Les cancers du sein masculin à Niamey

Moins frequent que chez la femme; le cancer du sein existe aussi chez l'homme. A partir d'une serie hospitaliere a Niamey au Niger; nous avons entrepris une etude retrospective afin d'en analyser les particularites epidemiologiques cliniques et therapeutiques. Durant la periode d'etudes (1992-2006); nous avons collige 18 cas microscopiquement confirmes. La majorite des malades etaient d'origine rurale. Ils se sont presentes a des stades avances : T3 et T4. Toutes les malades ont ete operees; seules 4 parmi elles ont eu un traitement complementaire adjuvant. Le carcinome canalaire infiltrant a ete le type histologique le plus frequent (55;5). L'evolution n'a pu etre evaluer car tous les malades etaient perdues de vue 6 mois apres l'acte operatoire

[Appendicitis and advanced pregnancy. Apropos of 3 cases in the National Hospital of Niamey, Niger]. / Appendicite et grossesse avancée: à propos de 3 cas à l'Hôpital national de Niamey, Niger.

Acute appendicitis during pregnancy is uncommon but a serious situation even in developed countries with imaging and laboratories' poor means. Failure to diagnose this disease during advanced pregnancy exposes foetus and mother to serious complications. In this atypical clinical picture associated with non-significant biologic sign only using sonogram can help to early diagnosis. In our developing countries where obstetrical exam was performed by paramedical or general doctor, in doubt the patient must be transferred in medical centre with a capacity of imaging or laboratory exams. Surgical treatment must be undertaken after surgeon, obstetrician, and other physicians's consultation. Antibiotic and tocolytic treatments are urgent. In this study, all babies were lost by premature labour occurred after surgery.

[Breast diseases in young women of Niger: results of a campaign for self examination awareness in a nursing school]. / Pathologie mammaire de la jeune fille au Niger: résultats d'une campagne de sensibilisation à l'autopalpation dans une école d'infirmières.

In order to favour the early diagnosis of breast cancer, the authors used an original method consisting in teaching nurses about breast tumors and cancer, and especially about self-examination of the breasts. Subsequently, 73 patients aged under 24 years were admitted to our survey: 90 per cent had an understanding of risk factors and 97 per cent were practicing self-examination. In 21 cases, consultation was carried out for mastalgia and in 12 cases for esthetic and/or banal inflammatory lesions: 40 patients presented a lump in the breast. Sonography turned out to be a better method of examination than mammography in those young women presenting breast lesions. Following surgery, histological examination found that in the majority of cases the tumour was benign (fibrocyst or adenofibromas). We were surprised by medullary carcinoma in one case.

[Colonic pseudo-obstruction disclosing bladder calculi: report of 2 cases]. / Pseudo-obstruction colique, révélatrice d'un empierrement vésical: à propos de 2 cas.

The authors report two cases of acute intestinal obstruction caused by bladder calculi and insist on differential clinical diagnosis. Simple X ray and sonography seemed to be sufficient-for diagnosis of this extrinseque colique obstruction and management consisted of removal of the bladder stones The prognosis is excellent.

[Large ventral hernia in tropical countries: etiology and results of treatment with the Judd technique]. / La volumineuse éventration médiane en zone tropicale: étiologies et résultats du traitement par la technique de Judd.

Large ventral hernia is a most common pathology in surgical practice in tropical countries. We reported 67 cases of large ventral hernia with mean diameter about 11.7 cm. There were 41 women and 26 men. It was incisional hernia in 49 cases; recurrent ventral hernia in ten cases (after first repair six cases and after the second repair in four cases). Ventral hernia occured in 18 women after many pregnancies (mean of five pregnancies in ten years): this etiology of ventral hernia is the particularity of our practice; rarely in developed countries where number of pregnancies by women varied from two and where the women had means to abdominal wall reeducation. Another factor was excessive weigh: in our country, woman must take some many kilogrammes after pregnancy by traditional practice. Without means in our hospital, preoperative exams were limited to detect and treated cardiorespiratory diseases. All patients had an repair of their ventral hernia by autoplasty like described by Judd completed by another layer with the same ligature. Postoperative time was marked by wound sepsis (11 cases), dyspnea (ten cases), intestinal pseudo-obstruction (eight cases) and three patients were died (failure of respiratory system in two cases and cardiac failure in one case). After 18 months there were seven recurrent ventral hernia, all in incisional hernia. Judd's autoplastic technic is an efficacy technic in primitive ventral hernia or for the first repair of incisional ventral hernia. Preoperative management must concern all respiratory problems and their treatment.

[Spontaneous giant cephalohematoma in a 13-year-old child]. / Volumineux céphalhématome spontané chez un enfant de 13 ans.

Cephalohematoma is usually observed in the neonatal period often as a result of birthing injuries induced during difficult labor (vacuum extraction and forceps delivery). Less common causes include vascular abnormalities, aneurysm, arterial dissection, blood coagulation disturbances, and vascular wall frailty. This report describes a giant cephalhematoma with right ocular protrusion and anemia with no identifiable cause in a 13-year-old boy. Rapid recovery was achieved by surgical drainage and prompt dressing.