[Hypertensive emergencies at the University Hospital Center in Brazzaville, Congo]. / Les urgences hypertensives au Centre Hospitalier et Universitaire de Brazzaville (Congo).

The purpose of this retrospective study conducted in the emergency department of the University Hospital Center in Brazzaville, Congo was to determine the prevalence and clinical characteristics of hypertensive emergencies. With a total of 76 patients admitted during the study period, the prevalence of hypertensive emergency was 4%. The sex ratio was 1 and mean patient age was 57.3 years (range, 30 to 80 years). Risk factors included obesity in 62 cases (81.6%), history of hypertension in 65 (85.5%) and low socioeconomic level in 58 (76.3%). Mean delay for consultation was 50 hours (range, 1 to 240 hours). The disease underlying the hypertensive emergency was stroke with 38 cases (50%), heart failure in 20 (26.3%), hypertensive encephalopathy in 11 (14.4%), malignant hypertension in 9 (11.8%), and renal failure in 10 (13.1%). The mean length of emergency treatment was 14.7 hours (range, 5 to 48 hours). Eight deaths (10.5%) occurred during hospitalization in the emergency department.

[Urological complications of gynecologic surgery]. / Les complications urologiques de la chirurgie gynécologique.

OBJECTIVE: To analyze the epidemiological, anatomoclinical, surgical and evolutionary aspects of the urological complications of gynecological surgery. MATERIAL AND METHODS: It was about a retrospective survey, concerning 81 patients hospitalized in the department of urology of the university hospital, Brazzaville from 2000 to 2008 for urological complications of the gynecological surgery. The epidemiological, diagnostic, surgical and evolutionary parameters have been analyzed. RESULTS: The urological complication of the gynecological surgery has been recovered in 3% of patients hospitalized in urology. The middle age was 37±14.52 years (17 and 74 years). The median was about 36 years. The middle delay of diagnosis was 15 days (0 and 350 days). The revealing clinical signs were: the oligoanuria (n=12), the urinary incontinence (n=57), the lumbar pain (n=9) and the cyclic hematuria (n=2). The surgical interventions in reason were: the Caesarean (n=50), the hysterectomy for fibroma (n=26), the myomectomy (n=3) and the hysterectomy for cancer (n=2). Anatomical lesion were 55 (67.9%) vesicovaginal fistulas, 12 (14.8%) ureteral ligatures, eight (10%) uretero-vaginal fistulas, three (3.7%) vesico-uterine fistulas, two (2.4%) wounds ureteral and one (1.2%) vaginal vesico-fistulas and uretero-vaginal fistulas. The treatment consisted in one termino-terminal ureterorraphia, 20 uretero-vesical reimplantation, 57 cures of vesico-vaginal fistulas and one nephrectomy. The recovery was obtained at 96% of the ureteral lesions and 90% of the vesico-vaginal fistulas. CONCLUSION: The lesions of the ureteral and the bladder were often met during the gynecological surgery. The treatment requires knowledge of the anatomy of pelvis.

[Interest of cervical epidural anesthesia in perioperative management of thyroidectomy with the high-risk anesthetic patient]. / Intérêt de l'anesthésie péridurale cervicale dans la gestion périopératoire d'une thyroïdectomie chez une patiente à haut risque anesthésique.

Cervical epidural anesthesia is an anesthetic technique that can be useful in patients with high perioperative risk undergoing to cervical surgery. We report the case of a patient of 49 years old with hypertension, diabetes mellitus, epilepsy, left hemiparesis sequelae of stroke and congestive left ventricular failure. The patient underwent total thyroidectomy under cervical epidural anesthesia. No difficulty breathing or decompensation of chronic underlying diseases were noted in the postoperative.

[67 cases of face and neck cellulitis managed at the Brazzaville Teaching Hospital]. / 67 cas de cellulite cervico-faciale, pris en charge sous anesthésie locale au CHUB de Brazzaville.

INTRODUCTION: Face and neck cellulitis is an infection of cellular adipose tissues of the head and neck. These are common complications but true diagnostic and therapeutic emergencies. We had for aim to analyze the diagnostic and therapeutic aspects of these infections treated under local anesthesia at the Brazzaville teaching hospital. MATERIEL AND METHODS: We conducted a retrospective study from January 1, 1999 to December 31, 2008 on 67 cases of patients admitted to the ENT and Stomatology units of the Brazzaville teaching hospital. RESULTS: We included 47 male (70%) and 20 female (30%) patients (sex ratio 2.35) with a mean age 21 years (range 14-69 years of age). The cause of infection was dental in 75% of cases, lymph nodes in 24% of cases, and otologic in 1% of cases. The treatment was medical and surgical. DISCUSSION: Cervico-facial cellulitis more frequently concerns young adults. Neglect, poor oral hygiene, and ignorance contribute to the occurrence of these complications. The main portal of entry is dental. The authors recommend the antibiotic and corticosteroid therapy associated with incision and drainage.