The esophagus is the most common site of impaction of an ingested foreign body. The main initial symptom is acute dysphagia; Patients with complete esophageal obstruction produce excessive amounts of saliva and are unable to swallow oral secretions. Complete obstruction can cause pressure necrosis and increases the risk of perforation if present for more than approximately 24 hours. Emergency endoscopy is necessary for sharp objects, disc or button batteries, and any obstruction causing symptoms that suggest complete obstruction. We report through this observation the extraction of an unusual esophageal foreign body at the Sominé Dolo hospital in Mopti. This was a 60-year-old patient, a farmer, with no known medical or surgical history to date, and no particular psychiatric disorder. The accidentally ingested foreign body was a cap from a recycled vinegar bottle. An attempt at extraction in the ENT department was made without success, then subsequently sent to the Hepato-gastroenterology unit. The endoscopic extraction of the foreign body was carried out without incident and the evolution was favorable after the endoscopy procedure.

We report through this observation the diagnosis of a case of achalasia of the cardia in a 14-year-old adolescent at the Sominé Dolo hospital in Mopti. This was the first case of Achalasia of the cardia out of the 2650 gastroscopies carried out in Mopti from 2018 to 2022. The patient had no particular personal or family medical/surgical history. According to the symptoms, it was classified as Stage 3 of the Eckardt Score. The esogastroduodenal fibroscopy performed revealed a narrowing of the cardia and a jump when passing the endoscope. It was stage II at the time of diagnosis, according to the distension of the body of the esophagus during esophagogastric transit and a Radish tail image at the level of the esophagogastric junction. Frontal chest x-ray showed significant mediastinal widening. However, monomerism (essential examination) inaccessible in our context could not be achieved. The diagnosis of achalasia of the cardia was retained based on clinical, endoscopic and radiological arguments.

We report the observation of a patient presenting with acute generalized peritonitis. Emergency surgery found a double perforation, one on the stomach and the other on the duodenum. We performed a suture revival of the perforations plus a gastro-entero-anastomosis, then washed and drained the cavity. We discuss the diagnostic and therapeutic features of this rare condition.

Peritoneal tuberculosis is a rare form of extra pulmonary tuberculosis in children. It represents 1 to 2% of all forms of tuberculosis. It is characterized above all by the occurrence of ascites, a progressive deterioration of the general condition, a fever. Its diagnosis can sometimes be very difficult; we report a case of peritoneal tuberculosis revealed by a surgical emergency.

AIMS:The goal of our work was to clarify the epidemiologicals, clinicals, etiologicals and prognostics of upper gastrointestinal bleeding at Segou Regional Hospital.PATIENTS AND METHODS:This cross-sectional study, which took place from October 1, 2017 to September 31, 2018, involved patients hospitalized for digestive hemorrhage.RESULTS:Upper gastrointestinal bleeding represented 9.7% of all hospitalizations. The mean age of the patients was 50, 94 ± 21, 6 years with a sex ratio of 1.6 in favor of men. Housewives and farmers were represented in 37.7% and 34% of cases. The main modes of disclosure were hematemesis and melena. Evolution was favorable with a mortality of around 34%.CONCLUSION:upper gastrointestinal bleeding is relatively common in our context. High mortality is linked to delayed treatment.

