[Primary ileostomy for typhoid-related ileal perforation: a 62-case series in Ouagadougou, Burkina Faso]. / Iléostomie première des perforations iléales d'origine typhique: 62 cas à Ouagadougou (Burkina Faso).

OBJECTIVES: The purpose of this report is to evaluate the efficacy of primary ileostomy for treatment of typhoid-related ileal perforation based on our experience. METHODS: This retrospective study included all cases of typhoid-related ileal perforation treated by primary ileostomy in the Visceral Surgery Department of the Yalgado Ouedraogo Teaching Hospital in Ouagadougou, Burkina Faso from January 2006 to June 2008. Diagnosis was based mainly on peroperative findings revealing specific anatomical lesions. There were 45 men (72.6%) and 17 women (27.4%) with a mean age of 26 years (range, 14 to 68). Asthenic forms were observed in 41 cases (66.1%) and sthenic forms in 21 (33.9%). The mean delay for seeking treatment was 6 days (range, 1 to 30 days). RESULTS: Primary ileostomy was used for treatment of typhoid-related ileal perforation in 78.5% of cases. Most cases (80.6%) involved single perforations. A temporary ileostomy was performed in 55 cases (88.7%) and terminal ileostomy was performed in 7 (11.3%). Complications were observed in 18 patients (29.03%) including suppuration of wall in 8 cases. The mean duration for re-establishing continuity and of hospital stay was 34 and 41 days respectively. Four deaths occurred due to hypovolemic shock. CONCLUSION: In our department, primary ileostomy for typhoid-related ileal perforation reduced mortality despite high morbidity.

[Diagnosis of a cutaneous endometriosis decidualised and fistualized during pregnancy]. / Diagnostic d'une endométriose cutanée, décidualisée et fistulisée au cours d'une grossesse.

A case of a decidualized and fistulized cutaneous endometriosis has been observed in the obstretrical and gynecological department of the Yalgado-Ouédraogo national hospital. The patient was a 3-year-old pregnant woman in her third pregnancy primipara, without any surviving child, who presented with a large scabby exulcerated plaque on an hyperpigmented lesion, associated with para umbilical. The patient underwent 12 years earlier a laparotomy for peritonitis worsened with parietal suppuration, then by rupture. The lesion has made the diagnosis difficult and the histologist concluded that it was a decidualised cutaneous endometriosis. Based on this observation, the first one until now, the authors have made a publication on the case.

[A case of malformation of aortic arches simulating asthma]. / Un cas de malformation des arcs aortiques simulant un asthme.

INTRODUCTION: Abnomalies of the aortic arches are rare and account for 1% of congenital cardiovascular malformations. They constitute one of the causes of compression of the airways with attacks of dyspnea sometimes simulating an asthma. We report the case of an infant with an anomaly development of aortic arches with impact breathing. CASE REPORT: It was a 22-month-old infant who consulted for a dyspnea with a type of stridor associated with a fat cough. This clinical table started 45 days after its birth and led to many hospitalizations in the pediatric emergency. Clinical exam found polypnea, with a wheezing, bronchial groan and diffuse sibilants on the auscultation. The chest X-ray revealed a slightly retractile right lung. The angioscanner of the thoracic and abdominal aorta showed a double aortic arch with retro-oesophageal left ventricular artery. A thoracotomy was performed and the operative sequences were simple. CONCLUSION: The congenital anomalies of the aortic arch are rare and varied, sometimes asymptomatic. This case reminds us that, in front of any recurrent or digestive respiratory signs in the infant, malformation of the aortic arches should be considered.

So-called "historical" necrotic breast cancers: a terrifying actuality in Africa. The case of Burkina Faso.

Study the epidemiological, diagnostic, and treatment features and outcomes of necrotic breast cancer in women. This observational, longitudinal, and descriptive study covered the period from January, 2011, to the end of May, 2016 at the Surgery and Gynecology Departments of Yalgado Ouedraogo University Hospital and Schiphra Medical Center. The study included all women with necrotic breast cancers. Survival was calculated by the Kaplan Meier method and survival comparison was possible with the log-rank method. À risk of error of 0.05 was allowed. Necrotic cancer accounted for 9.1% of all breast cancers. The median age of the patients was 46 years old. The median interval before consultation was 12.4 months. The histological type was invasive ductal carcinoma in 90.8% of cases. Surgery was performed in 51 patients (52%). It was a palliative (cleaning) procedure in 92.2% of cases. Chemotherapy was performed in 28 patients. Overall survival was 61.8% at 6 months, 39.5% at 1 year, and 9.2% at 3 years. Median survival was 10 months: 13 months for women with surgery and 6 months for those without it (p<0.001). Necrotic breast cancer is still common in Ouagadougou. Surgery is the mainstay of the treatment. Survival is mediocre. It therefore seems urgent to focus on raising population awareness and organizing screening campaigns.

