The aim of the work was to describe the epidemiological, clinical and therapeutic aspects of digestive surgical emergencies. Patients and method: the study was retrospective, and descriptive from January 2017 to December 2022.It was carried out in the general surgery department of the Sikasso hospital (Mali). Have been included patients received and cared for digestive surgical emergencies. The parameters studied were: frequency, age, sex, clinical aspects, treatment, and postoperative outcomes. Results: We listed 600 files that represented 44.8% of operated patients. The average age was 27.5 years. There was a predominance of men with a sex ratio of 2.3 at risk for men. One third of patients were admitted within 48 hours. Abdominal pain was the main symptom of the reasons for consultation, i.e. 90%. Plain abdominal X-ray found pneumoperitoneum in 24.3% of patients, and a fluid-air level in 20.8% of patients. Abdominal ultrasound showed thickening of the appendicular wall in 34.9% of patients, peritoneal effusion in 36.9% of patients, intussusception in 2.7% of patients, thickening of the gallbladder wall in 2.5%. The most common etiologies were acute peritonitis in 223 patients, acute intestinal obstruction in 141 patients, acute appendicitis in 128 patients. Appendectomy with or without burial, appendectomy plus peritoneal toilet, suture of the perforation, stoma, resection anastomosis, splenectomy were the surgical procedures performed. The postoperative course was simple in 93% of patients. Parietal suppuration was the most common complication in 5.5%. Mortality was 2.3%. Conclusion: Digestive surgical emergencies occupy an important place in surgery due to their high frequency. The etiologies are multiple. Delay in management increases the risk of complications occurring.

Objectives: The aim of this work was to determine the frequency of burns in adults and children, to describe the clinical and para-clinical aspects of burns and to analyze the results of treatment. Patient and Method: Retrospective and prospective study, January 1, 2014 to December 31, 2018, included all patients with severe burns admitted to the surgery department who had sometimes stayed in intensive care. Results: We collected 42 patients, the average age was 11.09 years with a standard deviation = 16.09 and extremes of 1 and 85 years, the sex ratio was 2.5 at the risk of men. 83.33% of patients came from an urban area. 90.48% were burned at home, thermal burn accounted for 92.86% and hot liquid was involved in 61.54%. 35.71% of patients were burned During the cold period (December). The upper limbs were affected in 76.19%. 20 patients (51.80%) had a burned body surface area greater than 10%. The superficial second degree was observed in 30 patients (71.43%). 26 patients (61.96%) had a standard burn unit less than 50%. 4 patients (9.52%) presented with ocular damage. Electrolyte disorders were observed in 6 patients (14.29%) on admission. The swab was taken from 14 patients (33.33%) and Escherichia coli was isolated from 3 patients (21.42%). All germs were sensitive to Imipenem; Amikacin; Fosfomycin. We adopted the PARK LAND formula for rehydration in 25 cases (59.53%). Within 24 hours all patients had received vascular filling, analgesic, dressing, anti-tetanus serum and 38 patients (90.48%) had undergone excision of the blisters. The Paracetamol+Tramadol combination was the analgesic observed in 24 patients. The combination of amoxicillin + clavulanic acid was used in 22 patients. The average length of hospitalization was 15 days with extremes of 3 to 35 days. The most common complication was local infection. The after-effects were brittleness (4 cases), keloids (3 cases). The death rate was 14.29% (6 patients).

Introduction: The purpose of this study was to conduct an analysis of the diagnostic and therapeutic aspects of prostate abscess and a review of the literature. Clinical Observation: We report the case of a 24-year-old patient; admitted to our ward for acute detention associated with a febrile state at (38°C). On physical examination, the digital rectal examination could not assess the condition of the prostate due to severe pain and the rest of the examination was unremarkable. We formulated the following diagnostic hypotheses: prostate abscess, prostate cyst, acute prostatitis. Ultrasound allowed the diagnosis of a prostatic intraparenchymal cyst. The CBC reveals hyperleukocytosis and the ECBU came back positive for Escherichia coli. The diagnosis of a prostate abscess was retained after a guided echo puncture. Treatment consisted of transperineal drainage combined with antibiotic therapy suitable for ECB of pus aspirated during ultrasound-guided puncture. The evolution was favourable. Conclusion: Prostatic abscess is a rare pathology. Faced with a prostate collection in a febrile context, a puncture under ultrasound guidance could confirm the diagnosis. His treatment of choice remains endoscopic drainage and adapted antibiotic therapy.

