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.

The aim of the study was to study the clinical and therapeutic aspects of injuries secondary to trauma to the external genitalia. This was a prospective and descriptive study of 18 patients with trauma to the external genitalia admitted and operated on at the urology department of the Fousseyni DAOU hospital in Kayes from June 2015 to November 2020. The average age of the patients was 17 years with extremes of 10 and 62 years. 3 clinical forms have been studied (coital missteps, accidental trauma to the penis and trauma to the purses). Coital missteps affected 38.8% of patients (7 cases). The average age of the patients was 48 years with extremes of 29 years and 62 years. These were consensual, heterosexual relationships. The main reason for consultation was Cracking accompanied by pain and swelling of the penis. We had collected 9 cases of open bursa trauma, i.e. 50% of patients. The average age of the patients was 18 years with extremes of 10 and 28 years. The reasons for consultation were pain, open wound in the scrotum, bleeding. Associated lesions were urethral rupture in 3 cases, rupture of the vas deferens in 1 case, leg fracture in 1 case and loss of skin substance. Penile trauma after road accident was 2 cases (11.11%). They most often occur in the context of war or psychiatric illness. Repair of trauma to the external genitalia accounted for 0.63% of our surgical activities.

Priapism is a painful and pathological erection caused by various abnormalities in erectile hemodynamics [1]. There are several aetiologies of which the common long-term risk is to cause sequelae erectile dysfunction in 50 to 60% [1, 2, 3]. In Mali, the main cause of priapism is sickle cell anemia. Our objective is to study the socio-demographic, clinical and therapeutic aspects of priapism at the Fousseyni Daou hospital in Kayes. This was a cross-sectional and descriptive study involving a series of 21 patients. It lasted 56 months (April 2016 to February 2020); performed in the urology department of the Fousseyni DAOU hospital in Kayes. The inclusion criteria for the study were: records of patients who presented with priapism during the study period. Records of patients with intermittent priapism were excluded. Treatment consisted of a transglandular caverno-cancellous shunt type Ebbehoj to local anesthesia associated with drug treatment. The main reasons for seeing patients are pain and being in a state of priapism. The age group of 8 to 20 years was 52% and 71.4% of our patients presented sickle cell traits including SS phenotype: 19%, SC: 19% and AS phenotype: 33.3%. 42.9% of our patients presented a lack of erection after an episode of priapism. Delays of more than a week were observed in 3 patients. Prevention of these priapisms involves regular monitoring of sickle cell patients.

Case Report Definition: Sacrococcygeal teratoma is a rare disease that most commonly occurs in female children. It is a most often benign tumor detectable before birth and occurs in only one in every 35,000-4,000 newborns. Objective: To describe the diagnostic and therapeutic epidemiological aspects of sacrococcygeal teratoma in newborns. Methodology: Retrospective descriptive study of three cases carried out in the pediatric surgery department of the Fousseyni Dao Hospital in Kayes from January 2014 to December 2020. Results: Extreme ages from 02 to 06 days, all male. The mothers were unschooled housewives and did not perform any antenatal consultations. The three parturients gave birth by caesarean section. The tumor mass was the main reason for consultation. On clinical examination the three teratomas were classified as type 1 according to Altmann. The ultrasound performed showed a heterogeneous retrosacral mass. The surgery was a monobloc resection of the tumor. The postoperative consequences were straightforward after a 10-day hospital stay and follow-up was done on an outpatient basis. Pathological examination of the two surgical specimens revealed a mature teratoma, while this examination was impossible in the third newborn for lack of means. Conclusion: Rare tumor in the Kayes region and the course depends on adequate management.

