-
Clinical and Histopathological Aspects of Acute Appendicitis at the Ignace Deen National Hospital of Conakry, Guinea
Naby Laye Youssouf Camara,
Saa Yawo Kondano,
Naby Fofana,
Louncény Konate,
Boubacar Barry,
Alsény Diallo,
Labilé Togba Soumaoro,
Aboubacar Toure,
Aissatou Taran Diallo
Issue:
Volume 10, Issue 3, June 2022
Pages:
101-103
Received:
13 April 2022
Accepted:
27 April 2022
Published:
12 May 2022
DOI:
10.11648/j.js.20221003.11
Downloads:
Views:
Abstract: Purpose: Acute appendicitis represents the most frequent surgical emergency in digestive surgery. The aim of this study was to describe the clinical and histological aspects of acute appendicitis at the Ignace Deen National Hospital in Conakry (Guinea). Method: This was a prospective study of a period of 6 months, from September 1 to December 31, 2020. All patients admitted and operated on in the department for acute appendicitis and whose surgical specimen was histologically examined were included in this study. Results: During the six months of the study, we collected 123 cases of acute appendicitis, i.e. 34.3% of the total surgical activity of the department. The average age of the patients was 17.50±11.30 years. The female gender was the most predominant (69%). The diagnosis was essentially clinical. Appendectomy was performed in all patients by conventional approach. Laterocacral topography was the most frequent (43.09%) followed by pelvic (26.01%). In 57.6% of cases it was a cathartic appendicitis and 9% of cases were normal appendicitis. The overall mortality was 2.44%. Conclusion: Acute appendicitis is the most common indication for emergency abdominal surgery worldwide. Its clinical diagnosis remains sometimes difficult and source of multiple controversies because of the absence of anatomical parallelism.
Abstract: Purpose: Acute appendicitis represents the most frequent surgical emergency in digestive surgery. The aim of this study was to describe the clinical and histological aspects of acute appendicitis at the Ignace Deen National Hospital in Conakry (Guinea). Method: This was a prospective study of a period of 6 months, from September 1 to December 31, 2...
Show More
-
Postoperative Peritonitis: Frequency, Clinical and Therapeutic Aspect in the General Surgery Department of the Ignace Deen National Hospital of Conakry, Guinea
Naby Laye Youssouf Camara,
Naby Fofana,
Labile Togba Soumaoro,
Saa Yawo Kondano,
Djouma Bailo Kante,
Boubacar Barry,
Alseny Diallo,
Aboubacar Toure,
Aissatou Taran Diallo
Issue:
Volume 10, Issue 3, June 2022
Pages:
104-106
Received:
13 April 2022
Accepted:
27 April 2022
Published:
12 May 2022
DOI:
10.11648/j.js.20221003.12
Downloads:
Views:
Abstract: Purpose: Postoperative peritonitis is a peritoneal infection that complicates an intraperitoneal surgical procedure within one month. The purpose of this study was to determine the frequency, describe the clinical and therapeutic aspects of postoperative peritonitis. Patients and methods: This was a prospective study of descriptive type, lasting two years (January 1, 2020 to December 31, 2021) carried out in the general surgery department of the Ignace Deen National Hospital of Conakry. It included all patients received and operated on in the department for postoperative peritonitis, regardless of the origin of the initial operation. Results: We collected 32 cases of postoperative peritonitis with an average age of our patients of 33.75 years. Fifty-seven point fourteen percent of our patients were diabetic. Appendectomy was the most performed initial procedure with a rate of 40.62% followed by acute intestinal obstruction (18.75%). Clinical signs were dominated by abdominal pain (100%), abdominal contracture (100%), fever (100%) and painful douglas (84.38%). The average time to management of our patients was 12.53 days. The management was medico-surgical and we performed median laparotomy above and below the umbilical in all our patients. The etiologies were dominated by anastomotic leakage (56.25%), subphrenic abcess (25%), digestive fistulas (18.75%). The surgical gesture consist temporary stoma (n=11) followed by a refection of anastomosis (n=7) and intestinal resection/anastomosis (n=4). Peritoneal washing and drainage were performed in all cases. The average duration of hospitalization was 18 days. We recorded 9 cases of death (28.13%). Conclusion: Post-operative peritonitis is a condition with a high mortality rate. Management must be multidisciplinary to improve the prognosis.
