Amyand’s Hernia Complicated by Acute Appendicitis, A Rare Condition: Case Report and Review of the Literature

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L'hémangiopéricytome pulmonaire primitif: deux nouvelles observations.

We describe two new resected cases of primary pulmonary hemangiopericytoma and the review of cases published in the period 1954-2002. The first patient has a large pulmonary mass of the right apex revealed by scapular pain. The right upper lobectomy with free margins reveals hemangiopericytoma. Pelvic and pulmonary metastases appear two years after surgery, treated by two series of chemotherapy without clinical response. After acute nephrotoxicity controlled by hemodialysis, the patient dies with distant metastases three years and an half after thoracotomy. The second patient develops dry cough and thoracic pain with discovery of a cavitary mass in the right pulmonary field. Fine needle aspiration cytology suggests a mesenchymatous lesion. Three months after extended pneumonectomy, the intrathoracic tumour relapses and regresses partially under chemotherapy. Femoral and brain metastases are irradiated. The patient dies 22 months after thoracotomy. Histology and immunohistochemistry of both tumours closely related to solitary fibrous tumour confirm malignant hemangiopericytoma. Primary pulmonary hemangiopericytoma is rare and may be benign or malignant. Radical resection is the best treatment. Chemotherapy and radiotherapy may improve the prognosis. Compared with lung cancer, the tumour is a slow growing mass, often voluminous, with delayed symptoms, very few lymph node dissemination, rare brain metastasis, more frequent cutaneous or retroperitoneal dissemination, often after long-term and requiring indeed a 10 to 20 years follow-up.Case ReportsEnglish AbstractJournal ArticleReviewSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Totally laparoscopic esophago-gastrectomy

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Incidence of Post-Operative Complications and Factors Influencing Their Occurrence in Patients with Sickle Cell Disease in a Low-Income Country: A Case Study of Cameroon

This study aimed to analyse post-operative complications and possible factors influencing their occurrence in the management of patients with sickle cell disease in a low-income country. We prospectively collected data regarding the management of patients with sickle cell disease requiring anesthesia for surgery in 11 Cameroonian hospitals from 1 May 2019 to 30 April 2021. The data were analysed using descriptive statistics and a binary logistic regression was used to determine the dependence between the variables. A total of 124 patients with sickle cell disease were enrolled; 64 were male and 60 female, giving a sex ratio of 0.93. The rate of post-operative complications was 23.4% (29/124) and the death rate was 3.2% (4/124). The female subjects had more complications than the male subjects p < 0.05. The number of vaso-occlusive crises experienced per year showed a significant impact on the occurrence of post-operative complications p < 0.05. Laparoscopic surgery had fewer post-operative complications 5/46 (10.9%) than laparotomy 14/43 (32.5%). The surgical technique for the abdominal procedures had a significant impact on the occurrence of post-operative complications p < 0.05. The type of surgery (p = 0.198) and the anaesthesia technique (p = 0.225) did not show a significant impact on the occurrence of post-operative complications. Particular attention should be paid to female patients with sickle cell disease as they are more likely to experience postoperative complications, as well as to the frequency of vaso-occlusive crises, which are also predictive of post-operative complications. Opting for laparoscopic surgery whenever possible would help to reduce post-operative complications.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Les plaies pénétrantes de l’abdomen avec éviscération : aspects cliniques, thérapeutiques et pronostiques sur 2 centers à Yaoundé