The purpose of this work was to evaluate the results of three campaigns to support women victims of obstetric or non-obstetric fistulas. This is a retrospective and descriptive study of a series of 58 patients operated on during three campaigns for the management of urogenital and rectovaginal fistulas (February 2016, January 2017 and June 2021). All women with urogenital or rectovaginal fistula after questioning and physical examination were included. Fistula concerned 94.8% of housewives. At the time of diagnosis, 41.4% of our fistula patients were between 11 and 25 years old, with an age at first marriage of 11 to 20 years in 94.8%. Married women accounted for 79.3%. The births took place in 41.4% at home and were spontaneous in 55.2%. The repair techniques used were fistulorrhaphy by low or high way in 91.4%. The healing rate of closed and dried fistula was 62.1%.

Crossed renal ectopia is a rare congenital anomaly, it was described by WILMER in 1938 [1], implies that one of the two kidneys sits on the contralateral side, the ureter of the ectopic kidney crosses the midline to meet in the bladder on the opposite side, the existence of a parenchymal fusion is frequent (85 to 90%). This anomaly is most often asymptomatic and discovered incidentally. We report the observation of a 21-year-old woman with a G1P1V1A0 obstetrical history (ATCD), presenting cross renal ectopia discovered fortuitously following pain in the right flank associated with palpation of an abdominal mass and to review the literature.

Introduction: A disease characterized by the protrusion of part of the intestine through the abdominal muscles at the level of the navel. Many infants are born with umbilical hernia especially in Africa. Materials and Methods: We conducted a retrospective study from January 2018 to December 2020. The objectives were to determine the hospital frequency of umbilical hernia at the regional hospital of Kayes, to describe the clinical and para-clinical aspects and finally to describe the immediate aftermath of surgical treatment. Results: During the period Janvier 2018 Décembre 2020, we consulted 1108 pediatric surgery patients and performed 805 surgical procedures including 76 umbilical hernias. The umbilical hernia has re present 9 .5% of all surgical procedures, 25% of hernias in children 8.3% of hospitalizations and a hospital frequency of 6.8%. The age group of 3 to 6 years was the most represented with 40.3%, the male sex was the most represented with 59%. Conclusion: Umbilical hernia is a frequent pathology, especially in Africa, whose diagnosis is clinical.

Ritual circumcision has been practiced for cultural and religious reasons since antiquity in Egypt, then in Judaism and the Muslim world. The rite is also in use among certain Christian communities (especially in the East). In Mali the practice of circumcision is cultural and religious. In our current practices, complications related to this act are not frequent. We report here two cases of complications related to the act of circumcision received at the regional hospital center "Fousseyni DAOU hospital in Kayes". These were aesthetic and infectious complications. The treatment was urethroplasty according to DUPAY and necrosectomy with controlled healing followed by scrotal plasty and removal of the penis. In Mali, circumcision is ritual. It exposes when it is practiced outside health structures or by unqualified personnel to sometimes formidable complications.

The aim was to study the epidemiological, clinical, paraclinical and therapeutic aspects of obstructive urinary calculi of the urinary tract. This was a prospective and descriptive study of 111 patients admitted to the urology department over a period of 6 years (January 2016 to December 2021). All patients with obstructive (symptomatic) urinary stones over 1.5 cm in diameter were included. Treatment results were analyzed 6 months later. Surgery for urolithiasis represented 4.10% of the interventions performed over the study period. The average age of the patients was 41 years old, with extremes of 1 and 81 years old. The age group 21 to 30 years was predominant, i.e. 24.3% of cases. The M/F sex ratio was 2.26. Renal colic was the main reason for consultation, i.e. 72.1%. Staphylococci, E. coli and Enterococci were respectively 22.5%; 21.6% and 12.6%. The operative technique used was open surgery. The postoperative course was simple in 92.8% and complicated in 7.2%.

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.