Abstract: Purpose: Postoperative peritonitis is a peritoneal infection that complicates an intraperitoneal surgical procedure within one month. The purpose of this study was to determine the frequency, describe the clinical and therapeutic aspects of postoperative peritonitis. Patients and methods: This was a prospective study of descriptive type, lasting tw...
Show More
-
Emergency Abdominal Digestive Surgery in Elderly: Indications and Results in the General Surgery Department of the Ignace Deen National Hospital of Conakry, Guinea
Labile Togba Soumaoro,
Saa Yawo Kondano,
Naby Fofana,
Mamadouba Fatou Soumah,
Naby Laye Youssouf Camara,
Houssein Fofana,
Aboubacar Toure,
Aissatou Taran Diallo
Issue:
Volume 10, Issue 3, June 2022
Pages:
107-110
Received:
22 April 2022
Accepted:
5 May 2022
Published:
12 May 2022
DOI:
10.11648/j.js.20221003.13
Downloads:
Views:
Abstract: Introduction: In an emergency, the physician has little time to explore the patient, which suggests that the diagnostic and therapeutic management is approximate, with the result that there is a certain reluctance to operate on the elderly. The purpose of this study was to determine the indications and results of abdominal digestive surgery in persons aged 60 years and older. Patients and methods: This was a 24-month prospective study (January 2020 to December 2021) of patients aged 60 years and over admitted and operated in emergency for abdominal digestive disease in the general surgery department of the Ignace Deen National Hospital of Conakry, Guinea. Results: we collected data from 80 patients aged 60 years and over who had surgery in emergency for digestive abdominal disease, representing 4.02% of the interventions. The patients were 47 men and 33 women. The age group 60 to 74 years was the most represented (78.75%). Acute bowel obstruction (27.5%), peptic ulcer perforation (22.5%), appendicular peritonitis (13.75%) and typhoid ileal perforation (11.25%) were the most noted surgical indications. The overall mortality rate was 13.75%. Conclusion: The presence of various comorbidities increases the risk of death for elderly undergoing any abdominal digestive surgery in emergency particularly in resources limited settings.
Abstract: Introduction: In an emergency, the physician has little time to explore the patient, which suggests that the diagnostic and therapeutic management is approximate, with the result that there is a certain reluctance to operate on the elderly. The purpose of this study was to determine the indications and results of abdominal digestive surgery in pers...
Show More
-
Low-Cost Surveillance for Lower Extremity Fracture Union After Intramedullary Nailing – Experience on 80 Sign Patients by a Philippine Trauma Center
Erika Paulina Stefani See,
Mamer Rosario
Issue:
Volume 10, Issue 3, June 2022
Pages:
111-116
Received:
25 April 2022
Accepted:
9 May 2022
Published:
24 May 2022
DOI:
10.11648/j.js.20221003.14
Downloads:
Views:
Abstract: There is a need to come up with low-cost strategies for assessing fracture union following surgical treatment in developing countries. We aimed to develop one by determining the optimal surveillance schedule taking into account associated factors and the diagnostic performance of the Squat & Smile (S & S) test. A total of 80 patients with lower extremity fracture treated with the SIGN nail were followed for at least 8 months. Time to fracture union was calculated using the Radiographic Union Scale in Tibial Fractures (RUST) scoring and variables were analyzed for association with fracture union. Forty-eight patients performed additional S & S test. Sensitivity, specificity, positive and negative predictive values, and the diagnostic accuracy of S & S test were assessed. Ten (12.5%) of 80 patients developed nonunion, and the presence of superficial infection (28.5 ± 5.6 weeks vs 17.2 ± 1.2 weeks, p=.01) and pain on weight-bearing (29.6 ± 2.2 weeks vs 16.8 ± 1.2 weeks, p < .001) were associated factors. Cumulative incidence at 16 weeks was 59% (58% to 60%). The S & S test had high Sn (90%) and Sp (100%) in diagnosing union. The NPV and PPV were 67% and 100%, respectively, with a diagnostic accuracy of 92%. We concluded that S & S test may reliably detect fracture union by fourth month after surgery, while closer follow-up is likely needed for patients developing superficial infection or pain on weight-bearing.