In our surgical practice we have experienced abdominal trauma by stretcher. The case we are reporting to you was a 65-year-old subject who was the victim of a motor-cart type traffic accident with piercing of the abdomen. by stretcher and taken to Sikasso hospital. A laparotomy made it possible to discover mesenteric contusions, hemoperitoneum without visceral lesion. We aspirated 200ml of hemoperitoneum after extraction of the stretcher, closure of the abdominal wall. We propose to review the literature in order to discuss the therapeutic modalities.

Adnexal torsion is a spontaneous rotation of the ovary and sometimes the fallopian tube around its axis which can interfere with arterial supply and lead to ischemia It is a rare complication of an ovarian cyst, which can occur at any age, from the fetal period to adulthood. The mature cystic teratoma accounts for 20% of all ovarian tumors and is seen especially in young girls and therefore is most often benign. It's a surgical emergency. We report here two cases of adnexal torsion operated at the level of the pediatric surgery unit of the Hospital of Mali The two girls are 14 and 13 years old, nulligest and normoregulated with recurrent abdominal pain admitted for acute pelvic pain. On palpation, an abdomino-pelvic mass of a firm and painful consistency is noted. An abdominopelvic ultrasound was performed in both cases and revealed torsion of the left adnexa on the left ovarian cyst in the first and on the right in the second. The surgical procedure performed was manual detorsion and cystectomy in both cases. The anatomopathological examination concluded with a dermoid cyst In the two girls and their postoperative course was simple.

Blunt abdominal trauma being one of the most common abdominal emergencies; they explain the patient's indication of armed expectation in the absence of any notion of hemodynamic instability. The objectives were to determine the hospital frequency, to identify the etiologies and to analyze the therapeutic modalities. The study was retrospective and prospective from January 1, 2010 to December 31, 2018 involving 45 patients treated for hemoperitoneum in the general surgery department of Sikasso hospital. All patients admitted to the department for blunt abdominal trauma with hemoperitoneum were included. We collected 45 patients whose mean age was 18.7 years (extreme 3 - 55 years). The sex ratio was 4.6 in favor of men (37 M, 8 F). We found 23 (51.12%) cases of AVP, 13 (28.89%) cases of falls from a height, 11 (7.7%) cases of aggression, hoof kick 1 (2.22%). 19 (42.22%) patients had low haemoperitoneum, 16 (35.56%) medium abundance, 10 (22.22%) high abundance. 32 (71.11%) provided non-operative treatment with a mean hospital stay of 13.7 days (range 5 to 20). 1 patient was unstable, it was activated 24 hours later. We immediately had 12 patients (26.67%) with an average hospital stay of 16.5 days (extreme 10 -24) and the postoperative course was simple in 66.67% (8 cases). We recorded 1 death (2.22%).

Introduction: Lipoma is a benign tumor consisting of fat. This is a fairly common pathology that affects men and women alike, more rarely children. It can occur at any age but remains more common after 40 years. It is called giant when its size exceeds 10 cm or it weighs more than 1000g. The giant lipoma can be a source of physical and aesthetic inconvenience, which can cause many complexes. We report a case of giant lipoma of the anterior aspect of the left thigh. Patient and observation: This was a 72-year-old patient with no known pathological history who consulted for a tumor of the left thigh evolving since22 years old. The tumor was bulky, unsightly with signs of compression leading to functional impotence of the limb. A computed tomography of the left thigh was suggestive of a bulky remodeled lipoma. The standard biological assessment was normal. Total excision of the tumor to a healthy zone was performed. The weight of the operating piece was 12 kilograms. The anatomo-pathological examination of the surgical specimen concluded to a fibrolipoma of the thigh. The postoperative course was simple. Conclusion: The giant lipoma is a benign pathology that can be a source of physical and aesthetic inconvenience. Treatment is essentially surgical excision.