English Title: Penetrating wounds of the abdomen with evisceration: clinical, therapeutic and prognostic aspects on 2 centers in Yaounde Introduction: Les plaies pénétrantes de l’abdomen (PPA) avec éviscération représentent une majeure partie des urgences chirurgicales viscérales, avec des chiffres préoccupants. Elles nécessitent une bonne sélection des malades en vue de réduire le taux de laparotomie blanche, sans augmenter la morbi-mortalité.Méthodologie: Nous avons mené une étude rétrospective, descriptive et multicentrique. Elle s’est déroulée dans les services de chirurgie du Centre des Urgences de Yaoundé(CURY), et le bloc des urgences de l’hôpital Central de Yaoundé (HCY) sur une période de 2 ans allant du 1 er janvier 2016 au 31decembre 2017.Résultats: Au total 65 patients porteurs de PPA avec éviscération ont été recensés. L’adulte jeune de sexe masculin était le plus touché, la profession de commerçants plus concernée (32,31%). Les agressions (66%) entrainaient un grand nombre de plaies à domicile (40%) par arme blanche (71%). La région ombilicale était la plus atteinte (20%) avec le grêle comme étant le viscère le plus extériorisé (36%). La stabilité hémodynamique (48%), et l’absence de signes d’irritation péritonéale (37%) justifiaient un traitement non opératoire « expectative armée » (36%) en lieu et place d’une laparotomie exploratrice (64%). Sur le plan pronostic, les suites opératoires étaientsimples (92%) réduisant ainsi la durée d’hospitalisation entre 5-10jours (65%).Conclusion: Les PPA avec éviscération sont en hausse chez l’adulte jeune. Chez les patients hémodynamiquement stables et sans signes d’irritation péritonéale, une exploration et réparation pariétale sous anesthésie locale suivi d’une expectative armée peut être considérée, mais dans plus de la moitié des cas une laparotomie exploratrice est indiquée. Mots clés: Plaies pénétrantes – éviscération - Laparotomi

Penetrating cardiac injuries in Belgium: 20 years of experience in university hospitals in Brussels.

Cardiac wounds remain as highly lethal lesions in which their prognosis depends on the emergency management.info:eu-repo/semantics/publishe

Blunt abdominal trauma with duodenal dissection: A case report

We describe a new case of duodenal wound with complete transection in a 22-year-old patient following a motorcycle accident. He presented to the emergency room of the rural Regional Hospital of Ed&eacute;a in Cameroon with a clinical picture of acute abdomen and post-trauma hemodynamic instability. A peritoneal puncture brought back an incoagulable blood. An exploratory laparotomy revealed a large hemoperitoneum mixed with food debris. A tear of the omentum and transverse mesocolon and a complete section of the third duodenum at the beginning of its free portion were observed. The surgeon performed emergency closure of both duodenal stumps and performed an isoperistaltic lateral gastrojejunal bypass. A transfer to a specialized center for a more anatomical continuity was considered, but the imminence of a humanitarian mission in the hospital prompted the surgeon to seize the opportunity of this mission for the reoperation. This surgical revision was performed on the fifth postoperative day. A resection of the distal duodenal stump and the adjacent jejunal segment including the anastomosis was performed. Continuity was restored by a mechanical duodenal-jejunal anastomosis. The patient was discharged on the 18th postoperative day. This type of lesion is difficult to manage in an emergency situation in a structure with limited technical resources. Unfortunately, surgeons treating polytraumatized civilians are encountering an increasing number of blunt duodenal wounds requiring laborious management

Late diagnosis of intestinal malrotation treated with gastrojejunal bypass: A case report

We report the case of a male African patient who presented at day 8 of life with recurrent episodes of proximal small intestine occlusion, which was treated conservatively, because of misdiagnosis. Physical and cognitive development was normal throughout with, however, some episodes of stagnation. At the age of 15 years the recurrence of symptoms, not responding to the current conservative treatment, resulted in severe weight loss with BMI at 11 kg/m2. The oesogastroduodenal barium study disclosed an extrinsic duodenal compression compatible with a congenital duodenal band. Because of the major concerns related to the patient and to the medical environment, jejunostomy for feeding was first performed to improve his weight. A year later the intestinal malrotation was cured by gastrojejunal bypass. The postoperative clinical course was favorable. The patient resumed a normal life and schooling. His BMI is currently 21.5 kg/m2.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Cannabis body packing: A case report

Drug traffic is a major concern worldwide. We report a case of a 27-year old male who presented with a diffuse abdominal plain to the emergency department. Abdominal X-ray demonstrated multiple foreign bodies along the intestinal tract, which were found to be cannabis packets. The patient was treated conservatively with a good result.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Prospective, randomized clinical trial of laparoscopic totally extraperitoneal inguinal hernia repair using conventional versus custom-made (mosquito) mesh performed in Cameroon: a short-term outcomes.

Adverse economic conditions often prevent the widespread implementation of modern surgical techniques in third world countries such as in Sub-Sahara Africa.info:eu-repo/semantics/publishe