Incidences and Risk Factors for Surgical Site Infections in Koutiala, Mali

Purpose: This paper aims to assess the incidences and risk factors for surgical site (ISO) infections in the general surgery department of the Koutiala District Hospital. Patients and Methods: This was a prospective and descriptive study from August 1, 2017 to October 31, 2020 involving all patients who underwent laparotomy in the general surgery department of the Koutiala District Hospital. Patients who were not operated on and who did not have a laparotomy were not included. Age, sex, frequency, patient history, National Nosocomial Infections Surveillance (NNIS) index, time to occur, bacteriological test results and course of infection were analyzed. Results: Fifty patients were registered. The average age was 34.2 ± 21.2 years old. Eleven patients were 60 years old or older. The hospital incidence rate was 4.3% and the community incidence rate was 6.1 cases per 100,000 population. The concept of smoking was noted in 15 patients. Patients were operated on in emergency 84% of cases. Peritonitis was the most common initial lesion with 32% of cases. Our patients had an NNIS index greater than 0 in 84% of cases. The time to develop infection from the surgical site was less than 3 days in 8 patients (16% of cases). Depending on the depth of the infection, it was superficial (cutaneous) in 39 patients (78%) and deep (subcutaneous and organic) in 11 patients (22%). Escherichia coli was the most common germ with 72% followed by staphylococcus aureus at 24%. We noted 22% morbidity. The median length of hospitalization was 9 ± 2.2 days. Conclusion: ISO is common in our service. Prevention and mastery require knowledge of risk factors.

Epidemiological and Anatomo Path Ological Aspects of Stomach Cancers at the Koutiala District Hospital

Aim: This paper aims to evaluate the epidemiological and pathological aspects of stomach cancer at Koutiala District Hospital. Methods: This was a retrospective study carried out in the General Surgery Department of the Koutiala District Hospital Health Centre. The records of patients admitted for stomach cancer in the period from August 1, 2017 to December 31, 2022 were collected. Patients who underwent surgery for stomach cancer were included in the study. Patients who had not undergone surgery were excluded. Results: We collected records from 40 patients operated on for stomach cancer. The median age was 58.4 years ± 5.7. Men were in the majority with 72.5% The sex ratio was 2.6. The incidence rate of stomach cancer in the general population in the circle was 4.9 cases per 100,000 population. Patients had a history of gastric ulcer in 90%, Helicobacter pylori infection in 47.5% and a notion of excessive salt consumption in 47.5%. The median duration of disease progression was 5 years ± 2.3. The seat was antro-pyloric in 77.5%. The cancer was ulcerative budding in 23 patients. Adenocarcinoma was the histological type in all patients. The cancer was classified as stage III in 30 cases and stage IV in 10 cases. Palliative surgical treatment was the most performed (47.5%). Postoperative morbidity was 15% and mortality was 42.5% at one year. Conclusion: Stomach cancer is common in the ward. Most patients consult at the stage of metastasis. Palliative surgery remains the most practical. Postoperative morbidity and mortality is very high.

Stranched Internal Hernia Revealed by Occlusion of the Large Libra: A Propos of a Case

The left para-duodenal internal hernia, whose origin is generally embryological, is a rare etiology of intestinal obstruction found mainly in young adults. We report here the case of acute intestinal obstruction by left para-duodenal internal hernia in a 36-year-old young man. It was a patient who consulted urgently for occlusive syndrome with cessation of materials and gases. Abdominal percussion noted abdominal tympanism and pre-hepatic dullness was preserved. The flow and icicle signs were negative. Palpation did not objectify hepatosplenomegaly and did not find any organomegaly either. On the other hand, she found an epigastric defense. The abdominal X-ray without preparation showed water levels that were wider than high, hail-like. We performed a median above and below umbilical laparotomy and intraoperatively, it was an internal hernia with incarceration of small loops in a voluminous left paraduodenal sac of 12 cm. They were not necrotic and quickly recolored after extrication. We resected the hernial sac and closed the hernial orifice with separate stitches with absorbable suture 0. The postoperative course was simple. The patient was discharged from the hospital on the 4th postoperative day. After 18 months of hindsight, he is doing well.