RESUMEIntroduction. L’appendicite aigue occupe une place importante dans les urgences chirurgicales digestives. L’objectif de notre etude etait de decrire les aspects epidemiologiques, cliniques et therapeutiques des appendicites aigues a l’hopital Fousseyni Daou de Kayes. Methodologie. Il s'agissait d'une etude prospective qui s'est deroulee de Decembre 2017 a Decembre 2018 inclus, ayant porte sur des patients souffrant d'une appendicite aigue dans le service de chirurgie generale de l'Hopital Fousseyni Daou de Kayes. Resultats. Au cours de la periode d’etude, 105 malades ont ete operes pour appendicite aigue dont 78 hommes et 30 femmes soit un sex- ratio de 1,6. L’âge moyen etait 26,92 avec des extremes de 8 et 60 ans. La douleur abdominale a ete le principal motif de consultation. Les signes physiques etaient domines par la positivite du signe de Blumberg dans 98,09% des cas, la defense de la fosse iliaque droite dans 97,14%, le signe Rovsing dans 96,19 % des cas, le Psoitis dans 39,04 % et la douleur a droite dans le cul de sac de Douglas dans 79,04%. Cet examen physique a permis de poser le diagnostic dans la majorite des cas. Nous avons demande une echographie abdominale dans . L’anesthesie generale etait la technique d’anesthesie la plus utilisee soit 95,23%. L’appendicectomie classique avec enfouissement par Mac Burney a ete la technique la plus utilisee. Les suites operatoires ont ete simples dans 98,1% des cas. Conclusion. L’appendicite reste l’urgence chirurgicale la plus frequente en milieu communautaire. Le diagnostic est essentiellement clinique. Le traitement est essentiellement chirurgical. La precocite du diagnostic et la rapidite de la prise en charge sont gages d’un bon pronostic. ABSTRACTIntroduction. Acute appendicitis occupies an important place in digestive surgical emergencies. The objective of our study was to describe the epidemiology, clinical features and management of acute appendicitis at the Fousseyni Daou Hospital in Kayes. Methods. This was a cross sectional prospective study that took place from December 2017 to December 2018 inclusive. It concerned patients with acute generalized appendicitis in the general surgery department of the Fousseyni DAOU Hospital in Kayes. Results. During the study period, 105 patients were operated on for acute appendicitis, including 78 men and 30 women , giving a sex ratio of 1.6. The mean age of patients was 26.92 with extremes of 8 and 60. Abdominal pain was the main reason for consultation. The leading physical signs were positivity of the Blumberg sign in 98.09% of the cases, defense of the right iliac fossa in 97.14%, Rovsing sign in 96.19% of the cases, psoitis in 39.04 % and pain on the right in Douglas's fornix in 79.04%. Physical examination was sufficient for the diagnosis in the majority of cases. In some doubtful cases, an abdominal ultrasound was required. General anesthesia was the most widely used anesthesia modality (95.23%). Classic appendectomy with burial (Mac Burney) was the most common surgical technique. Postoperative course was uneventful in 98.1% of cases. Conclusion. Appendicitis is the most common digestive surgical emergency in our community. The diagnosis is mainly clinical. The treatment is mainly surgical. The precocity of the diagnosis and the speed of treatment guarantee a favorable prognosis.

