[Migrant foreign body of the oesophagus: report of a case]. / Corps étranger de l'aesophage migrant: à propos d'une observation.

OBJECTIVE: Evaluate the risk brought by the traditional practice in the evolution of the foreign bodies of the aesophagus. CASE REPORT: 30 years old male with migration from the oesophagus of a fish bone in soft tissue of the neck, which could have been favored by the traditional practice. The diagnosis of migration was suspected when a laterocervical mass appeared after a traditional processing. The rigid aesophagoscopy was negative and the scanner allowed to identify the foreign body in an extraluminal location. It was removed by cervicotomy. Postoperative was uneventful.

[Management of patients with Covid 19: analysis of prescription drugs at Gabriel Touré University Hospital]. / Prise en charge des patients atteints de Covid 19 : analyse des prescriptions médicamenteuses au CHU Gabriel Touré.

COVID-19 was declared a pandemic in March 2020. For case management, Mali has created several treatment sites including the site of the CHU Gabriel Touré. AIMS: The objective of the study was to analyse drug prescriptions for the COVID-19 treatment at the CHU Gabriel Touré. METHODS: We performed a retrospective and descriptive study from April to September 2020. Drug prescriptions and hospital records were used to collect data. Prescriptions and hospital records were used to collect data. RESULTS: A total of 29 patients were hospitalized. The median age was 44 years, 75.90% of patients had at least one pathology associated with COVID-19. The number of prescriptions was 333 comprising 870 lines of prescriptions including 33.21% for standard treatments, and 66.79% for associated pathologies. with 86.23% available at the Hospital Pharmacy. Chloroquine, dosed at 250mg, was administered at 500mg twice a day. The national guidelines from the treatment of COVID-19 recommends 200mg of chloroquine in two doses. Vitamin C was prescribed for all patients although not included in the national guidelines. The class of drugs for the blood and blood-forming organs was the most prescribed (31.49%). The average cost of treatments was 65,602 ± 106,858 FCFA with a maximum of 567,860 FCFA. An evaluation of prescriptions in other treatment sites is necessary.

La COVID-19 est une infection virale qui s'est propagé dans tout le monde. Pour la prise en charge des cas, le Mali a créé des sites de traitement dont celui du CHU Gabriel Touré. OBJECTIF: C'était d'analyser les prescriptions médicamenteuses pour le traitement de la COVID-19 au CHU Gabriel Touré. MÉTHODOLOGIE: L'étude était rétrospective et descriptive et a concerné la période d'avril à septembre 2020. Elle s'est déroulée au Centre de Traitement COVID-19 du CHU Gabriel Touré et à la Pharmacie Hospitalière de cet hôpital. Les ordonnances et les registres d'hospitalisation ont servi à collecter les données. RÉSULTATS: Au total, 29 patients ont été hospitalisés. L'âge médian était de 44ans, 75,90% des patients présentaient au moins une pathologie associée à la COVID-19. Le nombre d'ordonnances était de 333 comportant 870 lignes de prescriptions dont 33,21% de traitements standards et 66,79% pour les pathologies associées avec 86,23% disponibles à la Pharmacie Hospitalière. Le phosphate de chloroquine, dosé à 250mg, était administré à 500mg deux fois quotidiennement. Dans les directives nationales le phosphate de chloroquine était à 100mg pour 200mg trois fois quotidienne. La vitamine C non prévue dans les directives a été prescrite à tous les patients. La classe des médicaments du sang et des organes hématopoïétiques a été les plus prescrits (31,49%). Le coût moyen des traitements était de 65602±106858 FCFA avec maximum de 567860 FCFA. Une évaluation des prescriptions dans les autres sites de traitement est nécessaire.

[Head and neck injuries: 184 cases in Mali]. / Traumatologie cervico-faciale: 184 cas au Mali.