Ultrasound Causes of Female Infertility at the Fertilia Medical Clinic in Bamako

Aims: Infertility is a major problem in our current societies and the Fertilia medical clinic in Bamako is a center for medical assistance in procreation (MAP) where there is an increasingly growing demand for ultrasound. The objective of our study was to investigate the ultrasound causes likely to prevent the occurrence of pregnancy in a group of infertile and subfertile women. Subjects and Methods: This was a 5-year cross-sectional and prospective study, between January 2017 and January 2022, which involved 250 women wishing to become pregnant (infertile or subfertile), who came for pelvic ultrasound or follicular monitoring and who agreed to participate in our study. The parameters used were ultrasound reports including uterine, ovarian and tubal pathologies. It should be noted that in some cases no ultrasound cause of infertility was found. Data were entered and analyzed in SPSS. Results: 250 women were recruited into our. The average age was 32 years with extremes ranging from 17 to 51 years. 179 patients or 71.6% were between 17 and 35 years old. 139 patients or 55.6% had secondary infertility against 44.4% primary infertility. 202 patients or 80.8% had at least one ultrasound lesion and 48 patients or 19.2% had no significant ultrasound abnormality. The most represented ultrasound lesions were of uterine origin with 72.20%, 23.7% ovarian lesions and 04% tubal lesions. Uterine lesions were dominated by myomas, adenomyosis, endometrial polyps, uterine malformations and synechiae. As for ovarian lesions we noted cysts, polycystic ovary syndrome (PCOS), ovarian endometriosis, non-follicular ovaries and tubal ultrasound lesions showed unilateral or bilateral hydrosalpinx. Conclusion: In our study, ultrasound was an invaluable contribution to the diagnosis of the causes likely to explain subfertility and infertility in our respondents. She highlighted uterine, ovarian and tubal lesions, some of which could be corrected and pregnancies ensued.

The Epidemiological, Clinical and Radiological (Echography, Mammography) Characteristics of Breast Pathologies at the Diagnostic Imaging Center (C.I.D) “Teriya” in Bamako

Breast pathology is varied, bringing together tumor and non-tumor lesions. Objective: To study the contribution of the ultrasound-mammography pair in the diagnosis of breast pathologies. Materials and Method: This was a retrospective descriptive study, carried out over a period of 3 years (from January 2018 to December 2020) at the Diagnostic Imaging Center (C.I.D) “TERIYA” in BAMAKO. It concerned all patients who came for a mammogram/ultrasound examination of the breast. All women admitted for mammogram or breast ultrasound who were diagnosed with a breast injury during the study period were included. Incomplete records and radiological checks were not included. The variables analyzed were age, sex, clinical data, and ultrasound and mammography aspects. The devices used are: a Voluson 730 PRO ultrasound machine and a G 600T type mammography machine. Results: At the end of our study, we collected 254 breast pathologies on a number of 382 women, i.e. a frequency of 66.49%. The average age of our patients was 41 years old. The dominant clinical data were mastodynia (41.88%) and mammary nodule (21.70%). On imaging (mammo-ultrasound) the lesions predominated on the left in 36% of cases, bilateral in 28% of cases and in the upper-outer quadrants in 31.5% of cases. Tumor pathologies represented 66.54% of which 45.27% were benign mainly composed of fibro-adenoma (20.88%) and cyst (18.50%), 11.8% of suspected cases and 9.45% of cancers. Non-tumor pathologies represented 33.46%, mainly mastitis (16.14%), galactophoric dilations (11.02%) and abscesses (5.51%). These pathologies were classified in 50.3% in ACR2, 17.75% in ACR3 and 4, and in 14.20% in ACR5. Lymphadenopathy was present in 73.21% of cases.