RESUME Introduction. La pratique d’endoscopie digestive basse notamment l’anorestoscopie et surtout la coloscopie est une activite recente a Kayes. Le but de notre etude etait d’inventorier les etiologies des rectorragies au niveau des differents centres d’endoscopie de la ville de Kayes au Mali. Materiels et methodes. Il s’agissait d’une etude retrospective ayant porte sur l’analyse des comptes rendus d’endoscopie digestive basse dans les unites d’endoscopie digestive de l’hopital regional Fousseyni DAOU de Kayes et de la clinique medicale ‘’ SEWA’’ de Kayes sur une periode allant du 1er Janvier 2018 au 31 Decembre 2018. Ont ete inclus les malades des 2 sexes, âges de plus de 15 ans qui ont presente une rectorragie exploree par une anorectoscopie seule ou parfois completee par une coloscopie partielle ou totale. Resultats. Durant la periode d’etude, l’endoscopie digestive basse a ete realisee chez 367 patients dont 117 cas realises pour rectorragie soit une frequence de 31,9 %. L’âge moyen des patients etait de 44±12,7 ans avec des extremes de 22 et 83 ans. Sur les 117 patients enregistres, 85 etaient de sexe masculin (72,6%) soit un sex-ratio de 2,6. Les menageres etaient la couche sociale la plus representee (31,6%), suivies des cultivateurs (26,5%). La douleur anale (58,1%), le prurit anal (29%) et la constipation (27,3%) etaient les signes fonctionnels les plus frequemment associes a la rectorragie. La maladie hemorroidaire a ete l’etiologie la plus retrouvee (60,7%), suivie de la fissure anale (24,8%). D’autres pathologies ont ete retrouvees egalement a des proportions non negligeables comme la rectosigmoidite non specifique (16,2%), la rectocolite hemorragique (11,1%), la tumeur colorectale (9,4%), la diverticulose colique (1,7%). Dans 6% des cas, aucune cause n’a ete retrouvee. Conclusion. Les rectorragies constituent le motif de realisation d’endoscopie digestive basse le plus frequent a Kayes. La maladie hemorroidaire a ete l’etiologie la plus Frequente. La realisation de la coloscopie totale doit etre systematique chez les malades a fin de ne pas meconnaitre une pathologie colique grave. ABSTRACT Introduction. The practice of lower digestive endoscopy including anorestoscopy and especially colonoscopy is a recent activity in Kayes. The aim of our study was to determine the etiological of rectorragy in the different endoscopy centers in the town of Kayes in Mali. Methods. It was a retrospective study that focused on the analysis of reports of low digestive endoscopy in the digestive endoscopy units of the regional hospital Fousseyni DAOU of Kayes and the medical clinic ''SEWA'' of Kayes over a period from January 1, 2018 to December 31, 2018. Included were patients of both sexes, aged over 15 years who presented a rectorragy explored by anorectoscopy alone or sometimes supplemented by a partial or total colonoscopy. The data were processed using Epi info version 6 software. Results. During the study period, lower GI endoscopy was performed in 367 patients, including 117 cases performed for rectorragy, i.e. a frequency of 31.9%. The mean age of the patients was 44±12, 7 years with extremes of 22 and 83 years. Of the 117 patients registered, 85 were male (72.6%), i.e. a sex ratio of 2.6. Housewives were the most represented social stratum (31.6%), followed by farmers (26.5%). Anal pain (58.1%), anal pruritus (29%) and constipation (27.3%) were the functional signs most frequently associated with rectorrhagia. Hemorrhoidal disease was the most common etiology (60.7%), followed by anal fissure (24.8%). Other pathologies were also found in non-negligible proportions such as non-specific rectosigmoiditis (16.2%), ulcerative colitis (11.1%), colorectal tumour (9.4%), colonic diverticulosis (1.7%). In 6% of the cases, no cause was found. Conclusion. Rectorragy are the most frequent reason for carrying out lower digestive endoscopy in Kayes. Hemorrhoidal disease has been the most common etiology. Total colonoscopy must be performed systematically in patients in order not to misunderstand a serious colonic pathology.