This prospective descriptive study was carried out from August 2007 to January 2008 in the emergency surgery department of Gabriel Touré Hospital in Bamako, Mali. A series of 184 patients treated for head and neck injuries was compiled. Patients presenting strictly neurosurgical lesions were excluded. Most of the patients included in this series were young single city-dwelling males (mean, age, 27 years; M/F sex ratio, 4.3. Most injuries were sustained in road traffic accidents (93%). The most common injuries were epistaxis and multiple fractures of facial bones, cervical spine and petrosal bone. These injuries ere often associated with avulsive wounds involving the external ear and nose. The main complication risks fell into four categories, i.e., circulatory loss, upper airway obstruction, functional and/or morphological impairment, and coma-related death (Glasgow score < 8). Shortage of medication and/or disposable treatment kits was a major handicap for optimal management of head and neck injuries.

[Mediastinitis complicating cervical cellulite: 8 cases observed in the ear, nose and throat department of the Gabriel Toure university hospital, Bamako (Mali)]. / Mediastinite compliquant une cellulite cervicale : a propos de 8 cas observes dans le service orl du chu Gabriel Toure de Bamako (Mali).

OBJECTIVE: The objective of this work was to analyze the diagnostic circumstances and the therapeutic management of mediastinal disease of a cervical origin. PATIENTS AND METHODS: We conducted a longitudinal prospective and retrospective descriptive study in the ENT department of the Gabriel Touré Hospital in Bamako, involving the records of patients treated for mediastinitis complicating cervical cellulite from January 2011 to April 2014. RESULTS: Eight patients met our inclusion criteria. The median age was 29 years, the standard deviation was 10.23 years with extremes of 25 and 57 years. All were initially admitted for dental reasons. The median time to consultation was 13 days with extremes of 10 days and 1 month. Six patients had non-steroidal anti-inflammatory drugs before entry into the service. Cervical and thoracic CT scan was used to guide diagnosis in all cases. Seven patients underwent mediastinal drainage through cervicotomy, 3 patients underwent percutaneous pleural drainage under ultrasound guidance. We had two deaths. CONCLUSION: Mediastinitis in cervical cellulitis is a serious infectious disease where the mortality rate remains high. Mediastinal drainage was performed by cervical route. Prevention is based on the awareness and the importance of dental hygiene and getting proper and early treatment for dental cavities.

OBJECTIF: L'objectif de ce travail était d'analyser les circonstances de diagnostic et la prise en charge thérapeutique des affections médiastinales à point de départ cervical. PATIENTS ET MÉTHODES: Nous avons mené une étude descriptive longitudinale pro et rétrospective dans le service d'ORL du CHU Gabriel Touré de Bamako et qui a concerné les dossiers des patients traités pour médiastinite compliquant une cellulite cervico-faciale de janvier 2011 à Avril 2014. RÉSULTATS: Huit patients ont répondu à nos critères d'inclusion. L'âge médian était de 29 ans, l'écart type était de 10,23 ans avec des extrêmes de 25 et 57 ans. La porte d'entrée a été dentaire dans tous les cas. Le délai médian de consultation était de 13 jours avec des extrêmes de 10 et 1 mois. Six patients avaient eu des antiinflammatoires non stéroïdiens avant leur admission dans le service. Le scanner a permis d'orienter diagnostic, en montrant des signes en faveur de médiastinite, dans tous les cas. Sept patients ont bénéficié d'un drainage du médiastin par voie de cervicotomie, 3 patients ont bénéficié d'un drainage pleural percutané sous guidage échographique. Nous avons eu deux décès. CONCLUSION: La médiastinite au cours de la cellulite cervicale représente une pathologie infectieuse grave avec une mortalité qui reste élevée. Le drainage médiastinal a été effectué par voie cervicale. La prévention repose sur la sensibilisation de la population et sur l'importance de l'hygiène dentaire et la prise en charge correcte et précoce des caries dentaires.

[Otorhinolaryngology pathologies and HIV/AIDS. Apropos of 19 cases]. / Pathologies ORL et VIH/SIDA. A propos de 19 cas.

