Traitement chirurgical des omphaloceles au CHU de Yaounde

But : l'objectif de ce travail etait d'analyser les methodes de prise en charge des omphaloceles dans une formation hospitaliere africaine ne disposant pas de service de chirurgie neonatale. Patients et methode : il s'agit d'une etude retrospective descriptive qui a inclus 10 nouveau- nes presentant une omphalocele et admis au Centre Hospitalier et Universitaire de Yaounde entre Janvier 2005 et Decembre 2010. Resultat : il n'y a eu aucun patient avec un diagnostic en prenatal. Aucun patient n'a presente de malformation associee. Les formes cliniques etaient reparties en 60 de type I et 40 type II selon la classification de Aitken. Neuf enfants ont beneficie d'une prise en charge medicale pre-operatoire. Un traitement chirurgical avec fermeture parietale en un temps a ete realise chez 7 patients (78). Deux patients (22) ont ete traites avec une fermeture parietale en un temps a l'aide d'une prothese de polyester. Un enfant est decede en postoperatoire immediat sans traitement. Le taux de mortalite dans cette serie etait de 20Conclusion : le diagnostic antenatal doit etre encourage afin d'ameliorer le pronostic de ces patients dans notre contexte. La fermeture parietale en un temps semble le traitement de choix dans les omphaloceles de type I. La fermeture parietale immediate avec prothese devrait etre progressivement indiquee dans le traitement des omphaloceles en Afrique pour les omphaloceles de type II chaque fois qu'il est possible d'assurer a l'enfant la securite anesthesique et chirurgicale

[Perioperative cholangiography: a case study at Yaounde (Cameroon)]. / Cholangiographie peropératoire: une observation a Yaoundé (Cameroun).

For many years peroperative cholangiography has been routinely used for bile duct surgery in the Western countries. However recent publications showing high rate of inconclusive peroperative cholangiography (47%) has cast doubt on this attitude. Surgeons in Africa and particularly in Cameroon have already replaced peroperative cholangiography with other indicators such as clinical history and preoperative echography, anticipating cholangitis. For some indications, e.g. Mirizzi syndrome, peroperative cholangiography is essential for surgery. The fluoroscopes required for this exploration should be made available in our hospitals since they are also needed for traumatology, vascular surgery, and other specialities. In addition this syndrome may be more common in our region.

Incidence and distribution of scaphotrapezotrapezoidal arthritis in 73 fresh cadaveric wrists.

The STT joint was examined in 73 fresh cadaveric specimens (25 male and 48 female with an average age of 84 years) with a view to study the incidence and characteristics of degenerative changes in this joint. The articular degeneration was graded from 0 to 3 according to increasing loss of cartilage and the location of the changes was noted. At the same time, the presence and extent of concomitant trapezio-metacarpal arthritis was noted. 61 of the 73 hands (83.3%) were found to present STT arthritis. Degeneration of the trapezoid articular surface was:- more frequent: 53 hands (72.6%) as compared to 48 (65.7%),-of greater severity: 40 cases (55%) of grades 2/3 as compared to 25 (34%), than that of the trapezium. Concomitant or isolated arthritis in the trapezometacarpal joint (90.4%) was present in 66 of the 73 hands (79%) examined with grade 3 changes in 13 cases. The apparent predominance of degeneration in the scapho trapezoidal articulation could, perhaps, lead us to assume that this might be the site of origin of STT arthritis. It could also explain the persistence of symptoms following prosthetic replacement of the trapezium.

Surgical correction of pseudo-ainhum in Vohwinkel syndrome.

Vohwinkel syndrome or hereditary mutilating keratodermatitis is a rare condition producing palmoplantar hyperkeratosis and constricting rings of the fingers and toes which can progress to compromise neurovascular function and mobility. Medical treatment with oral retinol derivatives is recommended when its use is not contra-indicated. This paper describes surgical correction of the constricting rings on both hands in a 33-year-old woman affected by this condition.

[Renal cysts at Yaounde (Cameroon). Prevalence and echographic profile]. / Les kystes rénaux à Yaoundé (Cameroun). Prévalence et profil échographique.

Few studies have addressed the prevalence of renal cyst in African countries south of the Sahara, although this condition is highly prevalent in other parts of the world. To determine the prevalence and the clinical and sonographic features of renal cysts in a population of black africans, we reviewed 1,527 consecutive sonograms performed at the Yaoundé Teaching Hospital in Cameroon in patients aged 0 to 82 years. We found 47 patients harbouring at least one renal cyst (prevalence 3.08%). Prevalence of renal cyst increased with age, from 0% before the age of 20 to more than 10% after the age of 70. Most of the renal cysts found were solitary and caused no symptoms. Both sexes and both kidneys were equally affected. Diameter of the cyst exceeded one centimeter in most instances. Drainage under ultrasonographic control was performed in one case. Overall, in our institution in Yaoundé prevalence of solitary renal cyst was lower than in Western studies but clinical and sonographic patterns were consistent with previous data.