RESUMEIntroduction. La maladie hemorroidaire a ete peu etudiee au Mali. Notre etude, la premiere dans la region de Kayes, avait pour but de decrire les aspects cliniques et endoscopiques de la maladie hemorroidaire interne a Kayes au Mali. Materiels et methodes. Il s’agit d’une etude retrospective, menee du 1er Janvier 2018 au 31 Decembre 2018, ayant porte sur l’analyse des comptes rendus d’anorectoscopie dans les unites d’endoscopie digestive de l’hopital regional Fousseyni DAOU de Kayes et de la clinique medicale ‘’ SEWA’’ de kayes. Les donnees ont ete recueillies a partir des registres d’anorectoscopie comportant les renseignements pour chaque patient ayant la maladie hemorroidaire interne comme diagnostic retenu a l’anuscopie a savoir l’âge, le sexe, la profession, la residence, l’indication de l’endoscopie, les pathologies anorectales associees. Resultats. Durant la periode d’etude, 249 patients ont beneficie d’examen anorectoscopique dans les deux centres d’endoscopie. La maladie hemorroidaire interne a ete diagnostiquee chez 93 patients soit une frequence de 37, 34 %. L’âge moyen des patients etait de 41, 70 ans avec des extremes de 19 et 80 ans. Sur les 93 patients enregistres, 62 etaient de sexe masculin (66,6%) soit un sex-ratio de 2. Les menageres etaient la couche sociale la plus representee (30,1%). La rectorragie (62,3%) etait le signe fonctionnel le plus frequent ayant motive la realisation de l’endoscopie. Chez 38 patients soit 41,9% des cas, elle etait associee a d’autres pathologies notamment la fissure anale (50%), la thrombose hemorroidaire externe (23,7%), la fistule anale (13,1%), le condylome anal (7,9%) et la mycose inter fessiere (5,2%). La maladie hemorroidaire interne a ete classee dans la plupart des cas en en grade I (36, 6%) et en grade II (51,6 %) selon la classification de Goligher. Conclusion. La maladie hemorroidaire est une pathologie frequente a Kayes. La rectorragie constitue sa manifestation la plus frequente. Elle est souvznt associee a d’autres pathologies (fissure anale, throbose hemorraidaire externe). Dans la moitie des cas, elle de grade 2.ABSTRACTIntroduction. Few data are avalailable about hemorrhoidal disease in Mali. Our pionner study aimed to describe the clinical and endoscopic features of internal hemorrhoidal disease in Kayes, Mali. Methods. This was a cross sectional descriptive retrospective study, conducted from January 1, 2018 to December 31, 2018, which reviewed the reports of anorectoscopy in the digestive endoscopy units of the regional hospital Fousseyni DAOU of Kayes and the medical clinic ''SEWA'' of Kayes.. The data were collected from anorectoscopy registries containing information for each patient with internal hemorrhoidal disease as a diagnosis retained at anuscopy namely age, sex, profession, residence, indication for endoscopy, associated anorectal pathologies. Results. During the study period, 249 patients had anorectoscopic examinations in the two endoscopy centers. Internal hemorrhoidal disease was diagnosed in 93 patients (37.34%). The mean age of the patients was 41.70 years (range: 19 - 80 years). There were 62 male (66.6%). Housewives were the most represented social stratum (30.1%). The most common reason for endoscopy was rectorragy (62.3%). In 38 patients (41.9%), bleeding was associated to other pathologies such as anal fissure (50%), external hemorrhoidal thrombosis (23.7%), anal fistula (13.1%), anal condyloma (7.9%) and gluteal fungus (5.2%). Internal hemorrhoidal disease was classified as grade I (36.6%) or grade II (51.6%) according to Goligher's classification. Conclusion. Hemorrhoidal disease is a common occurence in Kayes. Rectorragy is the most common manifestation. Hit is ofte associated to other pathologies (anal fissure, hemoridal thrombosis). In haf of ases, it is classified Grade 2.

