Anterior dislocation of the shoulder associated with a diaphyseal fracture of the ipsilateral humerus: a case report.

Background: Anterior dislocation of the shoulder associated with a diaphyseal fracture of the ipsilateral humerus is a rare and controversial occurrence, with very few cases reported in the literature. Case presentation: We present a case of a 39-year-old right-handed driver who presented with an anterior dislocation of the shoulder associated with a diaphyseal fracture of the ipsilateral humerus following a road traffic accident. The lateral approach to the fracture allowed us to use two forceps to gain a good grip on the proximal fragment and perform the maneuver to reduce the dislocation. The fracture was reduced and fixed with a molded Lecestre-type plate. Conclusion: In this case, we employed the approach of initially reducing the shoulder dislocation with forceps, followed by osteosynthesis of the humeral fracture. The functional results were excellent after 6 months.

Atypical fibromuscular dysplasia or carotid web revealed by cerebral infarction: A review of 2 cases.

Atypical fibromuscular dysplasia of the bulb or carotid web is a nonatheromatous pathology more common in African and African-American populations. It is implicated in the occurrence of cerebral infarcts of unknown causes. Its diagnosis is made by angio-CT of the supra-aortic trunks and is characterized by a defect in the posterior wall of the bulb. Treatment with antiplatelet agents prevents the occurrence of stroke, but radical treatment remains surgical and endovascular. We report 2 observations of carotid web diagnosed and medically managed at the regional hospital of Saint Louis.

Pylephlebitis complicating acute calculous cholecystitis: A case report.

Pylephlebitis is a complication of intra-abdominal infections. Its occurrence during cholecystitis is a rare situation. We report the case of a 43-year-old female patient who presented with septic thrombosis of the right portal branch following acute calculous cholecystitis diagnosed on abdominal CT. The clinical evolution was favorable under antibiotic therapy and a cholecystectomy was scheduled.

Laparoscopic treatment for colonic injuries following penetrating trauma: A feasible option in a surgical department of Sub-Saharan Africa.

Introduction: The management of abdominal penetrating trauma remains complex. Between the risk of negative laparotomy and missed visceral injury, laparoscopy is a good alternative. We report 2 cases of abdominal penetrating trauma with colonic injury diagnosed and treated with laparoscopic approach. Observations: The first patient was 15 years old, with no medical history and received at 3 h of a penetrating trauma by stabbing. Hemodynamic status was normal. An exploratory laparoscopy was performed. It objectified a penetration of the peritoneum on the left flank with an injury of the anti-mesenteric edge of the descending colon that was sutured. The second patient was 20 years old, with no history, who had a penetrating trauma of the left iliac fossa by stabbing. Arterial pressure was normal. He was received 6 h after the trauma. An exploratory laparoscopy objectified an injury of 2 cm located at the sigmoid colon which was sutured with a good evolution. Conclusion: Laparoscopy in abdominal wounds is a good option in selected patients. It has a diagnostic and therapeutic importance in colonic injuries. The limits are represented by the possibility of unrecognized visceral lesions that can lead to additional morbidity.

Hand compartment syndrome secondary to contrast media extravasation: A case report.

INTRODUCTION: Contrast media extravasation injury is a recognized complication of contrast media use. Compartmental syndrome of the hand secondary to contrast extravasation is exceptional. We describe a case of compartment syndrome of the hand secondary to contrast media extravasation. CASE PRESENTATION: We present a 47-year-old woman with a history of pulmonary embolism who was diagnosed of compartment syndrome of the left hand after injection of contrast medium during a CT scan. Whose first diagnosis was mild contrast medium extravasation injury 24 h before the compartment syndrome. Standard radiography showed an accumulation of contrast medium in the left hand. The patient underwent a fasciotomy and secondary healing. Follow-up showed good radiographic, clinical, and hand function after 2 months. DISCUSSION: The occurrence of hand compartment syndrome secondary to contrast media extravasation is rare. Most of the time, they are initially diagnosed as medium extravasation before the worsening of symptoms. Because of its unknown incidence, treatment is not codified. The goal of treatment is to save the limb and restore function. This can be achieved rapidly with early surgery because of the unpredictable course. CONCLUSION: Contrast media injection is not a harmless gesture. Hand compartment syndrome after contrast extravasation is rare and is a severe injury, our experience with this case suggests that early surgery helps save the limb and restore function. Always fear a compartmental syndrome in case of extravasation of contrast medium.

Management of midline ventral hernias in a surgical department of sub-Saharan Africa: A retrospective cohort study.

Introduction: The linea alba is the second most frequent site of abdominal wall hernias after the inguinal region. Prosthetic approach, often recommended, comes up against the low socio-economic level and the availability of these materials in developing countries. Our objective is to evaluate the indications and results of midline ventral hernia surgery. Methods: This was a retrospective cross-sectional study over 36 months including all adult patients (over 15 years old) treated for primary or recurrent midline ventral hernias. The parameters studied were: age, sex, risk factors, type of hernia according to the classification of the European Hernia Society (EHS), clinical presentation, hernial ring size, surgical technique and results (recurrence, chronic pain). Results: We included 65 patients. The mean age was 40.5 years ± 16.4. There was a female predominance (56.3%, n = 36) with a sex ratio of 0.77. According to the EHS classification, type M3 (umbilical) was more common (67.2%), followed by type M2 (epigastric) in 25% and M4 (infra-umbilical) in 1.6%. According to the clinical presentation, 85.6% (n = 55) were uncomplicated, 10.9% (n = 7) were strangulated in and 3.1% (n = 2) incarcerated. A primary suture was performed in 93.8% (n = 61) and a mesh repair in 6.15% (n = 4). With a mean follow-up of 8.2 ± 11.9 months, we noted a recurrence in 6.1% (n = 4) and chronic pain in 6.1% (n = 4). Conclusion: There is a need to individualize or contextualize the guidelines. In our context where meshes are not always available, pure tissue repairs keep their place in the treatment.