Varicocele and Spermogram Abnormality: About 264 Cases at the Fertilia Medical Clinic in Bamako

Aims: To determine the impact of varicocele on the result of the spermogram in a group of hypo-fertile or infertile men. Patients and Method: This was a cross-sectional, descriptive study concerning 264 men collected between February 2020 and March 2022 at the Fertilia medical clinic in Bamako. The study population consisted of consenting male subjects presenting for infertility. All of our patients had already done a spermogram, they then benefited from a scrotal Doppler ultrasound. The scrotal echo-doppler was completed by an abdominal and pelvic echography in search of a possible etiology, in particular a renal cancer, a thrombosis of the renal or spermatic vein, a retroperitoneal mass or a nutcraker syndrome. Testicular volume was measured on ultrasound according to Lambert’s formula (length × width × height × 0.71). A volume = 16 ml was considered normal. Results: 264 patients were recruited in ours. The average age was 33 years with extremes ranging from 25 to 65 years. 149 patients or 56.44% were between 30 and 45 years old. 213 patients or 80.68% had primary infertility. All the patients, i.e. 100%, had a sperm anomaly and dilation of the pampiniform plexus veins. The most common sperm abnormalities were oligoasthenoteratozoospermia, which concerned 214 patients, or 81%, followed by azoospermia (40 patients, or 15%) and oligospermia (10 patients, or 4%). 213 patients or 80.68% had a Hirshen grade II varicocele, 45 patients or 17% had grade I and 06 patients or 2.27% had grade III. Among the 6 patients, 04 had left testicular atrophy and 2 bilateral atrophy. The venous reflux was more accentuated on the left than on the right. Conclusion: Varicocele is significantly found in men with infertility. Sperm alterations concern both the concentration of spermatozoa, their mobility and their vitality. Even if the mechanism of alteration of the sperm parameters is not well elucidated, our study made it possible to make the link between the dilation of the veins of the pampiniform plexus and the sperm abnormalities mentioned above. It should be recognized that varicocelectomy has allowed a significant improvement in the quality of sperm with the obtaining of a certain number of natural pregnancies and those resulting from medically assisted procreation.

Endometrial Status and Embryonic Implantation about 150 Cases at the Medically Assisted Procreation Laboratory “Le Diafounou”

Background: The endometrium is the tissue that lines the inside of the uterus. It undergoes multiple changes during the menstrual cycle and prepares to welcome the fertilized egg. Endovaginal ultrasound is a first-line examination in the assessment of female infertility. Objective: We aimed to determine the impact of endometrial status by endovaginal ultrasound on the outcome of embryo transfers. Subjects and Methods: This was a prospective cross-sectional study of 150 women collected between January and October 2020 at the “Le Diafounou” medically assisted procreation laboratory. Were included in the study, women presenting for desire of pregnancy and having continued the treatment until the transfer of fresh or frozen embryos. An uterine score was used. This score took into account the thickness of endometrium, it is coffee bean aspect, the presence of the notch, the echogenicity of the endometrium, the pulsatility index, the presence of the flow at the end of diastole and sub-endometrial flow. Ultrasounds were performed using a General Electric logic 500, logic 9 and Voluson E8 device. The data was entered into Excel and then analyzed using SPSS version 21. Results: 150 women were selected for the study. 83 women or 55.3% were between 17 and 35 years old and 44.7% were over 35 years old with an upper limit of 50 years old. The number of women who became pregnant was 69% or 46%. The average thickness of the endometrium was 11.40 mm with extremes of 4.65 mm and 18.6 mm. There was a correlation between the thickness of the endometrium and obtaining a pregnancy (p i.e. 88.7%. The pulsatility index was relatively low for those who started a pregnancy, i.e. 90%. The high pulsatility index is one of the reasons for the failure of embryo implantation. The correlation was significant (p = 0.009). 141 women had no notch in the uterine arteries, i.e. 94%. 94 women or 62.7% had a triple line endometrium or typical coffee bean appearance. End-diastolic flow was observed in 127 women, i.e. 84.7%. The sub-endometrial flow was found in 128 women or 85.3%. Conclusion: The Knowledge of the status of the endometrium is essential and has an impact on the outcome of embryo transfers. The thinner (7 and <15). Doppler factors also play an important role.