Posterior urethral valves (UPVs) are congenital obstructive membranous folds that represent the main cause of bilateral renal obstruction and dysuria in children and infants. The seriousness of this malformative uropathy lies in the importance of its impact on the upper urinary tract with a significant risk of end-stage renal failure. The objective of this work is to report our experience on the management of this pathology, for this we carried out a retrospective and descriptive study over a period of 5 years, from January 2018 to December 2022, including all hospitalized patients or seen in consultation at the pediatric surgery unit of Hôpital du Mal. The parameters studied were demographic, clinical, radiological and therapeutic variables. We collected 10 patients, an average of 2 patients per year and a frequency of 0.38%. The infant age group was the most represented, i.e. 80% of cases. The average age of our patients was 9.1 months with extremes of 2 days and 48 months. The most common reason for consultation was dysuria with 60% of cases. Overflow urination was the most frequent functional sign. Fever was present in 90% of cases. Abdominal distension was present in nearly half of our patients and acute urinary retention in 30% of cases. All our patients underwent cytobacteriological examination of urine. It was positive in 4 patients, i.e. 40% of cases. THE. Coli was the majority germ. All our patients performed retrograde urethrocystography (UCR) and objectified a dilation of the posterior urethra in all patients. Surgical treatment concerned all our patients. The FOGARTHY technique was used in 9 patients and a vesicostomy was performed in one patient. In the immediate therapeutic follow-up, 1 patient died in intensive care, 3 patients presented with sepsis, one of whom subsequently died. After an 8-month follow-up, the consequences are simple in all our patients.

Strangulation of the penis by a metal ring is a rare situation in urology. It requires emergency care because it can jeopardize the functional prognosis of the penis. We report the case of strangulation of the penis by a metal steel ring associated with a right inguino-scrotal hernia from which we will present the non-surgical management of this urological emergency.

We report the case of a 42-year-old housewife patient whowasadmitted for impairedrenalfunction at 1246 μmmol/l with a clearance of 3.07ml/min/1.73m2, with the aim of to show a rare case of adynamicosteopathy with review of the literature. The clinical examination on admission hadfound a patient altered, impotent, pain in bothlowerlimbs, dehydrated, pale, BP=170/90mmhg, temperature at 36°7, heart rate at 100bts/min. Biologically:anemiawasfound at 7.2 g/dl. Hyperleukocytosis at 15400/mm3. Creatininewas 1246 µmol/l, urea 49mmol/l, uricacid 850umol/l, parathormone 58.4 pg/l and vitamin D 16 ng/l. The reprovedcalcemiawas at 2.73 mmol/l, the phosphorus at 2.69 mmol/l, the bicarbonateemia at 13 mmol/l. Blood sugarwas 6.1mmol/l, ferritinemia 1800 ng/ml, Na+=137mmol/l, K+=4.3 mmol/l, Cl-=106 mmol/l, proteinuria 6.8g/24 hours ,leucocyturia at 40000/mm3, withouthaematuria, an E.coliurinary tract infection whichwas sensitive to ciprofloxacin. Our patient had a heterozygous AC sickle cell profile, and wascarrying an evolving single-fetalpregnancy of 15 weeks +5 days on ultrasound. On the cerebral scanner, wefound a semi-recentischemic stroke in the deepterritory of the left middle cerebralartery. The patient alsounderwent five hemodialysis sessions. A biological control aftertwomonths of treatment hadfoundserumcreatinine at 212 µmol/l, urea at 40.3 mmol/l, sodium at 132.9 mmol/l, serum potassium at 5.2 mmol/, bloodchloride at 91.6 mmol/l, Magnesium at 1.1mmol/l, serum calcium=3.1mmol/l, CRP at 21mg/l, White Blood Cells at 1200/mm3, Hemoglobinlevel at 6.6 g/dl. The VS was at 90-100 mm.Urinary volume at 680ml. Adynamic osteopathyis a rare and fatal pathologythatrequiresearly treatment.

