Fistule artério-veineuse ulno-basilique pour hémodialyse au CHU de Yaoundé: à propos de deux cas

La fistule ulno-basilique est une éventualité peu sollicitée dans le choix des abords vasculaires pour hémodialyse. Elle est construite sur la veine basilique qui est souvent la seule veine épargnée par les ponctions veineuses de routine dans les services de médecine. De par l'existence de nombreuses complications comme l'infection des prothèses et des cathéters centraux, les thromboses, les patients hémodialysés chroniques nécessitent plus d'un accès veineux au cours de leur suivi médical. Les fistules artério-veineuses natives présentent moins de risques de complications que les prothèses d'une façon générale et une plus longue durée de vie. La confection d'une fistule sur une topographie proximale compromet le recourt à cette veine sur une localisation distale ultérieurement. Il existe donc une hiérarchisation dont il faut tenir compte pour une utilisation optimale du capital veineux disponible. Nous rapportons ici deux observations concernant des patients chez qui deux fistules ulnobasiliques ont été réalisées avec succès au CHU de Yaoundé.Key words: Fistule artério-veineuse, hémodialyse, ponction veineus

Meckel’s diverticulum: a case report from the University Hospital Center Yaoundé, Cameroon

To the best of our knowledge there is no reported case of Meckel’s diverticulum (MD) in Cameroon. The prevalence of MD in the general population is 2-3 %. The aim of this paper is to recapitulate the role of this pathology in acute abdomens and abdominal pain of uncertain aetiology in young patients and to review the medical literature

Retained sponge after abdominal surgery: experience from a third world country

Background: Retained abdominal sponge after surgery is a quite rare condition which can have heavy medico-legal consequences; its frequency is generally underestimated. Few reports of these conditions are available in African environment with specific technical and medico-legal background. We present our local experience of retained sponges after abdominal surgery and review current literature. Methods: A retrospective analysis of the medical files of 14 consecutive patients with a retained surgical sponge after abdominal and urological surgery. Results: The incidence was 1every 677 abdominal operations; no metallic foreign body described, only sponges; the female sex predominated with 10/14 patients. 85.71% of retained sponge occurred after an emergency procedure and 64.28% were gynecological or obstetrical procedures. Most cases presented as intestinal obstruction, localized persistent pain or abdominal mass and pre-operative diagnosis could be done only in 28.57% of cases. A falsely correct sponge count was reported in 71.42% of cases. 92.85% of patients were re-operated and the morbidity was low; no death was reported. None of our cases ended in a medico-legal claim despite proper counseling. Conclusion: The incidence of retained sponge might be significantly higher in an environment with reduced medico-legal threat; most cases of retained sponges are still related to human errors; the incidence will probably be reduced by a greater awareness about the condition

Intestinal helminths in some cases of acute appendicitis operated in Bamenda, Cameroon

Background: Acute appendicitis is the most frequent infectious surgical abdominal emergency and previous studies have noted the presence of parasites in the appendicular lumen.Objective: This study was done to determine the involvement of intestinal worms in the etiology of acute appendicitis.Materials and Methods: This was a prospective and descriptive study concerning cases of confirmed and operated acute appendicitis between 15th April, 2013 and 14th April, 2015 at the People’s Clinic, Ngomgham, Bamenda, Cameroon. The appendicular content was macroscopically examined for parasites and formol-ether concentration technique was carried out for ova detection.Results: A total of 112 patients were operated for acute abdominal pain within the study period. There were 74 (60.8%) cases confirmed with acute appendicitis of which 45 (60.1%) were males and 29 (39.2%) were. The most affected age group was the 21 to 40 years (50%). The removed appendices appeared congestive in 30 (40.5%) cases, suppurated in 27 (40.5%) cases and gangrenous in 17 (23.0%) cases.There was no relationship between the appearance of the removed appendix and the gender of participants (P>0.05).Three different helminth ova were identified in the 74 samples. In decreasing prevalence, the parasite trend was 8 (10.8%) Ascaris lumbricoides, 5 (6.8%) Enterobius vermicularis, 3 (6.0%), Ankylostoma duodenale, Adult Ascaris lumbricoides and Enterobius vermicularis were seen in 1 and 3 cases respectively.Conclusion: A small percentage of parasitic worm eggs were found in the appendicular content, though a good portion of patients took medications against parasites before surgery. Intestinal worms could not be incriminated in the causation of the appendicitis; nevertheless, one adult ascaris was found as an evident cause of appendicular lumen obstruction.Keywords: Intestinal Helminthes, Acute appendicitis, Bamend