Epidemio-Clinical and Uretrocystographic Profile of Pathologies of the Lower Urinary Tract at the Chu Pr Bss of Kati

Introduction: Pathologies of the lower urinary tract are common in urology composed of various conditions, responsible for urinary disorders. Despite the new methods, exploration in Africa is mainly based on retrograde urethrocystography (UCR). The main objective was to determine the importance of UCR in the diagnosis of pathologies of the lower urinary tract. Materials and Methods: This was a retrospective and descriptive study covering a period of 5 years (July 2016-June 2021). It involved all patients admitted to the ward for retrograde urethrocystography during the period. A remote-controlled table of the GE PRESTILIX 1600× type was used for the examinations. Results: At the end of our study we collected 100 cases of pathologies of the lower urinary tract out of a total of 112 RCUs performed or 89.28%. Pathologies of the lower urinary tract accounted for 78% of the UCRs in the department. The age group of (61 - 70) was the most affected with extremes from 1 year to 101 years. Non-specific urination disorders were the most common indications (43%), followed by acute urine retention (18%). Acquired urethral pathology was the most common (89%), followed by bladder neck disease 5% and posterior urethral valve with 4%, Bladder struggle was the most common associated sign (54%) with post-urination residue in 97% of patients. Conclusion: Pathologies of the lower urinary tract are relatively common in our region, dominated by urethral narrowings. Retrograde urethrocystography remains the reference examination in our control for the diagnosis of obstructive pathologies of the lower urinary tract while specifying the seat of the obstacle.

Environmental Risk Factors for Stomach Cancer in an African Setting about 193 Cases at the CHU Point G in Bamako/Mali

CHU (University Hospital Center) Point G: The department of surgery B is a surgical department of CHU Point G. The department is par excellence a reference department for cases of visceral surgery, cancer surgery, cardiovascular surgery, plastic and endocrinology surgery. As a reminder, the CHU Point G is the largest 3rd level referral hospital in Mali. Aim: To study the environmental risk factors of stomach cancer in the B surgery department of the Point G University Hospital in Bamako. Patients and Methods: We performed a cross-sectional study with retrospective collection from January 2008 to June 2018 (126 months). Results: We have identified 380 cases of digestive cancer, including 193 cases of stomach cancer or 50.79% of digestive cancers. The mean age of the patients was 57.21 ± 13 years. Male sex represented 55% (n = 106). Eating habits were dominated by the consumption of tô with potash (cereal paste) with 64.76% (n = 185). The main methods of preserving meat and fish were curing and smoking with 57.51% (n = 111). Chronic smoking was found in 24.35% (n = 47), alcohol + tobacco consumption in 2.59% (n = 5). The low socio-economic class represented 126 cases or 65.38%. Housewives and cultivators were respectively 37.82% (n = 73) and 227.97% (n = 54). 20.20% (n = 39) had a history of epigastric pain. Epigastralgia was the most common functional sign with 84.5% of cases (n = 169). An epigastric mass was found in 72 patients or 37.3%. Adenocarcinoma represented 97.4% (n = 188). Palliative surgery concerned the majority of our patients with 64.8% of patients (n = 79). The postoperative consequences were simple in 28.57% of cases (n = 28), the postoperative morbidity and mortality were respectively 33.61% (n = 41), and 23.77% (n = 29). The overall survival rate after surgery was 10.81% at 2 years and 2.94% at 5 years. This rate was 58.83% at 2 years and 28.50% at 5 years after curative surgery. Conclusion: The risk factors for stomach cancer are many and varied. Some are particularly present in Africa. Delay in diagnosis due to a belief in traditional healers is common in our community.

