Epidemiology of Digestive Surgical Emergencies in a Sub-Saharan African Country: A Multicentre Pilot Study Protocol.

Introduction: Digestive surgical emergencies remains one of the main general surgery activities. Despite the associated mortality rate in low income countries, epidemiologic data about this subject is rare and multicenter studies are even more. We aimed to study an epidemiology of digestive surgical emergencies in Senegal by multicenter protocol. Methods and analysis: it will a prospective multicenter pilot study from May to July 2022. The patients were from General surgery departments of these teaching hospital in Senegal: Dakar Principal Hospital, Aristide le Dantec Hospital, Dalal Jamm hospital and Saint-Louis Regional Hospital. The Schwartz formula was used. We used a proportion of abdominal surgical emergency of 20%. We had a sample size of 246 patients. Ethics and dissemination: this research protocol will be submitted to Ethics committee of four hospital that included. The results of this study can help to get better the management of our digestives emergencies and at the same time improve mortality rate. Highlights: Digestive surgical emergencies is a public health issueBecause of high mortality rate in poorest countries, epidemiological data in Senegal must be knownThese information can help to lower associated mortality.

[Giant lipoma of the back: a case report and litterature review]. / Lipome géant du dos: rapport de cas avec revue de la littérature.

Lipoma is a benign soft tissue tumour. It is a benign proliferation of mature adipocytes. It is described as giant when its weight exceeds 1 kg or its diameter exceeds 5 cm. Functional and aesthetic impairment may be a major reason for surgical excision. It can be located everywhere, but it mainly occurs in the posterior segment of the chest. We here report a case of giant lipoma of the left posterior-superior segment of the chest.

[Superior mesenteric artery syndrome in gastric cancer: a case report]. / Syndrome de la pince aorto-mésentérique sur cancer gastrique: à propos d'un cas.

Superior mesenteric artery syndrome or Wilkie syndrome is due to the compression of the third duodenum between the superior mesenteric artery and the aorta. It causes acute or chronic upper bowel occlusion. Abdominal CT scan facilitates the diagnosis. Severe malnutrition is its main etiological factor. Medical treatment can be based on aspiration of gastric contents and parenteral nutrition. If this fails, surgery is necessary. We here report the case of a 46-year-old patient, with a history of smoking, presenting with profuse postprandial bile and food vomiting. He had had weight loss of 7% over a period of 6 months. Upper GI endoscopy revealed non-stenotic antro-pyloric tumour mass. Histological examination showed poorly differentiated tubular gastric adenocarcinoma. Staging was without any peculiarity and allowed for the detection of superior mesenteric artery syndrome at an angle of 8°C. The patient received parenteral nutrition for 10 days, followed by inferior pole gastrectomy and gastrojejunal anastomosis (omega loop). The postoperative course was uneventful. Adjuvant chemotherapy was indicated.

Spontaneous colo-vesical and colo-cutaneous fistula complicating a sigmoid diverticulitis: A case report.

INTRODUCTION: Diverticular disease is a challenge in western countries. The occurrence of fistula complicating diverticulitis is uncommon. As a result, spontaneous and synchronous colo-vesical and colo-cutaneous is an even rarer situation. CASE PRESENTATION: We report the case of a 68 years old patient with medical history of bilateral inguinal hernia surgery and diverticular disease. He was admitted for fecal fistula through to the left inguinal area and recurrent urinary tract infections evolving for 2 months. Clinical examination revealed fecaluria and colo-cutaneous fistula. Abdominal CT scan revealed the presence of air in the bladder associated with fistula tract between the sigmoid colon and the inguinal abdominal wall. Surgical management was realized in two stages. The first stage, consisting to an end-colostomy, was performed. The second stage will be laparoscopic colectomy and is not yet realized. In the follow-up, the patient is doing well with a good quality of life. CONCLUSION: Spontaneous colo-vesical and colo-cutaneous fistula is an uncommon complication of diverticulitis. There is no guidelines about the management and the treatment should be tailored according to each patient characteristics. Laparoscopic surgery is a feasible and safe approach in the treatment.

Atypical localization of colorectal cancer metastasis one case and literature review.

INTRODUCTION: colorectal cancer is a public health challenge in France. Cutaneous metastases are rare but they give evidence of poor prognosis. PRESENTATION OF CASE: 88 years old female patient, with a previous history of hysterectomy, venous thrombosis outcomes of ankle fracture and stable multiple sclerosis without treatment. She came to emergency with peritonitis. CT scan showed a pneumoperitoneum, and a transverse colonic mass. A laparotomy was performed. This revealed a perforation of caecum, and an obstructive tumor of transverse colon. An extended right semi-colectomy was performed to remove both the perforate caecum and the tumor. The patient was discharged on the 7th post-operative day. Examination confirm an adenocarcinoma pT3N0Mx. At follow up, a nodule was found on her forehead. The biopsy showed a metastasis of colon adenocarcinoma. A surgical resection was performed. To date the patient is well with no evidence of recurrent disease. CONCLUSION: Cutaneous metastases are rare and there are no recommendations for their treatment. Surgical resection is the best choice, but radiotherapy may be an alternative.

Cystic mesenteric lymphangioma: A case report.

INTRODUCTION: Cystic lymphangioma is a benign malformative tumor. The abdominal localization is rare. The diagnosis is not easy in preoperative period. The surgery is the choice in the abdominal and symptomatic localization. PRESENTATION OF CASE: We report a 26 years old women. She consulted with left hypochondrial pain. The exam found left hyphochondrial swelling with 10 cm of diameter. The biologic screeming was normal. The ultrasound showed a multiloculated cyst which measured 130*80 mm. the CT scan showed a mesenteri cyst mass measured 15 cm. A fine needle aspiration cytology guided by abdominal ultrasound was realized and the cytology doesn't show malignant cell. A median laparotomy found a mesenteric cystic mass measured 15 cm of diameter. A resection was realized. The histologic exam membranous fibrosis cyst limited by an endothelium. CONCLUSION: Mesenteric localization of cyst lymphagioma is rare. The surgery is safe and efficiency for the treatment.

[Acute intestinal occlusion revealing abdominal pregnancy: a case study]. / Occlusion intestinale aiguë révélant une grossesse abdominale: à propos d'un cas.

Abdominal pregnancy (AP) is defined as the implantation and the development of the fertilized egg in the peritoneal cavity. It is a rare type of ectopic pregnancy, whose detection can be fortuitous, mimicking surgical emergency. We report a rare case of acute febrile bowel obstruction revealing abdominal pregnancy in a 27-year old patient, with no particular past medical history, admitted to hospital for the treatment of occlusive syndrome evolving over the last week. Physical examination showed shiny, distended, meteoric, completely sensitive abdomen. Laboratory tests showed white blood cell count 20300, haemoglobin 7,2g/dL. Surgical exploration showed hemoperitoneum 2000ml, retrouterine encapsulated mass, strongly adherent to the mesosigmoid and to the sigmoid, responsible of a stenosis of the descending colon. The patient underwent monobloc exeresis, which showed a portion of placenta next to the mesosigmoid attached to the fetus, right annexectomy and colostomy.