Strangulated or incarcerated spontaneous lumbar hernia as exceptional cause of intestinal obstruction: case report and review of the literature

Lumbar hernias are rare conditions and about 300 cases have been reported since the first description by Barbette in 1672. Therefore strangulation or incarceration are also exceptionally encountered. We present a 62 -year-old-man who had strangulated left lumbar hernia and consequent mechanical small-bowel obstruction, alongside with a non strangulated right lumbar hernia. Through a median laparotomy, an intestinal necrosis was found. A bowel resection with end to end anastomosis was performed and the lumbar hernias were repaired on both sides. The recovery was uneventfull. To the best of our knowlwdge thanks to the litterature review presented here, this is the 19th case of incarcerated or strangulated spontaneous lumbar hernia described in the surgical litterature since 1889

Confection D’une Colostomie De Maydl (Sur Baguette) En Situation De Precarite

Nous avions présenté une procédure simplifiée et reproductible de réalisation d’une colostomie sur baguette de Maydl, en conditions de précarité. Il s’agissait d’utiliser une seringue stérile de 10 cc et un fil à peau

Hypertrophic pyloric stenosis in infants: is it a congenital or acquired disorder? Reflections on 2 cases

Based on evidence from two collected and treated clinical observations of hypertrophic pyloric stenosis in children of 5 and 12 months of age, the authors give their point of view on the unresolved issue of the etiology of hypertrophic pyloric stenosis. They emphasize that there are more and more factors to prove this is an acquired condition

A Rare Cause of Sub-Acute Proximal Intestinal Obstruction Due to Annular Pancreas

Background: Annular pancreas is a rare congenital anomaly due to an abnormal fusion between the tip of the ventral pancreatic bud and the duodenum at about the 7th gestational week and, presenting usually with symptoms due to duodenal obstruction. We report a case of a 2- year old girl who presented electively for investigations of symptoms of a sub-acute proximal intestinal obstruction. Investigations revealed a partial duodenal obstruction and an exploratory laparatomy surprisingly showed a partially obstructing annular pancreas for which she underwent a bypass procedure. A precise preoperative diagnosis of annular pancreas can be difficult without good imaging and the diagnosis and surgical management decision may only be made at laparatomy. Children with atypical or mild symptoms of intestinal obstruction associated with failure to thrive should be investigated fully for a probable mechanical cause.Keywords: Annular pancreas, Duodenal obstruction, Surgical bypas

Anemia in type 2 diabetic patients and correlation with kidney function in a tertiary care sub-Saharan African hospital: a cross-sectional study

BackgroundAnemia is common in diabetic patients and increases morbidity and mortality, but its burden has been less well characterized in sub-Saharan Africans. We determined the prevalence of anemia and investigated the related factors, with a particular focus on the role of declining renal function, in type 2 diabetic patients attending a tertiary health care institution in Cameroon.MethodsHemoglobin (Hb) levels were measured in a consecutive sample of patients with type 2 diabetes, who reported for annual review at the outpatient section of the Douala General Hospital in 2013. Patients were classified as anemic according to the World Health Organisation criteria (Hb < 12g/dl for females and Hb < 13g/dl for males). Estimated glomerular filtration rate (eGFR) was calculated using the abbreviated Modification of Diet in Renal Disease Study Group formula. Determinants of Hb concentration and anemia were investigated using multivariable logistic regressions.ResultsA total of 636 patients were examined including 263 (prevalence rate 41.4%) who had anemia. The prevalence of anemia increased significantly with deteriorating kidney function, although up to 31.9% of patients with normal kidney function had anemia. Compared with their non-anemic counterparts, anemic diabetic patients were older, had longer duration of diabetes, lower eGFR, higher prevalence of proteinuria and diabetic retinopathy (all p < 0.05). In multivariable logistic regressions, eGFR (p = 0.001) and presence of retinopathy (p = 0.023) were the independent determinants of prevalent anemia.ConclusionsThe prevalence of anemia is high in type 2 diabetic patients attending referral institutions in Cameroon, including among those without chronic kidney disease. Routine screening for anemia in all diabetic patients may aid early identification and correction as appropriate

Prise en charge de la douleur post-operatoire immediate en salle de soins post interventionnels