The main aim of this study was to investigate the role of non-steroidal anti-inflammatory drugs in digestive bleeding in a hospital setting and in a context of social and security instability. Patients and methods: This was a prospective and analytical study that took place in the Hepato-Gastroenterology Department of the Gabriel TOURE University Hospital over a period of two years and included all patients hospitalized for digestive hemorrhage. These patients had benefited from the research of sociodemographic characteristics, the notion of taking non-steroidal anti-inflammatory drugs (dose and duration), a physical examination and a digestive endoscopy. Results: At the end of this study, 78 cases of non-steroidal anti-inflammatory drug use out of 210 patients hospitalized for digestive hemorrhage were recorded, i.e. a frequency of 37.1%. The mean age of our patients was 47.01±19.3 years with a sex ratio of 2.9. Housewives and farmers represented 28.2% and 20.5% respectively. Hematemesis was the reason for consultation in 71.8%. Digestive hemorrhage and smoking were the most common antecedents. Diclofenac was the most commonly used drug in 53.9% of cases, with bleeding occurring in the first week after taking the non-steroidal anti-inflammatory drug in 53.9% of cases. Signs of hypovolemic shock were frequently found. The GD ulcer was the cause found in 66.2% of cases. Hemorrhage occurred significantly (p=10-8) in the first week of taking non-steroidal anti-inflammatory drugs and was significantly associated with NSAID use. There was no statistically significant difference in the occurrence of death between the molecules. Conclusion: NSAID-induced GI bleeding in adults is one of the major GI emergencies and remains an important cause of morbidity and mortality.

Aims The aim of our study was to describe the epidemiological and anatomoclinic aspects of chronic inflammatory bowel disease (IBD) in Bamako/MALI

RESUME Introduction. Le but de notre etude etait de rapporter les resultats des trois premieres annees de pratique de la coloscopie a Kayes au Mali. Methodes. Il s’agit d’une etude transversale retrospective, menee du 1er Janvier 2018 au 31 Decembre 2020 a partir des registres de comptes rendus d’endoscopies digestives basses de l’hopital regional de Kayes et de la clinique medicale «SEWA». Les patients ayant beneficie d’une endoscopie interpretable ont ete inclus. Les donnees recueillies pour chaque patient etaient: l’âge, le sexe, la profession, la residence, l’indication de la coloscopie, la lesion retenue, le resultat de biopsie. Les donnees ont ete saisies et traitees au moyen du logiciel Excel. Resultats. Durant la periode d’etude, 108 coloscopies ont ete realisees sur un total de 1021 endoscopies digestives basses soit 10,6%. Sur les 108 patients enregistres, 76 etaient de sexe masculin (70%) soit un sex-ratio de 2,4. L’âge moyen des patients etait de 48,67 ans avec des extremes de 15 et 81 ans. Les indications les plus frequentes de la coloscopie etaient la rectorragie (39,9%), la diarrhee chronique (19,4%), la constipation (16,7%) et la douleur abdominale (13%). Les pathologies frequemment retrouvees etaient la maladie hemorroidaire (19,4%), les recto-sigmoidites non specifiques (13,9%), les maladies inflammatoires chroniques de l’intestin (13%), le cancer colorectal (12%). Conclusion. La pathologie digestive basse est frequente a Kayes au Mali. La frequence des cancers colorectaux et celle des maladies inflammatoires chroniques de l’intestin meritent une attention particuliere. ABSTRACT Introduction. The aim of our study was to report the results of the first three years of colonoscopy practice in Kayes, Mali. Methods. This was a cross sectional retrospective study, conducted from January 1, 2018 to December 31, 2020 from the lower digestive endoscopy report registers from the Kayes regional hospital and the \"SEWA\" medical clinic. Patients who underwent an interpretable endoscopy were included. The data collected for each patient were: age, sex, profession, residence, colonoscopy indication, lesion retained, biopsy result. Data were entered and processed using Excel software. Results. During the study period, 108 colonoscopies were performed out of a total of 1021 lower gastrointestinal endoscopies, ie 10.6%. Among the 108 patients, 76 were male (70%), i.e. a sex ratio of 2.4. The mean age of the patients was 48.67 years ( range: of 15 and 81 years. The most frequent indications for colonoscopy were rectal bleeding (39.9%), chronic diarrhea (19.4%), constipation (16.7%) and abdominal pain (13%). The most frequently found pathologies were hemorrhoidal disease (19.4%), non-specific rectosigmoiditis (13.9%), chronic inflammatory bowel disease (13%), colorectal cancer (12%). Conclusion. Low digestive pathology is frequent in Kayes in Mali according to our study. The frequency of colorectal cancer and that of chronic inflammatory bowel disease deserve special attention.