Small Bowel Obstruction: Epidemiological, Clinical and Therapeutic Aspects in the General Surgery Department of Hôpital SominéDOLO de Mopti

Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. We report an observational study which aims to describe the epidemiological, clinical and therapeutic aspects of small bowel obstruction. This study was carried out in the General Surgery Department of Hôpital Sominé DOLO de Mopti from October 1, 2016 to October 1, 2018. A total of 114 patients were recorded for whom the diagnosis was related to an occlusion. The median age was 37 years with extremes ranging from 6 months to 90 years. Male sex was predominant with a sex-ratio of 1.8. The frequency of small bowel occlusions over all occlusions was 74.03%. The most encountered clinical signs were as followed: abdominal pain (100%), vomiting (88.6%), cessation of materials and gas (79.9%) and meteorism (62.3%). All patients underwent medical imaging, the most common of which was an abdomen without preparation X-ray (AWP). On the etiological level, the main causes found postoperatively were: flanges and adhesion (55.2%), strangulated hernias (28.0%), acute intussusception (6.1%), small bowel volvulus (3.5%) and small bowel tumor (1.6%). Releasing the bridles was the most common surgery process (28.0%). The morbidity of the immediate follow-up was (13.1%) and the mortality was (7.0%). This high mortality is due to ignorance of the signs of seriousness and the socio-cultural barrier (decision of the patriarch to agree to a surgical intervention), the late use of hospital facility and the limited financial capability of the patients.

Indications and Techniques of Digestive Anastomoses at the Hospital in Koutiala District, Mali

Purpose: Describe the indications and techniques of digestive anastomoses at the Koutiala District Hospital. Patients and Methods: This was a prospective and descriptive study conducted in the general surgery department of the Koutiala District Hospital. Patients who benefited from digestive anastomosis between the hollow organs of the digestive tract during the period from August 1, 2017 to September 30, 2020 were included. The anastomoses with solid organs were not selected in this study. Results: One hundred and thirty-two patients were registered. Digestive anastomosis accounted for 11.5% of all surgical procedures. The average age was 38.6 years. Men were in the majority with 70.5%. The Karnofsky index was estimated to be less than 50% in 12 patients. Digestive anastomoses were indicated after resection of ileal necrosis in 43 patients (32.6%) followed by tumor resection in 32 patients (24.2%) and typhic perforations in 20 patients (15.1%). There were also 12 cases of digestive stoma (9.1%), 15 cases of volvulus of the sigmoid colon (11.4%), 7 cases of rectal prolapse (5.3%) and 3 cases of Hirschprung’s disease (2.3). Digestive anastomosis was performed in 89 patients in an emergency and was manual in all patients. Post-operative morbidity was 18.9%. These recorded complications, classified grade I (10 cases), grade II (3 cases), grade IIIa (2), grade IIIb (6 cases) and grade IV (4 cases) according to Clavien-Dindo, consisted of 8 cases of postoperative peritonitis (6.1%), 3 cases of external digestive fistula (2.3%), 2 cases of evisceration (1.5%), 12 cases of parietal suppuration (9.1%) and 4 cases of death (3.0%). Conclusion: Young male subjects are the most affected. Anastomoses are performed more often after the removal of the island necroses. Morbi-mortality is high. Success depends on several factors, including the general condition of the patient and the mastery of the anastomosis technique.

