Double ileo-sigmoid volvulus: Report of three (03) cases of ileo-sigmoid node.

INTRODUCTION: The ileo-sigmoid node is a rare condition that causes mixed intestinal obstruction. It is difficult to diagnose preoperatively and requires medical and surgical management. We report on managing 03 cases of the ileo-sigmoid node. CASE PRESENTATION: 02 male patients (25 and 37 years old) and one female patient (43 years old) were seen in emergency for occlusive syndromes. The abdominal X-rays in our patients showed air-fluid levels of the small intestine type in two cases and of the mixed type in one case. The diagnosis of intestinal obstruction by strangulation was accepted in all three patients. Hypovolaemic shock was found in the female patient. All three patients had received preoperative resuscitation. Laparotomy revealed type II ileo-sigmoid nodes in 02 cases and type I in one. We noted ileal and sigmoid necrosis in 02 cases and ileal necrosis in 01 case. All three patients underwent ileal and sigmoid resection followed by colorectal anastomosis and terminal ileostomy. Post-operative management was straightforward in all the 03 cases. CLINICAL DISCUSSION: The ileo-sigmoid node is a serious pathological situation, with the risk of rapid evolution of the intestines involved. It is a medical and surgical emergency requiring rapid and appropriate treatment. CONCLUSION: The ileo-sigmoid node is a serious condition with a complex preoperative diagnosis. It is a medical and surgical emergency requiring rapid and appropriate management.

Management of abdominal textilomas: A retrospective study.

INTRODUCTION: Textilomas are an infrequent but well-known surgical complication. The authors report a series of cases to describe the frequency of abdominal textilomas, the circumstances in which they occur, their clinical and morphological characteristics, and their management, to contextualise these data, which may serve as a basis for preventive measures. SETTING AND METHOD: This was a monocentric, retrospective, descriptive study conducted over 10 years at a tertiary hospital. The circumstances of the initial intervention, the diagnosis, and the treatment of textiloma cases treated in the said centre were documented. RESULTS: Twenty-one (21) cases of abdominal textiloma were collected, with an annual frequency of 2.1 cases/year. The cases were predominantly female, with a female-to-male sex ratio of 1.62. The median age of the patients was 37 years. The initial operation was performed in a public facility in 80.95 % of cases. Myomectomy was the main indication (23.81 %). The time for signs to develop before consultation was 16.47 ± 8.82 days. Textiloma extraction was performed in an emergency in 61.90 % of cases. We noted morbidity (38.10 %) and mortality (9.52 %) in our patients. CONCLUSION: Textilomas are a rare surgical complication, albeit with a high morbidity and mortality rate. Their clinical polymorphism and the difficulties of diagnosis and management mean that prevention is of prime importance.

Poland syndrome: Fortuitous discovery of a familial case in Togo.

INTRODUCTION AND IMPORTANCE: Poland syndrome is a rare malformative disease. It is characterized by agenesis or hypoplasia of the pectoralis major muscle associated or not with a malformation of the ipsilateral thoracic limb. The authors report the fortuitous discovery of a familial case of Poland syndrome in Togo. CASE PRESENTATION: He was a 25-year-old young man, with no known pathological history, examined as part of a physical fitness assessment and who presented with thoracic asymmetry. The clinical and radiological explorations made it possible to conclude to a Poland syndrome in its minor form without any other associated malformation. In addition, three other paternal uncles of the patient presented with the same clinical symptomatology. In the absence of a clear indication, the patient received no treatment. CLINICAL DISCUSSION: Poland syndrome is a rare congenital malformation. The abnormalities encountered are cutaneous-glandular, osteo-cartilaginous and muscular. The etiopathogenesis of the disease is unknown. The diagnosis is clinical and is based on the demonstration of agenesis of the pectoralis major muscle. The disease does not often lead to functional discomfort; therefore the treatment is not systematic and has only aesthetic value. CONCLUSION: A rare congenital disease, Poland syndrome can occur sporadically or in families. Its treatment depends above all on the psychological repercussion of the disease.