Aspects Épidémiologiques, Diagnostiques Et Thérapeutiques Des Traumatismes Abdominaux À Bembéréké-Nord Bénin

Objective: describe the epidemiological, diagnostic aspects and therapeutic approaches at Bembereke in northern Benin. Patients and methods: all victims of abdominal trauma received in the department of surgery between 1 st January 2010 and 30 July 2013 and with complete records were included in this retrospective study. Results: The abdominal trauma accounted for 1.1% of hospitalization and 10% of abdominal emergencies. The average age of patients was 28.04 ± 22.25 years with extremes of 02 and 67 years. The sex ratio equaled to 7.17. Half of the patients were children under 15 years. The first three circumstances abdominal trauma was road traffic accidents 31 (31.63%) cases, animal aggression 27 (27.55%) cases and falls from a tree 14 (14,29%) cases. Contusions were found in 73 (74.50%) cases and wounds in 25 (25.50%) cases. Fifty four (55.10%) laparotomy were performed. The rate of white laparotomy is 5.55% with 3 cases. The spleen was the most affected organ (15%) followed by small bowel (13%). Morbidity was 8.16% dominated by parietal suppuration. The rate of mortality was 2.04%. Mean hospital stay was 10.7 days. Conclusion: abdominal trauma interested young adult male in northern Benin. Road traffic accidents and animal injuries were the leading cause

Insuffisance Rénale Aigue Post-Opératoire Au Centre Hospitalier Universitaire Et Départemental Du Borgou : Fréquence Et Facteurs De Risques Associés

Introduction: Acute renal failure (ARF) post-operative is a specific form of acute deficiencies causing multiple declining factors. Objective: This survey aims to study the incidence and risk factors associated with acute renal failure (ARF) in post-operative surgical intensive care units to University Hospital of Borgou (UH-B): during 2015. Patients and Methods this study is a cross sectional, descriptive and analytical ones with the prospective data collection from March 1st to August 31th, 2015. The research has involved all patients admitted to the operating room for surgery and motherhood whatever reason and then transferred respectively to the intensive care areas at UH-B. The postoperative ARF has been investigated inner patients following inclusion criteria and classification according to RIFLE score. The socio-demographic, clinical and biological variables monitoring, even support and evolution are experimented. A questionnaire is designed for data collection. Data are analyzed by Epi-Info means with 5% of significance level. Results: 130 patients are registered. The mean age is 27.68 ± 12.87 years. The sex ratio is 0.66. The frequency of post-operative ARF reaches 12.31%. The associated risk factors are: hypertension (p = 0.0018), diabetes (p = 0.002), heart failure (p = 0.0104), severe sepsis (p = 0.006) hypovolemic shock (p = 0.002), ASA class ≥ 3 (p = 0.0014), preeclampsia-eclampsia (p = 0.012), the Altémier class classification ≥ 3 (p = 0.0164), a pathological urinary sediment like a proteinuria (p=0.006), haematuria (p= 0.001) and nitrituria (p=0.007). Consequently, three (03) subjects out of sixteen (16) have died (18.75%). Conclusion: The post-operative ARF is a reality in University Hospital Borgou , with a higher mortality rate. Thus, the prevention strategy is the best treatment through the screening and monitoring promotion towards risk factors

Mannheim Peritonitis Index: usefulness in a context with limited resources: Prognosis of acute peritonitis.

Background: The objective of this study is to evaluate the Mannheim Peritonitis Index (MPI) usefulness for acute generalized peritonitis management in a clinical limited resources context. Methods: This is a prospective study from 1 January to 31 October 2019 including patients admitted to a sub-saharan hospital for acute generalized peritonitis. Perioperative variables and outcomes were considered. Results:  70 patients were included. Mean age was 32.6 ± 14.6 years with a sex ratio of 1.33. The mean time to patients’ hospital admission was 3.9 ± 2.1 days. Most patients had ileal and gastric perforations (27.1% and 18.6%). Twenty six patients (37.1%) developed complications and thirty-day mortality rate was 14.3%. Positive predictive value of MPI was 63.6% and negative predictive value was 83, 8%. Sensitivity of MPI ≥ 26 was 77.8%; Specificity of MPI < 25 was 72.1%. Conclusion This experience shows that MPI is a good predictor of morbidity and mortality for patients with acute peritonitis even in a difficult context with few resources and many patients. Identifying the most critical patients, a more careful surgical staff involvement may improve patients outcome