RESUME Introduction. La peritonite aigue generalisee constitue une urgence grave necessitant une prise en charge medicochirurgicale rapide. L’objectif de notre etude etait d’etudier les aspects epidemiologique et therapeutique des peritonites aigues generalisees a l’hopital Fousseyni Daou de Kayes. Materiels et methodes. Il s’est agi d’une etude prospective allant du 1er fevrier 2013 au 1er janvier 2014 portant sur 42 patients operes dans service de chirurgie generale de l’hopital Fousseyni Daou de Kayes. Resultats. Durant la periode, 256 patients ont ete admis pour des urgences digestives dont 42 cas de peritonite aigue generalisee soit une frequence de 16,4%. L’âge moyen des patients etait de 40,1 avec des extremes de 1 et 80 ans. On a note une predominance masculine avec un sex-ratio de 1,33. Les paysans etaient la couche sociale la plus representee (26,2%). Les signes cliniques et para cliniques en faveur d’une peritonite aigue generalisee ont ete essentiellement : contracture abdominale, douleur abdominale intense, des nausees ou vomissements qui etaient presents chez tous nos malades et un pneumoperitoine a l’ASP (66,7%) des cas. L’incision-suture-lavage puis drainage a ete le geste le plus realise. Les perforations appendiculaires etaient des causes les plus frequentes (35,71%) ; Tous les germes ont ete sensibles a la Ceftriaxone et aucun patient n’a subi une monotherapie. En post operatoire, (76,2%) des patients subi une bi antibiotherapie. Les suites operatoires ont ete simples dans 69% des cas. L’evolution a ete marquee par la suppuration parietale (4,8% des cas) et nous avons enregistre 2 deces (4,8%). Conclusion. Le retard de consultation, l’absence de service de soins intensifs, le cout eleve de l’intervention chirurgicale d’urgence ont ete des facteurs determinant de la mortalite et de la morbidite.ABSTRACTIntroduction. Acute generalized peritonitis is a serious emergency requiring rapid medical and surgical management. The objective of our study was to study the epidemiological and therapeutic aspects of acute generalized peritonitis at the Fousseyni Daou hospital in Kayes. Materials and methods. This was a prospective study from February 1, 2013 to January 1, 2014 on 42 patients operated on in the general surgery department of the Fousseyni Daou hospital in Kayes. Results. During the period, 256 patients were admitted for digestive emergencies, including 42 cases (16.4%) of acute generalized peritonitis. The mean age of the patients was 40.1 with extremes of 1 and 80 years. A male predominance was noted with a sex ratio of 1.33. The peasants were the most represented social layer (26.2%). The clinical and para-clinical signs in favor of acute generalized peritonitis were mainly: abdominal contracture, intense abdominal pain and nausea or vomiting found in all of our patients and pneumoperitoneum in the ASP (66.7%) of cases. The incision-suture-wash followed by drainage was the most used technique. Appendicular perforations were the most common causes (35.71%); 100% of the organisms were sensitive to Ceftriaxone and no patient underwent the monotherapy. Postoperatively, (76.2%) of patients underwent bi-antibiotic therapy. The postoperative consequences were straightforward in 69% of cases. The course is marked by parietal suppuration (4.8% of cases) and we recorded 2 cases of death (4.8%). Conclusion. The delays in consultation, the absence of an intensive care unit, the high cost of emergency surgery were determining factors in mortality and morbidity.