Summary: Introduction: Knowledge of the birth cycle is important in the organization of reproductive health services in a facility. The main objective was to study the determinants of the birth cycle at the Kalaban-Coro health center. However, it seems that there are other determinants of the birth cycle, hence the relevance of this study. Material and methods: This was a cross-sectional analytical study from October 1 to December 31, 2020. Results: The study included 977 parturients who gave birth in the department. It recorded more night deliveries (59.1%) than day deliveries (40.9%). The average age of the women was 25 years. Non-educated births were the most represented with 39% of cases. Nocturnal admissions were predominant (58.8%); 59% of parturients had a history of nocturnal delivery and 40% preferred to give birth at night, while 30% had no preference. At admission, 57.91% of parturients were in the active phase during the night, compared to 42.59% during the day; 52.6% of parturients had a nocturnal onset of labor, compared to 47.4% during the day. Conclusion: The study showed that childbirth is more frequent at night than during the day. It highlighted the admission nycthemer, the previous nycthemer of deliveries and the preference of the parturient as other determinants of the nycthemer of the delivery.

It was a one month old female infant. He was sent to us on 03/22/2019 at the radiology department of Mopti’s hospital for a cervical ultrasound in the assessment of a cervical swelling observed by his mother a few days after his birth with a slight inclination of his head. Ultrasound exploration revealed a fusiform thickening of the left sternocleidomastoid muscle (SCM) with respect for its fibrillar appearance without other abnormalities. The diagnosis of fibromatosis colli of the left SCM muscle was retained. Fibromatosis colli is relatively rare in our environment. Complementary ultrasound at the clinic allows it diagnosis. The typical ultrasound image is the fusiform thickening of the sternocleidomastoid muscle with preservation of its fibrillar appearance. Ultrasound can also rule out other causes of cervical swelling in children.

We report a case of a left para-duodenal internal hernia in order to describe the role of a CT scan in its diagnosis. It was a 19-year-old boy with no known personal medical history. He was received at “The stars clinic’’ in Bamako (Mali) on 01/15/2020 for an abdominal CT scan for the assessment of diffuse abdominal pain on mass on palpation. The CT scan revealed agglutination of the small intestinal loops with its mesentery and its mesenteric vessels in the left paramedian location without complications. Faced with this semiological CT scan, the diagnosis of a left para-duodenal internal hernia was retained. Surgical management confirmed this diagnosis. Since the clinical diagnosis of an internal hernia is often unrecognized, cross-sectional imaging methods with multiplanar reformatting, in particular CT scan, remain essential in the management of this pathology.

Objective: To determine the X-ray, ultrasound, and epidemiological profile of the victims of the attacks of March and April 2019 received at the Mopti hospital. Materials and Methods: This was a cross-sectional study of the victims of the armed attacks of March and April 2019 received at Mopti hospital. The study included all stroke victims who had an x-ray or ultrasound during this time. The variables were the socio-demographic profile, the etiological mechanism, the imaging means and their results. Data analysis was done with SPSS version 25 and Excel 2016 software. Results: The most common age group was 15-29 years old at 35.4%. Men predominated with 66.7%. Civilians were more affected, 83.3%. Firearms accounted for 93.8% of the etiologies. The x-ray was no longer performed, ie 66.7%. The lower limbs were more affected with 31.8%. Fractures of the limbs and the presence of bullets were anomalies most frequent with 25% each one. Conclusion: The majority of the injured were predominantly young and male civilians. Firearms were the most common etiology with predominant involvement in the lower extremities. Radiography was the most used imaging method, and the most common abnormalities were fractures and the presence of ballistic fragments. Gastrointestinal perforation was the most suspected lesion on ultrasound.