Usefulness of a clinico-biological Francois’ score in the diagnosis of acute appendicitis. Experience of the University Hospital Center of Parakou, Benin

Introduction: Diagnostic wanderings of acute appendicitis are responsible for serious complications or abusive appendectomies. Existing Clinico-biological scores are efficient. Objective: To determine the diagnostic efficiency of François’ score in acute appendicitis. Methodology: over 10 months, all the patients admitted in the CHUD-Parakou Emergency Department for pain in the right iliac fossa had been examined by resident students who calculated François’ score. After verification by the surgeon, patients were put into three categories: category 1 score ≥ 2; category 2, score between -6 and 2; category 3, score below -6. Sensitivity and specificity were calculated. Results: out of 54 patients selected (29 men and 25 women), 29 were classified as group 1; 19 as group 2 and 6 as group 3. An ultrasound was performed in all patients in group 2, and signs in favor of appendicitis were found in 12 patients. Of the 41 appendicectomies performed, the histologic analysis of 33 operative specimens found a pathological appendix. Sensitivity, specificity and negative predictive value per group were 100%. It has prevented almost in one every four patients (24.07%) an abusive appendectomy. Conclusion: This score would reduce diagnostic wanderings and target patient groups for imaging studies

Prolapsus Muqueux de L’urètre au Centre Hospitalo-Universitaire Départemental de Borgou -Parakou, Bénin

Introduction: Le prolapsus muqueux de l’urètre est l’éversion circonférentielle de l’épithélium de la muqueuse urétrale congestive à travers le méat urinaire. L’objectif de cette étude était de rapporter la prise en charge des prolapsus muqueux de l’urètre. Méthodes: Il s’est agi de 7 dossiers de patientes prise en charge pour de prolapsus muqueux de l’urètre colligés rétrospectivement sur 4 ans dans le service de chirurgie du centre hospitalier universitaire départemental de Borgou à Parakou, au Nord du Bénin Résultats: L’âge moyen des patients, tous de sexe féminin, était de 4±0,8 ans avec des extrêmes de 2 ans et de 08 ans. Le principal motif de la consultation a été l’hémorragie génitale. A l’examen physique on retrouvait une tuméfaction sous-clitoridienne centrée par le méat urétral. La prise en charge a été chirurgicale. Nous avons procédé dans tous les cas en une excision de la muqueuse prolabée suivie d’une suture muco-muqueuse sur une sonde de Foley pour 48 heures. Les suites opératoires étaient simples et aucune récidive n'est observée après un recul moyen de 7 mois. Conclusion: Le prolapsus urétral est une affection rare qui se rencontre chez les fillettes prépubères. Le traitement chirurgical donne de résultats cliniques et esthétiques satisfaisants.  Background: Mucosal prolapse of the urethra is the circumferential eversion of the epithelium of the congestive urethral mucosa across the urinary meatus. The objective of this study was to report our experience in the management of mucosal prolapse of the urethra. Methods: We reviewed 7 cases of patients treated for mucosal prolapse of the urethra, collected retrospectively over 4 years in the surgical department of the departmental university hospital of Borgou in Parakou, northern Benin. Results: The mean age of the patients, all female, was 4±0.8 years with extremes of 2 years and 08 years. The main reason for consultation was genital hemorrhage. Physical examination revealed a subclitoral swelling centered on the urethral meatus. The management was surgical. We proceeded in all cases with an excision of the prolapsed mucosa followed by a muco-mucosal suture on a Foley catheter for 48 hours. The postoperative course was simple and no recurrence was observed after a mean follow-up of 7 months. Conclusion: Urethral prolapse is a rare condition that occurs in prepubertal girls. The surgical treatment gives satisfactory clinical and aesthetic results