The main objective of this work was to update the data on the epidemiological, clinical, etiological and prognostic aspects of these acute upper digestive hemorrhages. It was a prospective study for a period of 11 months (from March 2013 to January 2014) at the digestive endoscopy center of Gabriel Touré University Hospital in Bamako. At the end of this study, 63 patients had acute upper digestive bleeding (AUDB) among 954 hospitalized patients, that is to say a frequency of 6.7%. The sex ratio was 3.5. The average age of our patients was 45 ± 16.57 years with extremes of 15 and 84 years. A notion of smoking, epigastralgia and none steroid anti-inflammatory drugs (NSAIDs) were more reported in the history with respectively 14 patients (22.3%), 10 patients (15.9%) and 4 patients (6.3%), but haematemesis had occurred in 24 (38.1%) patients without any antecedent. The main causes of hemorrhage were rupture of oesophageal varices in 34 (57.6%) patients and peptic ulcers in 18 (30.5%) patients. Early recurrence occurred in 7 (11.1%) patients resulting in the death of 5 patients for an overall mortality of 9 patients among 63 (14.3%). Acute high digestive hemorrhages are always serious. The correct management of the hemorrhagic episode by haemostatic gestures when available and the causes of haemorrhage improve the prognosis.

The main goal of this study was to analyze hepatic amoebiasis abscess at the service of gastroenterology of CHU Gabriel Touré, Bamako- Mali.MATERIAL AND METHOD:It was longitudinal and prospective study from January 2013 to February 2014 and concerned patients having hepatic abscess diagnosed by echography and amoebic serology or chocolate pus finding.RESULT:During the study the frequency of disease was 2.4% (24/970). The sex-ratio was 2 with a mean age of 36.8±10.9 years. Smoking was observed in 58.8% of cases. Abdominal pain, fever and hepatomegaly were found respectively in 87.5%, 83.3% and 79.3% of patients. The abscess was mainly located in right lobe. HIV serology was performed among 18 patients and was negative in all cases. The medical treatment by the metronidazol was systematically proposed and was associated to abscess tap in 42.2% of patients. A total recovery was observed in 23 patients and 1 patient was died by abscess rupture in the peritoneum.CONCLUSION:An early management cans evord complication.

The main objective of this longitudinal and prospecting study from February 2013 to January 2014 was to analyze uper digestive tractus caustic injuries in adult patients at the service of gastroenterology of CHU Gabriel Touré Bamako-Mali.PATIENTS AND MÉTHOD:We include patients (age more than 16 years) hospitalized for digestive caustic injuries.RESULTS:During the period a hospital frequency was 2.1% (20/970). The mean age was about 33.1 ± 9 years. Over toxic substances was discovered in 45 % of patients. The caustic ingestion was intentional in 18 patients. Psychoaffective disorders were the main reason of caustic consumption. At the entry haematemesis was the main sign. The endoscopic lesions were in majority at stage IIIb of the Zargar et al classification. A case of inhalation pneumonia, a case of digestive perforation and 6 cases of digestive obstruction were the main complications of the caustics injuries. Early death was found in 3 patients.CONCLUSION:Upper digestive tractus caustic injuries are more and more met in our context. Preventive measures are necessary to prevent these serious lesions.

Le but principal de ce travail était d’étudier l’encéphalopathie hépatique sur cirrhose dans le service d’hépatogastroentérologie du CHU Gabriel-Touré, Bamako, Mali. Il s’agissait d’une étude longitudinale, prospective qui s’est déroulée sur une période de 14 mois allant de janvier 2013 à février 2014. Pendant cette période, une fréquence hospitalière de 6,5 % de l’encéphalopathie hépatique a été observée. La moyenne d’âge était de 46,4 ± 15 ans (extrêmes: 13 et 84). Le sex-ratio était de 1,42. Un antécédent d’ictère, d’hémorragie digestive et d’encéphalopathie hépatique étaient observés respectivement chez 23, 13 et 6 patients. À l’admission, 74,6 % des malades étaient en encéphalopathie. L’encéphalopathie hépatique était au stade II dans 65,1 % des cas et à son premier épisode dans 65,1 % des cas. La mortalité immédiate a été de 66,7 %. L’encéphalopathie hépatique est une complication redoutable des hépatopathies chroniques. Sa prise en charge reste complexe dans notre contexte.

