within 7 years, 276 cases of primary GI cancers were diagnosed in elderly patients. This represented 45.9% of all GI cancers. Sex ratio male/female was 3. The average age of patients was 63 years. The over 80 years were only 4% of the cases in our series. Comorbidities were noted in 24% of the cases. High blood pressure was the most common comorbid...
Le mélanome est une tumeur maligne développée aux dépens des mélanocytes. Ses caractéristiques ép... more Le mélanome est une tumeur maligne développée aux dépens des mélanocytes. Ses caractéristiques épidémiologiques restent peu étudiées dans les populations africaines. D'où le but de cette étude. Il s'est agit d'une étude rétrospective descriptive de janvier 2009 à décembre 2012 et prospective en 2013. Pour la partie rétrospective, nous avons inclus tous les patients atteints de mélanome confirmé par l'examen histopathologique et ayant un dossier clinique exploitable. Pour la partie prospective, nous avons inclus tous les cas de mélanomes recensés en 2013. Les variables étudiées étaient les caractéristiques sociodémographiques, anatomocliniques et thérapeutiques. Au total 19 patients étaient inclus, avec un âge médian de 53,42 ans et 10 patients de sexe féminin. La durée moyenne d'évolution de la maladie était de 3,7 ans. Les lésions étaient surtout ulcero-bourgeonnantes (13), hyperpigmentées (15), et siégeaient sur les plantes (14). Le type et acro-lentigineux était le plus fréquent (13). L'indice de Clarck a été mesuré dans 3 cas, l'indice de Breslow dans aucun cas. Les métastases étaient présentes chez 10 patients. Le traitement était surtout chirurgical. Les 11 patients inclus de manière retrospective étaient ont été perdus de vue. Un décès était noté parmi les 8 patients inclus de manière prospective. Le retard à la consultation semblait être le principal facteur de mauvais pronostic dans notre contexte. Une sensibilisation de la population et du personnel de santé sur les signes précoces de la maladie, permettrait probablement de réduire la morbidité.
Background: Typhoid fever is endemic in sub-Saharan Africa. Inadequate management often leads to ... more Background: Typhoid fever is endemic in sub-Saharan Africa. Inadequate management often leads to complications, which are mainly surgical. Surgical complications are fraught with heavy mortality. Objective: To describe the surgical and digestive complications of typhoid fever in the Surgical Department of Tenkodogo Regional Hospital in Central-Eastern Burkina Faso. Methods: This was a descriptive study performed in the digestive surgery department of Tenkodogo Regional Hospital. It covered the period from January 2014 to December 2018. The records of all patients who were admitted for a surgical complication of typhoid fever were included. Results: Two hundred and ninety-five patients were treated for a surgical complication of typhoid fever. There were 184 male patients (62.4%) and 111 female patients. Their average age was 15.7 years. The reported complications were peritonitis by ileal perforation with 212 cases (71.2%), acute cholecystitis with 45 cases (13.8%), primary biliary ...
Background: The purpose of this retrospective study is to determine the epidemiologic, clinic, th... more Background: The purpose of this retrospective study is to determine the epidemiologic, clinic, therapeutic and evolutive aspects of acute appendicitis in children. Patients and Methods: We conducted a retrospective study over six years between January 1st 2005 and December 31st 2010 at the Training Paediatric Hospital Charles de Gaulle of Ouagadougou on 367 children from 0 to14 years old admitted for acute appendicitis and who benefited appendicectomy. The data have been constituted from emergency admission register, surgery protocols, hospitalized patient register, consultations register. Results: A total of 367 children were involved in the study. Acute appendicitis of children was frequent and represented 27% of non traumatic abdominal pain and 10.8% of digestive surgical interventions. Ages between 11 and 14 years old were most frequently seen (55.3%). The male-to-female ratio was 2.2. Eighty three (83.9%) of patients got treatment before their admission at surgical emergency de...
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