RESUME Objectif. Decrire la morbimortalite et la survie des cancers coliques en occlusion en fonction des techniques operatoires. Patients et methodes. Il s’agit d’une etude transversale retrospective effectuee a l’Hopital de deuxieme reference de Kayes entre janvier 2009 et decembre 2018. Nous avons inclus tous les patients operes pour cancer du colon en occlusion. Les parametres etudies etaient le siege et le stade de la tumeur, les modalites de la chirurgie, la morbidite et la mortalite et le taux de survie. Resultats. Nous avons collige 27 patients, dont 19 hommes et 8 femmes soit un sex-ratio de 2,3. Leur âge moyen etait de 60,34 ans avec des extremes (23 ans- 80 ans). La nature tumorale etait meconnue avant l’intervention dans 93% (25) des cas. La tumeur siegeait sur le colon droit dans 16 (59%) des cas et le colon gauche dans 11 cas (41%). La tumeur a ete classee stade III dans 17 cas (63%), stade II dans 8 cas (30%). La chirurgie en un temps a ete realisee dans 19 cas (70%) et la chirurgie en deux temps dans 8 cas (30%) apres une colostomie. La morbidite etait de 33% et la mortalite de 11%. Le taux de survie a 3 ans etait de 33%. A 5 ans, ce taux etait nul. Conclusion. Le cancer du colon en occlusion est une pathologie de prise en charge difficile liee a l’âge et au contexte d’urgence. Le retablissement de la continuite digestive est beaucoup moins contraignant lorsque la tumeur est sur le colon gauche ; la chirurgie en deux temps a moins de morbimortalite. ABSTRACT Objective. To describe the morbidity and mortality of colorectal cancer depending on surgical techniques. Patients and methods. This was a cross sectional retrospective study carried out at the second reference hospital of Kayes between January 2009 and December 2018. All patients operated on for colon cancer in occlusion were included our data of interest were: site and staging of the rumor, surgical modalities, morbidity and mortality, survival rate. Results: We studied 27 patients (19 men and 8 women). Their mean age was 60.34 years (extremes: 23 years - 80 years), The nature of the tumor was unknown before surgery in 25 cases. (93%). The tumor was located in the right colon in 59% (16) of cases, the left colon in 41% (11) of cases. The tumor was classified as stage III in 63% (17) of cases; stage II in 30% (8) of cases. One-stage surgery was performed in 70% (19) of the cases. Two-stage surgery was performed in 30% (8) of the cases after a colostomy. Morbidity was 33%, mortality was 11%. Survival rate at 3 years was 33%, at 5 years the survival rate was nil. Conclusion. Colon cancer in occlusion is a surgical challenge because of the old age of the patients and the emergency context. Restoration of digestive continuity is less constraining if the tumor is on the left colon; surgery in two stages has less morbimortality.

RESUME Introduction. Le but de notre etude etait de decrire les aspects cliniques et endoscopiques de la fissure anale a Kayes au Mali. Methodes. Il s’agit d’une etude transversale retrospective, menee du 1er Mars 2017 au 31 Octobre 2018. Elle a porte sur l’analyse des comptes rendus d’anorectoscopie dans les unites d’endoscopie digestive de l’Hopital regional Fousseyni DAOU de Kayes et de la clinique medicale « SEWA » de Kayes. Les donnees ont ete recueillies a partir des registres d’anorectoscopie. Les renseignements pour chaque patient ayant la fissure anale comme diagnostic retenu etaient l’âge, le sexe, la profession, la residence, l’indication et les resultats de l’endoscopie. Resultats. Durant la periode d’etude, 402 patients ont beneficie d’examen anorectoscopique. La fissure anale a ete diagnostiquee chez 134 patients soit une frequence de 33,33 %. L’âge moyen des patients etait de 36,5 ans avec des extremes de 16 et 76 ans et le sex-ratio etait de 2,6. La proctalgie (59%) et la rectorragie (38,1%) etaient les indications d’anorectoscopie les plus frequentes. En position genu-pectorale, la fissure anale etait posterieure (85, 1%), anterieure (10,4%), bipolaire (3%) et laterale (1,5%). La fissure anale chronique representait 79,1% des cas. Dans 18% des cas, la fissure anale etait associee a d’autres pathologies proctologiques. La maladie hemorroidaire a ete la pathologie la plus frequemment associee (91,7 %) des cas. Conclusion. La fissure anale atteint l’adulte jeune de sexe masculin. Son evolution est en regle chronique et la localisation posterieure. ABSTRACT Objective. To report the clinical and endoscopic features of anal fissure in Kayes City, Mali. Methods. This was a cross sectional descriptive retrospective study, conducted from March 1st, 2017 to October 31 st, 2018 in the digestive endoscopy units of the Fousseyni Daou Regional Hospital in Kayes and the SEWA Medical Clinic of Kayes. Data were collected from the anorectoscopy registers. We recruited all patients with an endoscopic diagnosis of anal fissure. Our study data were: age, sex, occupation, residency, indication of endoscopy and endoscopic findings related to the fissure. Results. During the study period, 402 patients had an anorectoscopic examination. Anal fissure was diagnosed in 134 of them (33.33%). The average age of the patients was 36.5 years (range: 16 - 76 ) and the sex ratio was 2.6. Proctalgia fugax (59%) and hematochezia (38.1%) were the most frequent indications of endoscopy. In knee-pectoral position, anal fissure was posterior (85, 1%), anterior (10.4%), bipolar (3%), and lateral (1.5%). Features of chronic fissure were present in 79.1% of cases. Associated proctologic diseases were found in 18% of patients, among which hemorrhoid disease was the most common (91.7%). Conclusion. Anal fissure affects mainly young males. The course is usually chronic and the localization is most often posterior.