EnglishIntroduction The ARV therapy is nowadays one of the major responses against HIV infection. Although this treatment does not allow the eradication of HIV infection, transforms it into a chronic disease and must be taken for life. Objective To assess adherence to antiretroviral therapy in children aged 0-15 years infected with HIV in NGO- WALE Segou. Methods and Materials Our study, descriptive, transversal and driver with a prospective collection of data took place from 1 October, 2009 to March 31, 2010 at the NGO WALE Segou and covered thirty-six (36) children. Results The sample mean age was 5 ± 3.3 years with extremes of 2 years and 14 years. The sex ratio was 1.1 in favor of boys. Over the past 6 months 93.3% of children were watching with good rates ranging from 88.9%, 97.2%, 94.4%, 91.7% and 91.7% respectively from T0 to M6. The noncompliance most frequent causes were: the child’s refusal, forgetfulness, unavailability of the person to the custody of the child and side effects (vomiting, nausea). The noncompliance types most represented were taken and disrespect missed dose. We observed that 30.6% of children had experienced at least one side effect during our study. The regimens have been most effective in our study is secondary (AZT/3TC/NVP) with 34.3%. Patients on the protocol 2 NRTI and NNRTI were most numerous with 94.4%, the treatment protocol remained unchanged at 94.4% of children. Treatment failure was the sole reason for protocol change. 33,3% of persons having custody of the children expressed difficulties. The good compliance rate (92%) of children under 7 years old was higher than that (90.90%) of those above 7 years. Conclusion The adherence rate to ART in NGO- Wale children is encouraging these better results were the consequence of therapeutic education. francaisIntroduction Le traitement ARV est pour l’heure l’une des principales ripostes contre l’infection a VIH. Bien qu’il ne permette pas l’eradication du VIH, il transforme l’infection en une maladie chronique et doit etre pris a vie. Objectif Evaluer l’observance au traitement antiretroviral chez les enfants de 0 a 15 ans infectes par le VIH a l’ONG WALE de Segou. Methodes et materiels Notre etude, descriptive, transversale et pilote avec un recueil prospectif des donnees s’est deroulee du 1er Octobre 2009 au 31 Mars 2010 a l’ONG WALE de Segou et a porte sur trente six (36) enfants. Resultats L’âge moyen de l’echantillon etait de 5 ± 3,3 ans avec des extremes de 2 ans et 14 ans. Le sexe ratio etait de 1,1 en faveur des garcons. Au cours des 6 mois 93,3 % des enfants etaient bon observant avec des taux variant de 88,9%, 97,2%, 94,4%, 91,7% et 91,7% respectivement de T0 a M6. Les causes d’inobservance les plus frequentes etaient: le refus de l’enfant, l’oubli, l’indisponibilite de la personne qui a la garde de l’enfant et les effets indesirables (vomissement, nausee). Les types d’inobservance les plus representes etaient les prises manquees et le non respect de la dose. Nous avions observe que 30,6% des enfants avaient presente au moins un effet secondaire durant notre etude. Le schema therapeutique ayant presente le plus d’effet secondaire dans notre etude est (AZT/3TC/NVP) avec 34,3%. Les patients sous le protocole 2INTI+1INNTI etaient les plus nombreux avec 94,4%, le protocole therapeutique etait reste inchange chez 94,4% des enfants. L’echec therapeutique a ete l’unique motif de changement de protocole. 33,3% des personnes ayant la garde des enfants exprimaient des difficultes. Le taux de bonne observance de 92% des moins de 7 ans etait superieur aux 90,90% des plus de 7 ans. Conclusion Le taux d’observance therapeutique aux ARV chez l’enfant a l’ONG WALE est encourageant.ces resultats sont le benefice de l’education therapeutique.