[Study of early relaparotomies at the University Hospitals of Lubumbashi: epidemiological clinical and therapeutic features]. / Etude des relaparotomies précoces aux Hôpitaux Universitaires de Lubumbashi: aspects épidémiologiques, cliniques et thérapeutiques.

Early relaparotomies due to post operative peritonitis (POP) are surgical emergencies associated with a poor prognosis. This study aimed to describe the epidemiological, clinical and therapeutic features of early relaparotomies treated at the University Hospitals in Lubumbashi. We conducted a cross-sectional, descriptive study in two Hospitals in the health district of Upper Katanga, such as the University Clinics of Lubumbashi (UCL) and the General Referral Hospitals Jason Sendwe (GRH JS). This study included 56 patients undergoing 68 abdomen operations from 01 January 2012 to 31 December 2013. The medical records of mixed-gender patients aged 07 days to 83 years undergoing early abdomen surgery at least twice were reviewed. Epidemiological clinical, therapeutic data as well as postoperative outcome data were collected, entered and then examined using Epi Info 2011. During this study, 304 patients underwent laparotomy, of whom 248 had a favorable outcome while 56 underwent 68 relaparotomies (38 men and 18 women). The average age of patients was 34.6 ± 19 years. The average length of stay in hospital was 56.26 ± 51.82 days. Relaparotomy-related comorbidities were arterial hypertension, cancer and poor physical status, classified as ASA 3 and 4 before laparotomy, accounting for 34.62% (n=9); 26.92% (n=7) and 41.38% (n=12) respectively. General malaise, abdominal circumference increased of more than 2 cm per day at the level of the umbilicus as well diffuse and induced abdominal pain were found in 94.64% (n=53), 98.21% (n=55) and 83.93% (n=47) of cases respectively. Emergency laparotomy was performed in 51 (91.07%) patients. Laparotomy-related infections were the primary indication for reoperation in 55.36% of cases (n=31). Initial laparotomy was performed by a non-qualified surgeon in 60.71% of cases (n=34). Twelve patients who underwent reoperation died, reflecting a rate of 17.65%. Early relaparotomies for POP are commonly practiced at the University Hospitals of High Katanga. Delayed diagnosis aggravates prognosis.

Wolf-Hirschhorn Syndrome: Clinical and Genetic Data from a First Case Diagnosed in Central Africa.

Wolf-Hirschhorn syndrome (WHS) is a multiple congenital anomaly-intellectual disability syndrome caused by a deletion involving chromosome 4p16.3. We report clinical and genetic findings of the first WHS patient diagnosed in central Africa. This boy who presented with cleft palate, microcephaly, severe growth delay, and intellectual disability was 12 years old. Typical craniofacial features were present, though the characteristic "Greek helmet" appearance of the nose was less evident, probably reflecting a variable expression related to the genetic background. The clinical diagnosis of WHS was confirmed by array CGH, which revealed a terminal 4p16.3 deletion of 3.47 Mb, typically associated with a milder phenotype, contributing to the long survival of this child in a developing country.

[A rare case of suppurative mesenteric adenitis associated with intussusception in a child: a clinical case]. / Un cas rare d'adénite mésentérique suppurée associée à une invagination intestinale chez un enfant: cas Clinique.

Some cases of suppurative mesenteric adenitis have already been described in the literature but not associated with intussusception. We describe the case of a 3-year-old boy presenting to the department of surgery at the University Hospital of Lubumbashi with bowel obstruction. He was visited elsewhere, in the previous 12 days, for diarrhea, vomiting, fever, coma and treated for cerebral malaria and blackwater fever. Surgery revealed an ileal intussusception and a suppurative mesenteric adenitis whose pyoculture revealed the presence of Enterobacter cloacae, sensitive to norfloxacin. We performed desinvagination, sucked the pus out into a syringe and excized completely the site of suppurative adenitis. The evolution of patient was good. The clinician must know that the association between suppurative mesenteric adenitis and intussusceptions exists. The diagnosis is not easy and there is the risk of developing acute peritonitis due to its fistulation in the abdominal cavity.