[Endoscopic features of esophageal cancer in Dakar, Senegal: study of 76 observations]. / Aspects endoscopiques du cancer de l'oesophage à Dakar (Sénégal): étude de 76 observations.

OBJECTIVE: In response to the lack of cancer register and paucity of publications on esophageal cancer in Senegal, this retrospective descriptive single-center study was undertaken to determine epidemiological, clinical, endoscopic and histological features of the disease at a digestive endoscopy center in Dakar. PATIENTS AND METHOD: Reports describing upper digestive tract endoscopy procedures performed at the Aristide Le Dantec Teaching Hospital in Dakar between January 2006 and December 2009 were reviewed. Cases involving histologically confirmed esophageal cancer were compiled and patient data including age, sex, and indication for endoscopy as well as endoscopic and histological findings were analyzed. RESULTS: A total of 78 reports were collected including 76 patients with suitable data for analysis. Esophageal cancer accounted for 0.97% of upper digestive tract endoscopy procedures performed. Mean patient age was 49 years and the sex-ratio was 1.9. The main indication for endoscopy was dysphagia (92.1%). The most frequent endoscopic finding involved budding lesions with (42%) or without (29%) ulceration. The most common location was the middle third of the esophagus (50%). The most frequent histological type was squamous cell carcinoma (92.1%). CONCLUSION: Esophageal cancer observed at the endoscopy center of the Aristide Le Dantec Teaching Hospital in Dakar mainly affects young male adults. Lesions are generally located in the middle third of the esophagus and corresponded to squamous cell cancer. There is a need to establish a cancer register and to conduct multicentric studies to gain insight into risk factors for esophageal cancer in Senegal.

[Obstacles in the management of pesticides intoxication in Senegal: about a case of malathion autolysis]. / Difficultes du traitement des intoxications aux pesticides au Sénégal: a propos d'un cas d'autolyse au malathion.

Pesticides are widely used inSenegal as in others africans countries. This situation facilitate occurrence of intoxications, whose management is limited by unavailability of antidotes. We report a case of acute pesticide intoxication in a suicide attempt by a girl of thirteen. The clinical evaluation showed a coma with advanced muscarinic and nicotinic syndrome. The absence of antidotes in the country limited the care management to atropine administration and reanimation measures. The evolution was positive in few days and the patient referred to pediatrics in order to be clinically and psychologically managed. The positive evolution should not hide the necessity for the country to make available all antidotes of toxic substances and to implement Poison Control Centre in order to improve medical management of poisoned people.