Objectif : Le but de cette étude était de décrire les aspects épidémiologiques et étiologiques du CHC. Méthodologie : Il s’agit d’une étude descriptive rétrospective de patients atteints de CHC vus à l’unité d’hépato-gastro-entérologie du Centre de Santé de Référence (CS Réf) de Koutiala entre Janvier 2017 et Décembre 2019. Résultats : 52 cas ont répondu à nos critères d’inclusion sur 1020 dossiers des patients hospitalisés et vus en consultation soit une fréquence de 5,09 %. Les patients se répartissaient en 40 hommes (77%) et 12 femmes (23%) soit un sex-ratio de 3,33. L’âge des malades variait entre 22 et 89 ans avec une moyenne d’âge de 50,96 ans±12,50 ans. La majorité des patients appartenait à la tranche d’âge 40-49 ans.Les motifs de consultation les plus fréquents étaient la douleur de l’hypochondre droit (17,30 %), l’ascite (15,40%) et l’hépatomégalie douloureuse (15,40%). L’antigène HBs était présent chez 29 patients (55,70%), les anticorps anti-VHC étaient positifs chez 6 patients (11,53%) et 5 patients (9,60%) étaient positifs à la fois pour l’Ag HBs et les Ac anti VHC. Quatre patients (7,70%) avaient une ingestion importante d’alcool et chez 8 patients (15,40%), l’étiologie était indéterminée. Le dosage de l’alpha fœtoprotéine (AFP) était supérieur à 400UI/ml chez 60 % des patients.L’aspect morphologique des tumeurs multi nodules à prédominance hétérogène ont été retrouvédans 50% des cas à l’échographie abdominale. Conclusion : Dans notre étude, le CHC a été retrouvé principalement chez les patients de sexe masculin dans la tranche d’âge de 40 à 49 ans. L’hépatite virale, en particulier le VHB, est le facteur étiologique le plus important du CHC chez nos patients. Mots-clés : Aspects épidémiologiques, étiologiques, carcinome hépato-cellulaire, centre de santé de référence Koutiala

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

Digestive hemorrhage by rupture of esophageal Varices is common and has a pejorative prognosis in our context. Purpose: The main purpose of this work was to study the digestive bleeding by esophageal varices and prognosis value of blood transfusion in the Hospital of Gabriel Touré. Methodology: It was a prospective study that took place in the service of Hepato-gastroenterology of Gabriel Touré Hospital from June 2016 to May 2017 and from November 2017 to August 2018. Results: At the end of the study, 77 patients met the inclusion criteria out of 1396 patients hospitalized during the same period. Varices bleeding represented a prevalence of 5.5% among hospitalized patients during the same period. The average age of our patients was 46.58 ± 15.09 years. The male sex was more reported in our study with a prevalence of 67.5%. At admission, 63.2% had clinical anemia, 58.4% low arterial pressure and 50.6% hemoglobin rate less than 7 g/dL. Blood transfusion was indicated in 47 patients (61%). The mortality rate was 23.4% and was comparable in both groups (p = 0.0990). Early rebleeding was significantly observed in the case of transfusion (p = 0.0452). Hepatic encephalopathy was the leading cause of death of our patients with 72.2%. Conclusion: Digestive bleeding by esophageal varices is a worsen complication in cirrhosis in hospital setting. Transfusion has not significantly improved the prognosis of our patients.

Justification: Heart failure (HF) is the evolutionary end of all cardiac diseases. Given the aging population, the rate of incidence is increasing among the elderly. Objectives: The study aims to determine the prevalence of heart failure in the elderly; to describe the clinical aspects; describe etiologies; describe the therapeutic aspects; and describe the evolution of heart failure among the elderly. Method: This was a retrospective study over five years on the operating records of patients hospitalized in the internal medicine department of Hospital Point G. Result: The study included records of 22 elderly patients who were with heart failure of a total of 595 patients hospitalized from 1st January 2008 to 31st December 2012. The prevalence rate was 3.7%, and the average age was 67 ± 7.79 years. The sex ratio was equal to 1. HTA accounted for the cardiovascular risk factors in 77.3%. 72.7% of patients had the symptom of dyspnea and 95.5% of patients had the symptom of IMO. According to the cardiac ultrasound, dilation of the OG represented 68.2% of cases, followed by impaired LVEF (63.6%). The etiologies of IC were represented by dilated cardiomyopathy (95.5%), followed by 13.6% in cardiothyreosis. Drug treatment was dominated by the use of diuretics, ACE inhibitors and sodium diet respectively 95.5%; 81.8% and 45.5% of cases. The clinical outcome was favorable in 73%. We recorded four (4) cases of death, which accounted for 18% of patients.

INTRODUCTION:Metastatsic tumoral ascites are characterised by the presence of cancerous cells in peritoneal fluid. They are frequent at an advanced stage of cancer. The goal of our work was to study cytology's contribution in the diagnosis of metastatic ascites at the teaching hospital of Point G.MATERIAL AND METHODS:It was a 3 years retrospective and prospective study, from January 2013 to December 2015. The study included every ascitic samples containing malignant cells at the teaching hospital of Point G. We looked for clinical informations in the patient's fold to find the primary cancer site, the histological diagnosis and the folllowup.RESULTS:We collected data from 213 patients with ascite. Among them, 61 where malignant (28.6 %). Sixty-six percent (66%) of our patients were women. The most represented range age was from 46 to 60 years with a mean of 57.7 years. Housewives were the most frequent among our patients with a rate of 50.8%. Ovarian cancer was the first site with metastatic ascite (26%). It was followed by liver and stomach with respectively 20% and 18%. Ascite was the first clinical manifestation in 36% patients with cancer. It was isolated in 78%. After 6 months, the mortality rate was 76.6%.CONCLUSION:The cytology of ascite liquid is an imortant test for the diagnostic of metastatic ascites.

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.

UNLABELLED:The aim of this study was to analyze digestive hemorrhage by oesophageal varicose vein bleeding, were pharmacological and endoscopic treatments suitable are not available.PATIENTS:This prospective study related to 50 patients admitted for oesophageal varicose vein bleeding in the service of hepato-gastro-enterology of the hospital Gabriel Touré (MALI), from June 2003 to December 2005.METHODS:The patients underwent clinical examination and upper digestive endoscopy to appreciate oesophageal varicose vein and marks of bleeding. Some biological examinations (haemoglobin, hematocrit, prothrombin time) were carried out in emergency to appreciate systemic repercussion of the haemorrhage.RESULTS:Our results showed that by oesophageal varicose vein bleeding represented 2.5% of the hospitalizations during the period of study.The average age of the patients was 37 years with, a sex ratio of 6.1% in favour of men. Antecedent of jaundice was frequently found (54%). The main cause of the varicose vein was cirrhosis. Mortality was 48%. The prognosis was not significantly improved by blood transfusion.CONCLUSION:At the end of this study, the stress must be laid on the HBV prevention because HBV is the main cause of chronic liver diseases.