Double Emergency Pulmonary Embolism and Aortic Dissection: About a Clinical Case

Introduction: Pulmonary embolism and aortic dissection are two formidable cardiovascular emergencies. Their exceptional association has a poor prognosis with very high mortality. The aim of our study was to report the case of a 31-year-old patient with pulmonary embolism associated with De Bakey’s type I aortic dissection, admitted to the cardiology department of Kati University Hospital. Case Presentation: We report the case of a young patient of 31 with no known cardiovascular history, on estrogen-progestogen contraception for 10 years, who consults for a left basal thoracic pain of increasing intensity, a whitish productive cough, hemoptysis and dyspnea stage III. She was admitted to the cardiology department, transthoracic cardiac ultrasound objectified aortic insufficiency, dissection of the aorta, the presence of the intimal flap, the false and the true channel, dilation of the right cavities with HTAP. The chest CT scan revealed bilateral lobar and segmental pulmonary embolism, De Bakey’s type I aortic dissection. Medical treatment was instituted for hemodynamic stabilization at the end of sending her to a center specializing in cardiovascular surgery for better management; unfortunately she succumbed before the preparations for her evacuation were finished. Conclusion: The pulmonary embolism associated with aortic dissection constitutes a medical emergence of rare incidence in a cardiological environment;if the diagnosis was quickly made in our patient, the lack of technical platform made management difficult.

Skin Graft in the Surgery Department “B” of the CHU du Point “G” about 50 Cases

Aim: To analyze the practice of skin grafting in the surgery department “B” of the CHU of Point “G” in Bamako. Patients and Methods: This was a retrospective and prospective study carried out between 1980 and 2014, covering all patients who underwent a skin graft and hospitalized. It covered all patients who underwent a skin transplant and were hospitalized in the department during the study period. Result: There were 50 patients including 25 women and 25 men. The mean age was 25.2 ± 19 years. The average duration of lesion evolution was 1 year. The lesions to be grafted were located in the lower limbs in 60%. The average area of substance loss was 13.2 cm2. The indication for skin graft was asked for loss of substance following scar bridles in 40%, ulcerative-necrotic wounds of infectious or traumatic origin (32%), malignant skin tumor (14%). In pathology, there were 5 cases of malignant melanoma and 2 cases of squamous cell carcinoma. Thin skin grafting was the most used technique (62%). The postoperative follow-ups were simple in 94%. There were 3 cases of graft necrosis. The average length of hospital stay was 28 days. The esthetic result was judged satisfactory in 84% of the cases (n = 42), average in 14% of the cases (n = 7) and unsatisfactory in 2% of the cases (n = 1). The sensitivity was good in 36 patients (72%), average in 12 patients (24%) and poor in 2 patients (4%). Conclusion: They mainly affect young people. The reduction of accidents on the public highway, good management of burn injuries, wounds and good hygiene of the population will considerably reduce the rate of its affections.

Epidemiological Profile of Intestinal Obstructions in Koutiala, Mali: About 65 Cases

Aim: To assess the epidemiological profile of intestinal obstructions at the Koutiala district hospital. Patients and Method: This was a prospective and descriptive study taking place from August 1, 2017 to April 30, 2020. The files of patients with acute intestinal obstruction in the general surgery department of the Koutiala district hospital were collected. In this study, patients operated on for acute intestinal obstruction were included. Non-operated patients were not included in the study. Result: The records of 65 patients operated on for acute intestinal obstruction were collected. The mean age was 32 ± 22 with extremes of 1 year and 94 years. 7 infants (10.8%) and 1 4-year-old child (1.5%) were identified. The 16 to 59 age group was more common. Males were the majority with 70.8% (n = 46). The sex ratio was 2.4. The rate of bowel obstruction in the general population in the circle was 8.1 cases per 100,000 population. According to provenance, patients came from inside the circle (rural areas) in 87.7% of the cases (n = 57) and from the city of Koutiala in 12.3% (n = 8). 33.9% of our patients had undergone laparotomy (n = 22). Patients consulted urgently in 93.8%. The etiologies are dominated by post-operative straps (33.8%) and volvulus (24.6%). We noted 12 cases of intestinal necrosis. Postoperative morbidity was 13.8% of cases (n = 9) and mortality of 6.1% of cases (n = 4). Conclusion: Bowel obstruction is one of the most frequent surgical emergencies in our circle. They most often affect young subjects and young adult males. The etiologies are dominated by the post-operative flanges. Complications remain elevated.

