[Diagnostic, therapeutic, and prognostic aspects of typhoid intestinal perforations in Dapaong, Togo]. / Aspects diagnostiques, thérapeutiques et pronostiques des perforations typhiques du grêle à Dapaong, Togo.

PURPOSE: This study's aim is to describe the diagnostic, therapeutic, and prognostic aspects of typhoid intestinal perforations (TIP) at the Dapaong regional hospital (Togo). MATERIAL AND METHODS: This retrospective study covered all patients with such perforations seen and managed in the Dapaong regional hospital's general surgery department during the 3-year period of 2009-2011. RESULTS: There were 110 patients with TIP during the study period, and they accounted for 67.9% of the patients treated for generalized peritonitis (162 cases). Their mean age was 10.2 years. The sex-ratio was 1.4. A single perforation was present for 69 patients (62.7%) and multiple perforations for the other 41 (37.3%). Sixty (54.5%) patients underwent simple closure, 36 (32.8%) had an ileal resection and enteroanastomosis, and 14 (12.7%) had loop or double-barrelled ileostomy. The postoperative course was complicated in 26 cases (23.6%), most often by surgical site infection, seen in 19 patients (17.3%). Overall, 23 patients died during the postoperative period, for a mortality rate of 20.9%. CONCLUSION: Typhoid intestinal perforations are the most common cause of generalized peritonitis at the Dapaong regional hospital. Most patients have only a single perforation, which is repaired by excision-suture. Their morbidity and mortality rate are high.

Management of peptic pyloroduodenal stenosis in Sylvanus Olympio teaching hospital in Lome (Togo).

This study's aim was to describe the management of ulcerous pyloroduodenal stenosis in Sylvanus Olympio teaching hospital of Lomé (Togo). It was a retrospective study of medical files of all patients managed for peptic pyloroduodenal stenosis at the visceral surgery department of Sylvanus Olympio teaching hospital in Lomé (Togo) from january 1(st), 2002 to december 31(th), 2011. Twenty-five patients were selected. Mean age was 38 ± 7.4 years. Sex-ratio was 5. Twenty four patients underwent upper digestive tract endoscopy, completed by upper gastrointestinal series in 18 cases. One patient had only an upper gastrointestinal series. Pyloroduodenal stenosis was improved by antisecretory therapy in 3 cases. Twenty two patients underwent laparotomy. Truncal vagotomy was performed in 15 cases associated with pyloroplasty in 8 cases, and gastrojejunostomy in 7 cases. An antrectomy was performed in 5 cases. Selective vagotomy was associated with pyloroplasty in 1 case, and a gastrojejunostomy in 1 case. One patient died in postoperative period. Functional results were classified Visick I (17 cases) and II (4 cases). Peptic pyloroduodenal stenosis affects young adults. Its tight nature requires association of upper gastrointestinal series and esophagogastroduodenoscopy for diagnosis. Its surgical treatment is exclusively performed by laparotomy at present. Mortality is low and functionnal prognosis is good.

[Non urgents surgical digestive affections in 300 patients at the University Teaching Hospital of Lome]. / Les affections chirurgicales digestives non urgentes chez 300 patients au CHU de Lome.

AIMS: To establish the epidemiology of non traumatic gastrointestinal and non urgent affections managed in the department of abdominal surgery service of the University Teaching Hospital of Lomé and to report their post operative period. PATIENTS AND METHODS: It was a retrospective study carried out over 5 years. Were included patients aged 15 years and above presenting a non traumatic digestive affection hospitalised in the department of abdominal surgery for elective surgery. Parameters studies were: the age, the sex, the diagnosis the treatment received and post operative period. RESULTS: Non urgent digestive affections accounted for 52.3% of non traumatic digestive affection and occurred in relatively young patients with an average of 43 years. Parietal pathologies namely inguinal hernia (52%), benign ano-rectal affections with first anal fistula (18.3%) and cancers with first gastric cancers (16%) were the most frequents. Ninety two per cent (92%) of our patients have been operated. Post operative period were uneventful in 86.3% of cases. The rate of complications was 11.7% and registered 8.1% of death. CONCLUSION: Inguinal hernias are majority of affections managed in the department of visceral surgery of Lomé University Teaching Hospital. Malignant affections came in third position after benign anorectal pathologies and have heavy morbidity and mortality.

[Mesenteric serous cysts. Report of 2 cases]. / Kystes séreux du mésentère. A propos de deux cas.

Two cases of mesenteric serous cysts were reported. The first was a 65 years old woman who underwent laparotomy for abdominal pain associated with a mass initially thought to be ovarian. The second cyst was also an incidental discovery in a 59 years old female during abdominal computed tomography for thrombocytopenia. After surgical resection the first woman was well, 7 months and the second lady 4 years later, without recurrence. The two were unilocular serous cysts. By reporting these two observations, the authors aimed to show the rarity of the mesenteric serous cysts in a succint clarification on the disease.

[Bilobar Thyroid Agenesis]. / Agénésie bilobaire de la thyroïde.

A case of a 27-year-old female patient presenting with bilateral agenesis of the thyroid gland and a benign euthyroid adenoma of the isthmus and the pyramidal lobe is reported. The patient had for several years been followed for a cystic nodule that was presumed to have developed from the left thyroid lobe, having recently increased in size. Scintigraphic and echographic studies evoked the absence of right lobe. Direct examination at cervicotomy found hypoplasia of the two lobes. This report highlights the similarity of this rare anomaly to widely known hemiagenesis.

[Venereal vegetations of the urogenital tract and their urological complications. Apropos of 257 cases]. / Les végétations vénériennes de la sphère génito-urinaire et leurs complications urologiques. A propos de 257 observations.

A retrospective study was conducted during 8 years to determine the epidemiological features of condyloma and its complications in patients attending urology consultations in Lomé teaching hospital. During this period, 257 cases (218 males, 38 females) of condyloma were diagnosed. The condyloma represented the fifth cause of consultation in urology, after genito-urinary infection (n = 1214), prostatic dysuria (n = 1095), vesicovaginal fistula (n = 849), lower tractus urinary lithiasis (n = 500). The average age of the patients was 28 years (range: 14-57). In 51 cases the condyloma were associated with others sexually transmitted diseases: 25 cases of gonococcal infection, 11 cases of chancroid, 9 cases of vaginal candidiasis, and 6 cases of genital trichomoniasis. We noted 41 cases of urological complications: 19 cases of urinary infection, 13 cases of retention of urine, 7 cases of urinary forked jet, and 2 cases of urethrorrhagia. The results of this study shows that, the condyloma is commun sexually transmitted disease seen in urology clinic. Its classically benign course in patients males, were predominant, in this sex, by the urinary infection and urological mechanical accidents.