This work is the result of a retrospective study carried out over three months, from February to April 2002 in the ENT service of Gabriel Touré hospital of Bamako (Mali). The purpose of the study was to find out the prevalence of HIV/aids among ENT patients over the study period. Out of 691 patients, there were 19 cases of seropositivity (2.7%). These seropositive patients were quite often young women, over half of them urban (16/19), jobless and unpaid. The oro-pharyngo-laryngology symptoms though not often obvious in the HIV/AIDS manifestations deserve to be studied more as they can point out possible screening.

[Laryngeal papillomatosis in Mali. Apropos of 19 cases collected at the Gabriel Touré Hospital of Bamako]. / Papillomatose laryngée au Mali. A propos de 19 cas colligés à l'hôpital Gabriel Touré de Bamako.

From 1994 to 1999, 19 cases of laryngeal papillomatosis were observed. The sex-ratio M/F was 0.9 and the mean age 10 years. The motive for consulting was dyspnoea for 45% of the cases and in all these cases resulted in emergency tracheotomy. The only available means of intervention was peeling under general anaesthesia. An anatomopathological examination could be carried out for only 63.1% of cases. Prevalence of the disease has been under-estimated for reasons of late diagnosis and the inaccessibility to health structures for some cases.

[Cervico-facial cellulitis during pregnancy: about a series of 10 cases in Mali]. / Cellulite cervico-faciale au cours de la grossesse. À propos d'une série de 10 cas au Mali.

The objective of this work was to analyze the predisposing factors, diagnostic and therapeutic aspects of cervico-facial cellulitis on pregnancies and to determine maternal-fetal prognosis. We conducted a longitudinal observational descriptive study from January 2011 to March 2013 including records from pregnant women with cervicofacial cellulitis treated at the Oto-Rhino-Laryngology (ORL) and cervico-facial surgery department at Gabriel Touré Hospital in Bamako. Ten women met our inclusion criteria. The median age was 23 years. The entry way was dental in all cases. Three women had taken antibiotics and 3 others antibiotics associated with non steroidal anti-inflammatory. The medico-surgical treatment had permitted to cure 8 cases. Two cases of death were recorded and 4 cases of stillbirths. The cervico-facial cellulitis during pregnancy is a serious pathology that can be life-threatening to the mother and or child. Prevention is based on the control of dental status and informing women about the importance of dental hygiene.

[Giant mucocele maxillary sinus: About a case]. / Mucocele geante du sinus maxillaire: A propos d'un cas.

The maxillary mucocele sinus are rare and may extend outside the sinus and cause a facial deformity and orbital manifestations. OBSERVATION: We report a case of giant mucocele of the right maxillary sinus from a 48 year old man. The history of disease has found a right cheek tumefaction. hypoesthesia of the right hemifacial, nasal obstruction lasting for 2 years. CT scan of the facial confirmed diagnosis by showing a cystic mass of the right maxillairy sinus bulging into the right nasal cavity with bone thinning without bone lysis. The treatement is removal of the mucocelique pochet by Caldwell-Luc under general anesthesia and allowed disparition of symptoms. CONCLUSION: Africa the Caldwell-Luc seems to us preferable because of diagnosis tardif the origin of the importance of the expansion.

INTRODUCTION: Les mucocèles du sinus maxillaire sont rares et peuvent s'étendre en dehors du sinus et entrainer une déformation faciale et des manifestations orbitaires. OBSERVATION: Nous rapportons un cas de mucocèle géante du sinus maxillaire droit chez un homme de 48 ans. L'histoire de la maladie a retrouvé une tuméfaction jugale droite, une hypoesthésie de l'hémiface droite, une obstruction nasale évoluant depuis 2 ans. Le scanner du massif facial a confirmé le diagnostic en montrant une masse kystique du sinus maxillaire droit bombant dans la fosse nasale, avec amincissement des parois osseuses, sans lyse osseuse. Le traitement, a consisté à l'exérèse de la poche mucocélique par voie de Caldwell-Luc sous anesthésie générale, et a permis la disparition de la symptomatologie. CONCLUSION: En Afrique le Caldwell-Luc nous semble préférable du fait du diagnostic tardif à l'origine de l'importance de l'expansion.