Acute Peritonitis Generalized at the Koutiala Reference Health Center, Mali: Epidemiological, Etiological and Therapeutic Aspects

History: In Mali, several studies have been carried out on acute peritonitis but in the Koutiala circle it is a first. Aim: To evaluate the epidemiological, etiological and therapeutic aspects of generalized acute peritonitis at the Koutiala reference health center. Method: This was a 14-month prospective and descriptive study from August 1, 2017 to November 30, 2019, covering all patients admitted and operated for generalized acute peritonitis. The parameters studied were age, sex, frequency, clinical aspects, etiologies, treatment and postoperative operations. Result: The number was 93 cases, 72 men and 21 women. The average age was 34.2 years (Extremes: 2 - 75 years). The hospital frequency was 2.0%. The incidence rate of generalized acute peritonitis in the circle was 12.4 cases per 100,000 population. The clinical picture was still of peritonitis. The Widal-Félix serology was positive in 19 cases. Perioperative bacteriological sampling was systematic. The etiologies were dominated by digestive perforations in 81 cases (87%) of which 33 were located at the ileal level, postoperative peritonitis (6 cases) and ruptured pyocholecyst (2 cases). There were also 3 cases of primary peritonitis and 1 case of gynecological peritonitis. Excision-suturing was the most used surgical technique with 35.5% (n = 33). Postoperatively, we identified 10 cases of parietal suppuration (10.8%), 6 cases of postoperative peritonitis (6.5%), 2 cases of external digestive fistula (2.2%) and 7 cases of death (7.5%). Conclusion: Acute peritonitis occupies second place in abdominal surgical emergencies in the Koutiala circle. The etiologies are multiple and varied and are dominated by the ileal perforation which is secondary to typhoid fever more often. In most cases the surgical treatment is done by excision-suturing of the perforation. Mortality and morbidity remain high.

Study on Compliance with Radiation Protection Rules in the Medical Imaging Department of Pr Bocar Sidy Sall Hospital of Kati (Mali)

Objective: Evaluate the level of compliance with radiation protection rules in the medical imaging department of the University Hospital Center (CHU) of Kati. Methodology: This was a cross-sectional and descriptive study carried out in the medical imaging department of Pr Bocar Sidy Sall (BSS) Hospital of Kati. A questionnaire was developed and sent to the staff of the medical imaging department. The assessment focused on the radiation protection of personnel, radiation protection measures for patients, the delimitation and signage of zoning as well as the application of radiation protection principles. Results: Twenty-one people participated in the study, 90% of whom were men. The 30 - 39 age group was predominant with 61.90%. 33.33% of the staff knew the principles of radiation protection;86% of our sample knew the basic rules of radiation protection. The majority of the staff in the imaging department (61.90%) had a perfect knowledge of protective equipment. For 76% of our workforce, the limits of the radiation doses received are regulated in Mali. 76% of those surveyed have not taken any additional training in radiation protection. The doors are closed during the X-ray examination for 76.19% of the respondents and 95% of the staff put themselves behind the sealed screen during the examination. For 81% of the respondents, the design of the premises met radiation protection standards. 62% of practitioners have a dosimeter and 80% of them wear it during their shift. For 62% of our sample, the change of the dosimeter is quarterly. The systematic request for DDR (date of last menstrual period) in women and the adaptation of the delivered dose to the patient’s morphology was only carried out by 65% of practitioners. The majority of staff (81%) did not benefit from medical surveillance, while for 55% of respondents the level of radiation protection in the establishment was average. Conclusion: This study enabled us to highlight the shortcomings in terms of radiation protection within the imaging department of the CHU Kati.

Fortuitous Discovery of a Multifocal Enchondromatosis in a Case at the “Luxembourg” Hospital Center in Bamako

The aim of this study was to clarify the interest of standard radiography in the management of Ollier’s disease. Observation: Enchondromas are benign lesions that may present on imaging with nonspecific features in children, and they are relatively large lesions, with frequent endosteal erosion and rare matrix mineralization. We report a case of predominantly right-sided multifocal enchondromatosis in a 5-year-old girl with no known medical history, diagnosed fortuitously on standard radiography during a trauma assessment and confirmed by histology. No sign of pain was noted after a 6-month follow-up. But the radiographic control noted signs of diffuse osteoarthritic remodeling in the surgical areas and early fusion of the growth cartilages. Conclusion: Ollier’s disease is rare, you have to know how to think about it in the face of fortuitous discoveries, especially at an early age. Enchondromas are benign lesions that may present on imaging with nonspecific features in children. In all cases, standard radiography is essential in the diagnosis and follow-up of Ollier’s disease.

