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

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

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

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A Rare Presentation of Maydl’s Hernia

We present a case of an unsual type of obstructed indirect inguinal hernia with impending strangulation. The operative findings revealed a sliding Maydl’s hernia with an ischemic inner ileal loop and an adherent inflamed appendix. This case highlights the importance of intraoperative examination of the intra-abdominal bowel loops proximal to the hernia sac of an incarcerated, obstructed, or strangulated hernia

Lichtenstein hernioplasty for groin hernia in central Africa

Background: Herniorraphy is a common surgical procedure in our surgical practice in Cameroon. A study was conducted in The General Hospital of Yaoundé, to assess Lichtenstein hernioplasty technique, among other hernioplasties. Materials and methods: Fourteen patients were studied, in a retrospective study of 9 years (1996 to 2005) in A General Hospital in Yaounde Cameroon, Central African. All the patients benefited from a tension-free repair using a surgical mesh of polyglactin 910 (vicril*) under local anesthesia. This technique was applied for simple inguinal hernias, bilateral hernia and recurrent hernia. Results: The time of surgery varied from 35 minutes to 140 minutes. Three complications were noted including one hematoma, one scrotal oedema and one crural neuralgia; 9 patients out of 14 were followed up closely for 9 years; no recurrence was noted. Conclusion: We therefore recommend the technique of the Lichtenstein in the repair of the groin hernia, in association to local anaesthesia in Cameroon. Keywords: groin hernia, hernioplasty, surgical mesh, Lichtenstein technique Nigerian Journal of Surgical Research Vol. 7(3&4) 2005: 315-31

Occlusions intestinales aigues : causes, prise en charge et évolution post opératoire dans deux hôpitaux de Douala (Cameroun)

Objectif : Déterminer le profil épidémiologique, étiologique, clinique et évaluer les modalités thérapeutiques dans deux hôpitaux de la ville de Douala.Matériel et méthodes : Nous avons mené une étude rétrospective descriptive, s’étendant du 01 janvier 2014 au 31 décembre 2018, ayant inclus 202 patients de tout âge et des deux sexes ayant présentés une occlusion intestinale aigüe dans les services de chirurgie des hôpitaux général Laquintinie de Douala. Les variables étaient relevées sur des fiches de collecte des données conçues. L’analyse des résultats obtenus a été faite à l’aide du logiciel SPSS version 20.Résultats : La prévalence des occlusions dans les hôpitaux de notre étude était de 21,9%, avec une prédominance masculine à 52,5% pour un sex ratio de 1,1. L’âge moyen était de 43,23 ans (+/- 13, 62ans). La grande majorité des patients a été opérée (188 cas, 93,1%). La strangulation (140 cas, 74,5%) a été le mécanisme dominant. Les principales étiologies étaient les brides et les adhérences 46,3% (87 cas), suivi du volvulus (38 cas, 20,6%, et les tumeurs (19 cas, 10,1. Les complications ont été observées chez 24 patients, soit une morbidité de 12,8, avec et un taux de mortalité de 4,9%.Conclusion : Les occlusions intestinales restent assez fréquentes parmi les urgences digestives. Elles restent dominées par les brides et adhérences, les volvulus et les tumeurs. La prise en charge précoce de l’occlusion intestinale aigüe à travers une bonne sensibilisation des populations, pourra réduire le taux de morbidité et de mortalité qui sont encore augmentées dans nos pays en voie de développement. Mots clés : occlusion intestinale aigüe, traitement, morbidité, mortalité, Douala (Cameroun). English Abstract: Acute intestinal occlusions: causes, management and post-operative evolution in two hospitals in Douala (Cameroon)Objective: To determine the epidemiological, etiological, clinical profile and to evaluate the therapeutic modalities in two hospitals in the city of Douala.Materials and methods: We conducted a descriptive retrospective study, extending from January 01, 2014 to December 31, 2018, including 202 patients of all ages and both sexes who presented with acute bowel obstruction in the surgical departments of the Doual General and Laquintinie Hospitals. Variables were recorded on designed data collection sheets. The analysis of the results obtained was carried out using SPSS version 20 software.Results: The prevalence of occlusions in the hospitals in our study was 21.9%, with male predominance at 52.5% for sex. ratio of 1.1. The average age was 43.23 years (+/- 13, 62 years). The vast majority of patients underwent surgery (188 cases, 93.1%). Strangulation (140 cases, 74.5%) was the dominant mechanism. The main aetiologies were flanges and adhesions 46.3% (87 cases), followed by volvulus (38 cases, 20.6%, and tumors (19 cases, 10.1. Complications were observed in 24 patients, or a morbidity of 12.8, with a mortality rate of 4.9%.Conclusion: Intestinal obstructions remain fairly frequent among digestive emergencies. They remain dominated byflanges and adhesions, volvulus and tumors. in early management of acute intestinal obstruction through good sensitization of populations, could reduce the rate of morbidity and mortality which are further increased in our developing countries. Key words: acute intestinal obstruction, treatment, morbidity, mortality, Douala (Cameroon