Ibrahima Konaté

Appendicular peritonitis in situs inversus totalis: a case report

IntroductionSitus inversus is a congenital anomaly characterized by the transposition of the abdominal viscera. When associated with dextrocardia, it is known as situs inversus totalis. This condition is rare and can be a diagnostic problem when associated with appendicular peritonitis.Case presentationWe report the case of a 20-year-old African man who presented to the emergency department with a 4-day history of diffuse abdominal pain, which began in his left iliac region and hypogastrium. After examination, we initiated a surgical exploration for peritonitis. We discovered a situs inversus at the left side of his liver, and his appendix was perforated in its middle third. A complementary post-operative thoracic and abdominal tomodensitometry revealed a situs inversus totalis.ConclusionAppendicular peritonitis in situs inversus is a rare association that can present a diagnostic problem. Morphologic exploration methods such as ultrasonography, tomodensitometry, magnetic resonance imaging, and laparoscopy may contribute to the early management of the disease and give guidance in choosing the most appropriate treatment for patients.

Internal supravesical hernia as a rare cauase of intestinal obstruction: a case report

IntroductionSupravesical hernias develop at the supravesical fossa between the remnants of the urachus and the left or right umbilical artery. They are often the cause of intestinal obstruction. We describe the anatomical variant of the supravesical hernia in this case and discuss the pre-operative findings revealed by computed tomography. We discuss diagnostic and therapeutic procedures, and review other anatomical variants.Case presentationA 60-year-old Senegalese man was admitted with a two-day history of small bowel obstruction. A physical examination showed abdominal distension. An abdominal X-ray revealed dilated small bowel loops. A computed tomography scan showed an image at the left iliac fossa that suggested an intussusception. A median laparotomy showed a left lateral internal supravesical hernia. The hernia was reduced and the defect was closed. The patient recovered uneventfully.ConclusionsSupravesical hernia is a possible cause of intestinal obstruction and diagnosis is very often made intraoperatively. Morphological examinations, such as computed tomography scanning, can lead to a preoperative diagnosis. Laparoscopy may be useful for diagnosis and therapy.

Giant splenic pseudocyst, a rare aetiology of abdominal tumor: a case report

IntroductionSplenic pseudocysts are nonparasitic cyst without epithelial lining. We report this case especially by its way of revelation, its large size and its per operative presentation which needed total splenectomy. To this opportunity, we discuss the diagnostic procedure and therapeutic indications.Case presentationA twenty-year old Senegalese woman, was admitted with a three-month history of spontaneous abdominal mass associated with a pain. Ultrasonography and CT scan found the giant splenic pseudocyst with a diameter of 20 cm which needed a total splenectomy by median laparotomy.ConclusionUsually, symptomless splenic cysts are untreated. When surgical treatment is indicated, recommendations are to preserve splenic parenchyma by partial splenectomy or fenestration especially by laparoscopy. Total splenectomy retains some guidance.

Léiomyome géant de la trompe utérine : une cause rare de tumeur abdominale

Leiomyomas of the fallopian tube are extremely rare. They are often managed with autopsy or surgery. We report a revealed case by a voluminous-abdominal mass in a 35-year-old woman. Neither the tomodensitometry nor, even, the laparoscopy did not permit specifying the tubal origin of the tumor. The diagnosis has been finally carried to the laparotomy. An annexectomy had been achieved. The histological examination concluded to a leiomyoma without malignant-cellular atypia.

Indications and Results of Thyroidectomies in Northern Senegal

Goiters account for a very high prevalence disease. In Senegal, surgery is a very important part of the management. Our aim is to determine indications and results of thyroidectomies at the regional hospital of St. Louis. Patient and Method: We conducted a descriptive retrospective study over a period of 6 years on 81 records. All patients who underwent thyroidectomy during the study period were included. Computer software EPI INFO and Excel were used for collection and processing of data. Results: The average age of our patients was 40 years with a sex ratio at 0.05. The determination of TSH found 88.9% in euthyroid, 1.2% in hypothyroidism and 9.9% in hyperthyroidism. Thyroid ultrasound was performed in 97.5% of patients. Surgically, gestures performed were divided between the lobo-isthmectomies (43.1%), subtotal thyroidectomy (9.8%), total thyroidectomy (46.91%). The postoperative course was uneventful in all patients. The histology was benign in 88.9% of surgical specimens and found adenocarcinoma in 11.1%. Conclusion: Our study confirms the predominance of female thyroid pathology. The thyroidectomy which is getting better codified occupies an important place in the management. It offers the advantage around the problem of therapeutic non-compliance and also stockouts in our region.

A case Report of Perforated Primary Follicular Lymphoma of the Jejunum presenting as Aneurismal Form

Primary Gastrointestinal Follicular Lymphoma is very rare. It is considered as an indolent lymphoma, but a complication such as a perforation can increase the morbidity and mortality. We report the case of a 57-years-old man who had a perforation primary follicular lymphoma of the jejunum presenting as aneurismal form. He had peritonitis at his admission, and his abdominal CT revealed a massive pneumoperitoneum and a segmental dilatation of the small intestine.

Faisabilité et pertinence de la check-list de sécurité au bloc opératoire central du Centre Hospitalier Régional de Saint Louis du Sénégal

Introduction La check-list (CL) de sécurité au bloc opératoire est un outil de qualité qui permet de réduire la morbimortalité péri opératoire. C’est une des exigences de la Haute Autorité de Santé (HAS) française dans la procédure de certification des établissements de santé. L’objectif de ce travail est de réaliser une évaluation quantitative et qualitative de l’utilisation de cet outil au sein du bloc opératoire central du centre hospitalier Régional de Saint Louis. Méthodes Une évaluation prospective des indicateurs de l’utilisation pratique de la check-list et de son apport dans l’amélioration des pratiques chirurgicales au bloc opératoire du centre hospitalier régional de Saint-Louis a été entamée depuis son lancement en mars 2016. Résultats Le taux d’utilisation de la CL était de 75%, le taux de conformité était de 60%; le taux de renseignements était de 99% pour les items pré-induction, 93% pour les items pré-incision et 88% pour les items postopératoires. Seules 73% des CL analysées avaient été remplies avec une communication orale effective aux trois temps. La CL a permis de détecter des dysfonctionnements matériels et/ou des événements indésirables dans 15% des cas. Aucune erreur d’identification de patient ni de coté opéré ne furent objectivées dans notre étude. Conclusion La CL participe au développement de la culture de sécurité dans les blocs opératoires, et a débouché sur la mise en place d’une cartographie des risques au bloc opératoire. Certes importante, elle ne doit néanmoins pas être présentée comme l’outil magique pour éviter les erreurs, mais s’intègre dans l’amélioration de la qualité des soins avec d’autres programmes comme le signalement d’évènements indésirables et les revues de morbi-mortalités.

Trachélocèle incarcérée à la suite d’un fibrome géant du col utérin : à propos d’un cas

The authors report a sparse case of incarcerated procidentia due to cervical fibromyoma in a 43-year-old Senegalese woman. This is about the second case known around the world. Clinic was about a giant cervical mass, irreducible with haemorrhage and procidentia.