[Clinical and therapeutic aspects of brain abscesses: 17 cases reviewed at the Gabriel Toure teaching hospital In Bamako]. / Aspects cliniques et therapeutiques des abces cerebraux: 17 cas colliges au CHU Gabriel Toure a Bamako.

OBJECTIVE: The purpose of this study was to determine the incidence, clinical features, localization, and therapeutic aspects of the evolution of the brain abscess. PATIENTS AND METHODS: This was a retrospective study which included patients admitted for brain abscess at the Gabriel Touré Hospital in Bamako between January 2007 and September 2010. RESULTS: We collated the data of 17 patients. Fever was the predominant symptom in 14 patients and headache in 13. The main clinical signs were hemiparesis (11 patients) and vomiting (8 patients). The origin of infection was especially posttraumatic in 5 patients, locoregional by contiguity in 5 where 3 whose originated in the sinuses. All patients received triple antibiotic therapy. The surgical management by trépanoponction was indicated in 16 patients. The clinical outcome was favorable in 14 patients. Three patients died. CONCLUSION: Brain abscess is a common condition in Mali. Despite improved diagnostics and treatment of patients, mortality remains high hence the interest of prevention through early diagnosis and treatment of infectious ORL.

BUT: L'objectif de cette étude était de déterminer la fréquence, les aspects cliniques, la localisation, les aspects thérapeutiques et l'évolution de l'abcès cérébral. PATIENTS ET MÉTHODES: Il s'agissait d'une étude rétrospective incluait les patients admis pour abcès cérébral au CHU Gabriel Touré à Bamako entre janvier 2007 et septembre 2010. RÉSULTATS: Nous avons colligé 17 patients. La fièvre était le symptôme prédominant chez 14 patients et les céphalées chez 13 patients. Les principaux signes cliniques étaient l'hémiparésie (11 patients) et les vomissements (8 patients). L'origine de l'infection était surtout post traumatique chez 5 patients, locorégionale par contiguïté chez 5 dont 3 à point de départ sinusien. Tous nos patients ont bénéficié d'une triple antibiothérapie. La prise en charge chirurgicale par la trépanoponction était indiquée chez 16 patients. L'évolution clinique a été favorable chez 14 patients. Trois patients sont décédés. CONCLUSION: L'abcès cérébral est une pathologie fréquente au Mali. En dépit de l'amélioration des moyens diagnostiques et du traitement des patients, la mortalité reste élevée d'où l'intérêt de la prévention par le diagnostic et le traitement précoce des foyers infectieux de la sphère ORL.

[Medical handicap and otorhinolaryngologic foreign bodies about 4 original cases]. / Handicap et Corps Etrangers ORL, a propos de quatre observations originales.

The multiple variant of aero-digestive foreign bodies' pathology determine many complex aspects with regard to their physiopathology, nature, and their location. The presence of a medical handicap or any particular condition could increase morbidity and expose to major risks. We are reporting here about 4 cases including an esophagus foreign body in a leprosies patient, an esophago-gastric case in a mental disorder patient, and two laryngeal-tracheal-bronchial cases during epileptic episodes. From the rarity of such accidents in an adult to their happening during a loss of consciousness or a delirious state, the clinical history is always missing. The symptoms are atypical and may misguide. The classical penetration syndrome cannot be reported. Only a clinical examination carefully conducted and completed with targeted para clinical examinations can help make early diagnosis. Endoscopy of the Esophagus on one hand, and endoscopy of the trachea and lungs on the other hand were used to extract these foreign bodies.

[Morbidity of the tumours of the sphere head and neck in Bamako]. / Morbidite par tumeurs de la sphere tete et cou a Bamako.