15 à 50 % des opérés font l'expérience des douleurs post opératoires en dépit des traitements analgésiques. Le but de ce travail a été d'évaluer la prise en charge de la douleur post opératoire (DPO)en salle de soins post interventionnels (SPPI). Il s'agit dune étude prospective et descriptive réalisée dans le service d'anesthésie et de réanimation de l'Hôpital Général de Yaoundé, République du Cameroun. Ont été inclus dans cette étude des patients âgés de plus de 15 ans admis en salle de soins post interventionnels et capables d'utiliser les différentes échelles d'évaluation de la douleur (échelle visuelle analogique, échelle numérique, échelle verbale simple). La DPO a été évaluée et les patients ont été traités. Les résultats ont été présentés sous forme de moyennes et de pourcentages. Le test de chi carré a été utilisé pour la comparaison des valeurs. 174 patients ont été recrutés, âgés de 34 ans en moyenne. Le sex ratio a été d'un homme pour 5 femmes. La majorité des interventions chirurgicales a été faite sous anesthésie générale (91 %). L'incidence des DPO a été de 94 %. La fréquence des DPO a été élevée dans les chirurgies orthopédique (13 cas soit 100 %) et gynéco obstétrique (118 cas soit 97,5 %) La Noramidopyrine a été l'antalgique le plus prescrit (73 % des patients). 4 % des patients ont présenté des effets indésirables dus au traitement. La lutte contre la DPO requiert une bonne évaluation de la douleur, des protocoles thérapeutiques adaptés et une surveillance clinique rigoureuse. Clinics in Mother and Child Health Vol. 3(1) 2006: 473-47

Neurinomes et neurofibromes spinaux diagnostic et resultats du traitement chirurgical a yaounde

Description les neurinomes et neurofibromes spinaux restent très peu étudiés en Afrique sub-saharienne. Objectif rapporter les résultats du traitement chirurgical des neurinomes et neurofibromes spinaux à Yaoundé. Méthodes étude rétrospective menée à l’Hôpital Général et à l’Hôpital Central de Yaoundé, du 1er Janvier 1995 au 1er Janvier 2005. Critères d’inclusion: dossier médical comprenant les résultats de l’examen clinique pré et post opératoire, ceux des examens neuroradiologiques et histopathologiques, le compte rendu opératoire. Un suivi post-opératoire minimal de six mois. Le résultat fonctionnel été évaluée par l’échelle de Karnofsky. Résultats sur 62 patients opérés d’une tumeur intrarachidiennes, 12 (19,35 %) ont été sélectionnés (neuf neurinomes, deux neurofibromes, un neurofibrosarcome). L’age moyen était de 40,66 ans ±13,20, le sex ratio 0,71. La durée moyenne de symptômes avant le diagnostic était de 17,83 mois ± 5,81, extrêmes 6 et 28 mois ; le signe d’appel le plus fréquent était la radiculalgie (six cas). Cinq patients étaient paraplégiques. Le score deKarnofsky moyen préopératoire était de 50,00 ±12,79 et de 70,83±23,53 en postopératoire. Le siège tumoral était cervical (quatre cas), dorsal (six cas), lombaire (deux cas). La tumeur était extradurale dans six cas, intra durale quatre, intra et extradurale deux cas. L’exérèse était macroscopiquement complète dans neuf cas, partielle dans trois. Cinq patients ont connu une amélioration permettant une réinsertion professionnelle. Conclusion le diagnostic des neurinomes et neurofibromes reste tardif dans notre environnement, ce qui limite lerésultat chirurgical

Current antibiotic susceptibility profile of the bacteria associated with Surgical wound infections in the Buea health district in Cameroon

Background: Most surgical wounds seen in clinical practice in the Buea Health District, Cameroon are infected prior to arrival or while they are in the hospital. Sometimes the infection necessitates a combination of local wound site measures and systemic antibiotherapy to properly manage the patient.Objective: To identify the current antibiotic susceptibility profile of the common germs that cause surgical wound infections in the Buea Health District of Cameroon.Methods: A total of 2120 specimens comprising swabs from burns, ulcers, open or post-operative wounds were collected from hospitalized patients attending health institutions in Buea. The samples were collected from different anatomic sites of the patients. Cultures were effected from the specimens and bacteria isolated from infected wounds using standard microbiological techniques. Antibiotic susceptibility of the different isolates was determined.Results: Majority (79.8%) of the wounds were infected with pathogenic bacteria. The germs globally showed multi resistant patterns to commonly used antibiotics in the study area, especially to co-trimoxazol, doxycycline, chloramphemicol, ampicilline and aztreonam. However appreciable sensitivity was noted to ofloxacillin, perflacin, and ceftriazone.Conclusion: This study has revealed ofloxacin as the only antibiotic to which all the isolated bacteria from infected wounds were sensitive in the study area.Keywords: Wound infection, Antibiotic susceptibility profile, Buea Health District, Cameroo