[Hyperthyroidism in surgery at the Teaching Hospital Yalgado Ouedraogo Burkina Faso. About 95 cases]. / Les hyperthyroïdies en milieu chirurgical au Centre Hospitalier Universitaire Yalgado Ouédraogo, Burkina Faso. A propos de 95 cas.

The authors pay in a retrospective study, 95 cases of hyperthyroidism, listed in the teaching hospital Yalgado Ouedraogo of Ouagadougou from January 2000 to June 2005. These hyperthyroidism represent 39% of the thyroid affections, with a female prevalence (97%), 32 years of average age, the urban source of the patients (90% of the cases) and the importance of self medication (73%). They stress the importance of sonography, allowing a classification in diffuse goiter (44%) and multi nodular (56%). They insist on a good preparation of the patient before the intervention and on the interest of the sub total thyroïdectomy. They estimate that a correct binding of the vessels, the dissection of recurring, the visualization and the dissection of parathyroid and their vascular pedicle should make it possible to reduce the post-operative complications: null morbidity and death rate 12.5%.

Acute appendicitis due to schistosomiasis: four cases at the Yalgado Ouédraogo University Hospital of Ouagadougou.

Acute appendicitis is a frequent pathology with diverse causes. Although Burkina Faso is a tropical country with endemic schistosomiasis, bilharzial appendicitis remains rare. We report 4 cases of appendicitis due to schistosomiasis that we treated at the university hospital of Yalgado Ouédraogo to call attention to the need for routine review of appendectomy parts. Four male patients, aged 22, 26, 30, and 35 years old, were admitted for abdominal pains. Eosinophilia was observed in one case. The preoperative diagnosis was acute appendicitis in 2 cases and appendiceal peritonitis in 2 others. Appendectomy was performed in all cases. Pathological examination of the appendectomy piece observed acute suppurative appendicitis due to schistosomiasis, specifically, Schistosoma haematobium. All patients received praziquantel for antiparasite treatment. Clinical course was uncomplicated in all cases. Routine antiparasite treatment would make it possible to prevent these cases of bilharzial appendicitis. In addition, routine histologic examination of appendectomy parts would enable us to determine the real frequency of this disease in our country, where bilharziasis is endemic. The treatment is appendectomy and the prognosis is good.

[Warm saline enema for reduction of intestinal invagination under the ultrasonographic guidance: preliminary results apropos of 2 cases]. / Désinvagination intestinale par lavement au sérum salé isotonique tiédi sous contrôle échographique: résultats préliminaires à propos de deux cas.

The authors describe the use of isotonic normal saline enema under US guidance in the treatment of acute uncomplicated intestinal intussusception in infants. The technique was successfully used in two patients aged respectively 18 and 16 months, with 11 and 9-month follow-up. The various steps of this technique and the results are analyzed and discussed. It is a valuable alternative to surgical treatment or hydrostatic reduction with opaque x-ray contrast under fluoroscopic guidance.

[Intestinal invaginations in children: 24 cases treated at the Yalgado National University Hospital in Ouedraogo]. / Les invaginations intestinales de l'enfant. A propos de 24 cas traitésau Centre hospitalier national Yalgado-Ouédrago.

We report a retrospective study of 24 cases of acute intestinal invagination in children, accounting for 4.4% of the cases of mechanical intestinal occlusion. More boys than girls were affected (sex ratio of 3:1). Consultation was often delayed, there was a high frequency of occlusive forms and of idiopathic forms (17 of the 24 cases) and the mortality rate was high (1 of the 24 children died). This study demonstrates the importance of ultrasound scans in the diagnosis of this condition.

Femur malunion treated with open osteotomy and intramedullary nailing in developing countries.

INTRODUCTION: In developing countries, malunion, after diaphyseal femur fractures initially untreated by internal fixation, is not rare. Their difficult management contrasts with the deficiency of the technical operating room facilities. PATIENTS AND METHODS: Our prospective study, conducted over a 1-year period, reports 16 open osteotomies fixed using Küntscher intramedullary nailing in patients who presented malunion of the femoral diaphysis. Twelve males and four females (mean age, 34.5 years; range, 18-67 years) were managed with a mean time to surgery of 8 months (range, 4-14 months). All had initially consulted a bonesetter. The mean length inequality was 3 cm (range, 2-6 cm); the mean knee flexion limitation was 90° (range, 10°-120°). Locking of the rotation was obtained by the obliquity of the osteotomy line. No bone filling was added but reaming and decortications were systematic. The patients were clinically and radiographically assessed at D21, D45, D90, and D120, based on the evaluation of the length inequality, mobility, and bone union. Rotational malunion or deformity were not analyzed. RESULTS: Fifteen patients had achieved union in 90 days. In one case, secondary incurvation of the nail led to changing the nail, allowing union with no axis deformity at D120. The mean postoperative knee flexion was 120° (range, 45°-130°). The mean gain in length was 2 cm (range, 1.5-4 cm). DISCUSSION: This open technique using non-interlocking material allowed us to obtain bone union while improving joint mobility and length inequality. LEVEL OF EVIDENCE: Level IV. Retrospective study.