The use of negative pressure therapy for the treatment of gunshot wounds in a limited resource setting in eastern part of the Democratic Republic of Congo: Case series.

Key Clinical Message: The use of negative pressure therapy in the management of gunshot wound have a favorable outcome, NPT is easy to build, accelerates wound budding, reduces patient's stay in hospital and its low cost. It showed reassuring results in the management of wound with soft tissue lost, comparatively to other dressing. Abstract: Wounds due to gunshot injuries are common in east of Republic Democratic of Congo and its management should be well known by surgeons and other health practitioners. Reconstruction is possible with simple surgeries using skin grafts and negative pressure therapy (NPT). In this study, we present our results of wounds treatment after gunshot injury with a simple non-surgical procedure using NPT. We present four patients with soft tissue losses caused by gunshot injury. These patients underwent an average of four to eight sessions of vacuum dressing, the length of hospital stay was decrease and soft tissue losses were reconstructed using at the end skin grafts.

Unusual posterior elbow dislocation associated with radial head fracture managed nonoperatively in low- and middle-income countries: A case report and literature review.

Key Clinical Message: In LMICs, the nonoperative management of posterior elbow dislocation associated with radial head fracture is still a therapeutic option with favorable outcomes. Abstract: Elbow dislocation associated with radial head fracture is a rare lesion. The occurrence of such a lesion requires high energy trauma. The restoration of joint and radial head fracture that allows early mobilization is the best guarantee of a good functional outcome. We report a case of posterior elbow dislocation associated with radial head fracture managed by closed reduction and 1 week cast immobilization in neutral prono-supination and 90°flexion followed by early mobilization was performed favorable functional outcome was obtained after 12 weeks. We review the different pattern of elbow dislocation and question the need of open reduction and internal fixation for displaced radial head fractures.

Multiple Bladder Diverticula Presenting in an 82-Year-Old Congolese Male.

Bladder diverticulum is a congenital malformation characterized by the outpouching of the bladder following an obstruction of urine flux. We present a case of 82-year-old Congolese male patient presented at our facility with a poor urinary stream and lower abdominal pain. A distended abdomen was found on physical examination while the external genitalia were normal. All blood laboratory values were found to be within normal ranges. The patient's urine analysis revealed an uncountable number of white blood cells. Ultrasonography revealed multiple diverticula in the right posterolateral and posterior wall. An ultrasound of the abdomen revealed numerous bladder diverticula in the bladder's left posterolateral and posterior aspects, mild right-sided hydronephrosis, and severe left hydronephrosis with a thinned-out cortex. Both ureters were normal. A computed tomographic (CT) scan of the abdomen confirmed the diagnosis. The patient underwent an open laparotomy which allowed complete ablation of the diverticula followed by bladder wall repair. A one-week course of antibiotics was prescribed, and the patient was discharged fully recovered with no immediate complications. Although bladder diverticula are a congenital malformation, the presence of multiple diverticula suggests that the condition is acquired. In elderly patients, open laparotomy combined with intravenous antibiotics yields positive results.