Intra-Sellary Arachniodocele: About a Case at the Medical Clinic “The Stars” of Bamako

Intrasellar arachnoidocele is a herniation of the optochiasmatic cistern through a dehiscence of the sellar diaphragm producing an empty sella turcica, hence its name empty sella turcica syndrome. It is an extremely rare benign malformative pathology. We report a case of intra-sellar arachnoidocele in a 34-year-old woman revealed during an annual control of a sellar mass under dossinex by cerebral magnetic resonance imaging (MRI) which found the cystic formation of liquid signal identical to that of the LCS in hypo signal T1 and hyper signal T2 without enhancement after injection of Gadolinium. The epidemiological, clinical and radiological aspects of arachnoidocele were analyzed. The purpose of this work is to bring the interest of MRI in the management of this pathology.

Hysterosalpingography Profile of Utero-Tubal Lesions in Female Infertility in Mopti (Mali, West Africa)

Introduction: Infertility is the inability to achieve pregnancy after 12 months of regular, unprotected sexual intercourse by a couple of childbearing age. It is a real public health problem because of its high prevalence in both developed and developing countries. Female infertility occupies a prominent place in reproductive health in Africa such as in our country Mali. The objective of this work was to determine the hysterosalpingography profile of utero-tubal lesions in the etiological research of female infertility in Mopti. Materials and Method: This was a cross-sectional descriptive study covering a period of one year from January 2019 to December 2019 in the radiology department of Sominé Dolo Hospital in Mopti. The variables analyzed were patient age and hysterosalpingography results. The hysterosalpingography examination was performed 3 or 4 days after menstruation on a remote-controlled table under fluoroscopic control. Data analysis was done with the aid of SPSS version 22 and Excel 2016 software. Results: During the study period, 9012 patients were seen in the imaging department, including 115 patients, or 1.3% for infertility assessment. The 25 - 29 age group was the most represented with 34 patients or 29.6%. The mean was 30.39 ± 6.96 years with extremes of 17 and 46 years. Tubal abnormalities represented 45 cases or 39.1%. Hydrosalpinx was the most prevalent with 26 cases or 36.6%. Conclusion: Tubal lesions were the most observed, especially hydrosalpinx following. Hysterosalpingography remains the first choice in the radiological assessment of female infertility in our context.

Rare Antenatal Fetal Malformations of the Anterior Abdominal Wall in Mali: About a Case

Abdominal wall malformations correspond to a wide spectrum of congenital anomalies that are due to a defect in the closure of the anterior abdominal wall and can be fatal. We report the case of laparoschisis associated with a poly malformation syndrome in the same fetus at the reference health center of commune III of the district of Bamako. The objective is to clarify the interest of antenatal ultrasound in the diagnosis and prognosis of these malformations. It was a 19-year-old prim gravid woman received as part of the prenatal check-up. Antenatal ultrasound had allowed the diagnosis of malformation of the anterior abdominal wall of the gastroschisis type associated with abnormalities of the neural tube, the urogenital system and the bone skeleton. The antenatal diagnosis of the malformations had motivated the realization of a therapeutic termination of pregnancy at 19 weeks of amenorrhea and 3 days by triggering and vaginal delivery, allowing the confirmation of the diagnosis of gastroschisis and the poly malformation syndrome which is extremely rare. Antenatal ultrasound remains an ideal means of imaging for monitoring pregnancy and had made it possible to make the prognosis and antenatal diagnosis of multiple malformations in association, and to indicate better therapeutic decision-making.