We report a case of intrauterine device (IUD) migration in order to describe the contribution of imaging in its diagnosis. It was a 35-year-old woman received on 06/01/2018 for pelvic ultrasound for pelvic pain. Ultrasound examination revealed a hyperechoic right para-uterine tubular image. A hysterosalpingography revealed an IUD in the pelvis in extra-urine position. Surgical extraction was done without complications. Intrauterine device migration is rare in our context. The radiological means make it possible to specify its topography.

Les traumatismes de l´os temporal concernent 14 à 22% des fractures du crâne survenant dans le cadre du traumatisme crânien. Le but de notre étude est de connaitre l´apport du scanner hélicoïdal dans le traumatisme du rocher et illustrer les types de fractures et les lésions associées. C´était une étude rétrospective portant sur 12 cas de traumatisme des rochers dont 10 hommes et 2 femmes sur une période de 14 mois. La moyenne d´âge était de 30 ans, avec un extrême allant de 18 à 42 ans. Le scanner des rochers multicoupes haute résolution sans injection de produit de contraste (PDC), avec des coupes infra-millimétriques de 0,6mm tous les 0,3mm a permis de retrouver les fractures suivantes: 8 cas de fracture transversale extra-labyrinthique; 1 cas de fracture longitudinale extra-labyrinthique; 2 cas de fracture trans-labyrinthique et 1 cas de fracture oblique. Les lésions associées sont dominées par: 5 cas de de lésions ossiculaires; 4 cas d´atteinte de l´os temporal et 2 cas d´atteinte du ganglion géniculé. La tomodensitométrie de haute résolution permet d'affirmer l'existence de la fracture, de décrire l'orientation du trait et de préciser les différentes structures atteintes. Elle peut être réalisée dans l´urgence ou à distance de l´urgence.

INTRODUCTION:Surgical site infections (SSI) are frequent and dangerous in the surgical ward. They represent an obsession for the surgeon. The objectives were to determine the frequency of ISOs and risk factors, to identify the germs and to study their sensitivity to different antibiotics.MATERIALS AND METHODS:This was a cross-sectional study with prospective data collection, performed at the general surgery department of the Bocar Sidy Sall University Hospital Center (Kati CHU) from January 2015 to December 2018.RESULTS:During this period of study we recorded 55 cases of ISO out of 650 operated patients with a frequency of 8.46%. 450 patients were operated on the cold operating program (69.23%) and 200 patients on emergency (30.77%). The average age was 39, the sex ratio was 2.66. Among the 55 cases of ISO, 60% of these patients were operated in emergency and 40% in the operating program. The most common strains found were Escherichia coli (E. coli) in 38.3% of cases, Staphylococcus aureus in 23.4% and Klebsiella pneumonia in 13.3%. Hemoglobin levels were normal in 70% of cases. 4 of our patients or 7.27% were diabetic. We did not have any cases of obesity. Of the 55 cases of ISO, 66% were of class 3 and 4 of Altemeier, 59% were of ASA score 2 and ASA 3, 55% were of score 2 of NNISS (National Nosocomial Infection Surveillance System), 5.45% were NNISS score 3 or 3 cases and these 3 cases developed ISO. The ISOs were parietal in 49 cases, ie 89%. The recovered germs were 100% sensitive to imipenem. The most informative interventions of the ISOs were peritonitis 25 cases (45.45%), intestinal occlusions 12 cases (21.82%), appendicular abscess 8 cases (14.55%). We had 2 death cases, 3.64%, the average hospital stay was 13 days.CONCLUSION:Escherichia coli was the common germ found in the ISO in general surgery at Kati BSS Hospital. The usual resistance to antibiotics must provoke effective preventive actions.