RESUME Introduction. Le but de notre etude etait d’etudier les manifestations cliniques et les aspects endoscopiques de la pathologie anorectale a Kayes au Mali. Methodes. Il s’agit d’une etude retrospective, menee du 1er Mars 2017 au 31 Aout 2018, ayant porte sur l’analyse des comptes rendus d’anorectoscopie dans les unites d’endoscopie digestive de l’Hopital Regional Fousseyni DAOU de Kayes et de la clinique medicale ‘’ SEWA’’ de Kayes. Les donnees recueillies etaient l’âge, le sexe, la profession, l’indication de l’endoscopie et la lesion retenue. Les donnees ont ete traitees au moyen du logiciel Epi info version 6. Resultats. Sur les 358 patients enregistres, 252 etaient de sexe masculin (70,4%) soit un sex-ratio de 2,3. L’âge moyen de nos patients etait de 36,32 ans avec des extremes de 02 et 89 ans. Les menageres etaient la couche sociale la plus representee (24,6%), suivies des cultivateurs (19%), des commercants (14,2%) et des transporteurs (8,9%). Les indications les plus frequentes de l’endoscopie etaient la rectorragie (38,8%) et la douleur anale (31%). Les pathologies les plus retrouvees ont ete la maladie hemorroidaire (36,6%) et la fissure anale (33,5%).Conclusion. La pathologie anorectale est frequente a Kayes au Mali. La maladie hemorroidaire et la fissure anale sont les principales pathologies rencontrees. Des efforts sont necessaires pour la vulgarisation des centres d’endoscopie digestive. ABSTRACT Introduction. The aim of our study was to report the clinical manifestations and endoscopic aspects of anorectal pathology in Kayes, Mali. Methods. This was a retrospective study, conducted from 1 March 2017 to 31 August 2018, which focused on the analysis of anorectoscopic reports in the digestive endoscopy units of the Fousseyni DAO Regional Hospital in Kayes and the SEWA Medical Clinic of Kayes. Our study variables were age, sex, occupation, indication of endoscopy, and the lesion that was found. The data were processed using EPI info version 6 software. Results. Out of 358 registered patients, 252 were male (70.4%). The average age of the study population was 36.32 years with extremes of 02 and 89 years. Housewives were the most represented social group (24.6%), followed by farmers (19%), traders (14.2%) and transporters (8.9%). The most frequent indications of endoscopy were rectal bleeding (38.8%) and anal pain (31%). The most common pathologies were hemorrhoid disease (36.6%) and anus fissure (33.5%). Conclusion. Anorectal pathology is common in Kayes, Mali. Hemorrhoid disease and anus fissure are the most common pathologies. Efforts to increase the availability of digestive endoscopy center are mandatory.