Abstract: There is a need to come up with low-cost strategies for assessing fracture union following surgical treatment in developing countries. We aimed to develop one by determining the optimal surveillance schedule taking into account associated factors and the diagnostic performance of the Squat & Smile (S & S) test. A total of 80 patients with lower ext...
Show More
-
Duodenal Intussusception Secondary to Brunner's Gland Hamartoma: Case Report
Adolfo Leyva-Alvizo,
Jose Emmanuel Martínez-Escalante,
Cristina Villar-Canton,
Diana Paola Padilla-Armendariz
Issue:
Volume 10, Issue 3, June 2022
Pages:
117-120
Received:
29 April 2022
Accepted:
12 May 2022
Published:
24 May 2022
DOI:
10.11648/j.js.20221003.15
Downloads:
Views:
Abstract: Brunner's glands are submucosal glands found in the duodenum. When they proliferate, they can lead to the formation of hamartomas, they are a rare cause of benign lesions of the duodenum. The aim of the article is to present a case of a Brunner gland hamartoma, which was surgically approached due to obstructive symptoms, in addition to showing apparent images of intussusception on the abdominal tomography.
Abstract: Brunner's glands are submucosal glands found in the duodenum. When they proliferate, they can lead to the formation of hamartomas, they are a rare cause of benign lesions of the duodenum. The aim of the article is to present a case of a Brunner gland hamartoma, which was surgically approached due to obstructive symptoms, in addition to showing appa...
Show More
-
Iconography, Physiopathology and Spontaneous Healing of a Broncho – Pleural Fistula Following a Right Pneumonectomy for NSCLC
Flavio Colaut,
Aurelio Piazza,
Tommaso Stecca,
Micaela Romagnoli,
Catino Cosimo,
Giovanni Morana,
Marco Massani
Issue:
Volume 10, Issue 3, June 2022
Pages:
121-124
Received:
2 May 2022
Accepted:
23 May 2022
Published:
9 June 2022
DOI:
10.11648/j.js.20221003.16
Downloads:
Views:
Abstract: Bronchogenic fistula with or without empyema is considered among the most life - threatening complications in lung resections. Many proceedings to treat this kind of fistula have been described in Literature, most of them are very aggressive indeed (re - do thoracotomy, re - do bronchial anastomosis, open window thoracostomy). This is a report about a patient who developped broncho – pleural fistula after nearly sixt months from right pneumonectomy fot NSCLC. Unexpectedly in this case healing was spontaneous and requested only a chest drainage and antibiotics. Probably in this patient the fistula at the right main bronchial stump occurred on the basis of a somewhat disorder of the riparative and inflammation pathway. Propensity to infective disease (previous TB end Staphylococcus infection) could confirm this explanation.
Abstract: Bronchogenic fistula with or without empyema is considered among the most life - threatening complications in lung resections. Many proceedings to treat this kind of fistula have been described in Literature, most of them are very aggressive indeed (re - do thoracotomy, re - do bronchial anastomosis, open window thoracostomy). This is a report abou...