This work reports the results of one year (November 2004-October 2005) descriptive study of tumours located in the head and neck areas in the ENT department of the University-Hospital of Gabriel Toure in Bamako. Were included in the study patients whose files showed epidemiology data: age, sex, profession, residence and period of the medical checking, and exposition factors: anatomic location, results of histology and image data of the tumours. Where excluded from the study the patients whose file were not completed and those that have had eye and brain tumours From the data base of the department, a total of 60 cases of tumours were monitored and 25 others cases were excluded according to the criteria. Among the 60 cases, 24 tumours (40%) were malign and 36 were benign. Goiter was the most found benign tumor according to the results of the hystology analysis. In most cases (15 out of 36, 41.67%) the histology analysis showed an colloid adenoma Other rare tumors like rhinoscleroma (5 cases out of 36, 13.89%), nose invertus papilloma (2 cases out of 36, 5.55%) where found. These were easily diagnosed and treated. In the group of malign tumors, the pharyngolaryngeal cancer was the most found (11 cases out of 24) and the most predominant histology of these cancers was the epidermoid carcinoma. Two of these cancers were found in patients below fifteen years of age, but no other risk factors like expositions was noted in the files of these two patients. Other malign tumors have been found: nose and sinusal cancers and thyroid carcinoma. In most cases these tumors were diagnosed at an advanced stage.

[Laryngo-pharyngeal cancer at a health service of last resort in Mali: anatomo-clinical and therapeutic aspects]. / Les cancers laryngo-pharynges dans un service de sante de dernier recours au Mali: aspects anatomo-cliniques et thérapeutiques.

The purpose of this study is to describe the clinical, anatomic and therapeutic aspects of laryngitis--pharyngeal cancers in Mali. It was a prospective, descriptive and cross sectional study which was help in the ORL and cervical facial department of the university hospital center Gabriel TOURE between April 2006 and March 2007. The study looked at 18 patients hospitalized for larynx or hypo pharynx cancer, diagnostic was confirmed histologically. The parameters (age, other favorable features, clinical signs, endoscopic aspect of the tumor, histological type and treatment type) have been analyzed. Men were the most affected (66.7%), with an average age of 58.17 year old. Chronic smoking has been the most evocated factor of risk (55.17) with an average consumation of 39.5 P/A. A delay in consultation was noticed (60% with a period greater than 1 year after the first symptoms appear). The burgeoning aspect (66.7%) end the carcinoma epidemic type of the tumor (94.7%) have dominated the anatomy pathologic table. Only 27.8% of patients had surgery because of late diagnosis.

[Epidemiologic aspects of pharyngitis, Bamako]. / Aspects epidemiologiques de l'angine a Bamko.

We are reporting here a 12 month-prospective study on epidemiologic aspects of sore throat in the ENT department of the national hospital Gabriel Touré. We recorded 260 cases of sore throat with 23 loco-regional complications representing 1.8% of all pathologies in our department; the sex ratio was 2.6 in favour of women, and the age group most affected was 20-24 years (18.07%). Sore throat was most frequently diagnosed at the beginning and at the end of the rainy season respectively May and October. In 63 of the cases, local and regional complications were seen, and represented by peri-tonsils phlegm (54%), chronic tonsillitis (41.3%), retropharyngeal abscess (3.2%), and cervical adeno-phlegm (1.6%). Therapy with antibiotics should be of rule, and well justified surgical decisions should be made after informed consent of the patient. Sore throat with its complications should really benefit of better attention and better management.

[Cytodiagnosis of hepatoma. Apropos of 100 fine needle punctures of primary cancers of the liver]. / Cytodiagnostic des hépatomes. A propos de 100 ponctions à l'aiguille fine de cancers primitifs du foie.

The authors report the results of 100 liver biopsies with fine needle aspiration performed in patients with primary hepatocellular carcinoma (P.H.C.). The method is simple, quick, without danger and reliable: cytodiagnosis on aspirated material shows typical P.H.C. in 69 p. 100 of cases and probable P.H.C. in an additional 21 p. 100 of cases. Peritoneoscopic or ultrasonic guidance gives even better results.