Show More
-
Immunohistochemical Analysis of Mediastinal Lymph Node Metastasis of Lung Cancer by EBUS-TBNA
Issue:
Volume 10, Issue 3, June 2022
Pages:
125-130
Received:
9 June 2022
Accepted:
Published:
9 June 2022
DOI:
10.11648/j.js.20221003.17
Downloads:
Views:
Abstract: Objective: To analyze the immunohistochemical characteristics of mediastinal lymph node metastasis of lung cancer, and compare the positive expression of immunohistochemical markers in the main pathological types of lung cancer. Materials and Methods: From January 2015 to March 2019, 142 patients who underwent EBUS-TBNA examination in Cancer Hospital Affiliated to China Medical University due to hilar and mediastinal lymphadenopathy on CT were analyzed retrospectively. The pathological and immunohistochemical results of these patients were statistically analyzed. Results: P63 and CK5 / 6 were significantly expressed in lymph node metastasis from lung squamous cell carcinoma; CK8 / 18 was only statistically different between small cell lung cancer group and squamous cell carcinoma group (P < 0.0001), with higher positive expression in squamous cell carcinoma group; TTF-1 was almost not expressed in mediastinal lymph node metastasis from lung squamous cell carcinoma group, so it can effectively distinguish and exclude lymph node metastasis from lung squamous cell carcinoma; Napsin A and CK7 could effectively identify lymph node metastasis from lung adenocarcinoma; Syn, TTF-1, CD56 and CgA were significantly different in lymph node metastasis from small cell lung cancer, of which Syn was the most sensitive (positive expression rate was 90%). Conclusions: Immunohistochemistry can improve the accuracy of EBUS-TBNA in the diagnosis of lung cancer with lymph node metastasis, and is conducive to the accurate classification of lung cancer with mediastinal lymph node metastasis.
Abstract: Objective: To analyze the immunohistochemical characteristics of mediastinal lymph node metastasis of lung cancer, and compare the positive expression of immunohistochemical markers in the main pathological types of lung cancer. Materials and Methods: From January 2015 to March 2019, 142 patients who underwent EBUS-TBNA examination in Cancer Hospit...
Show More
-
A Case Study on Treatment of Ankylosing Spondylitis with Kyphosis Deformity by Two-Level Pedicle Subtraction Osteotomy
Yongchun Xiao,
Gengxiong Lin,
Guowei Zhang,
Hua Yang,
Zhisheng Ji,
Hongsheng Lin
Issue:
Volume 10, Issue 3, June 2022
Pages:
131-135
Received:
1 June 2022
Accepted:
22 June 2022
Published:
30 June 2022
DOI:
10.11648/j.js.20221003.18
Downloads:
Views:
Abstract: Ankylosing spondylitis is a disease characterized by inflammation of sacroiliac joint and spinal attachment point. It is strongly associated with HLA-B27. About 30% of patients will develope kyphosis. It not only causes severe kyphosis, restricted mobility, ugly appearance, and human head-up disorder, but also severe kyphosis causes sleep difficulties, compression of the chest and abdominal organs, and abdominal muscles. Contractures lead to disorders of the digestive function of the gastrointestinal tract and superior mesenteric artery syndrome, and even more serious psychological disorders, and even loss of confidence in life. The most effective treatment for ankylosing spondylitis kyphosis is spinal orthopedics. We report a 38-year-old male patient who was hospitalized with ankylosing spondylitis and kyphosis due to low back pain and activity limitation for 20 years, and progressive aggravation of his kyphosis for 10 years. The measurement of preoperative imaging parameters indicated: Pelvic Incidence (PI) = 61°, Pelvic Tilt (PT) = 64°, Sacral Slope (SS) = -3°, Lumbar Lordosis (LL) = -25°, Thoracolumbar Junction (TLJ) = 45°, Thoracic Kyphosis (TK) = 65°, Chin-Brow Vertical Angle (CBVB) = 60°. With adequate preoperative planning and discussion, we performed a two-level pedicle subtraction osteotomy, which requires comprehensive perioperative care and more refined intraoperative manipulation. The postoperative patient was 169cm, the height increased by 32cm, postoperative parameter measurement, PI = 60°, PT = 38°, SS = 22°, LL = 52°, TLJ = 15°, TK = 19°, CBVB = 13°. After the operation, the patient recovered well, the treatment effect was satisfactory, and the quality of life was significantly improved. Two-level pedicle subtraction osteotomy is a high-risk and high-demand operation that needs to be performed by an experienced spinal surgery team.
Abstract: Ankylosing spondylitis is a disease characterized by inflammation of sacroiliac joint and spinal attachment point. It is strongly associated with HLA-B27. About 30% of patients will develope kyphosis. It not only causes severe kyphosis, restricted mobility, ugly appearance, and human head-up disorder, but also severe kyphosis causes sleep difficult...
Show More
