Symphyseal Disjunction after Dystocic Vaginal Delivery: About Two Cases at the SourôSanou University Hospital of Bobo-Dioulasso (CHUSS)

Diastasis of the symphysis pubis is a rare postpartum complication. We report two cases of symphysis diastasis after dystocic delivery, in two patients who presented in the postpartum period with functional impotence, pubalgia and acute urine retention. A frontal radiograph of the pelvis confirmed the diagnosis, showing a symphyseal separation of 12 mm and 18 mm. In our case, management was mainly medical, with a favorable clinical outcome.

Postpartum Eclampsia in the Department of Obstetrics Gynecology and Reproductive Medicine of the Souro Sanou University Hospital;Burkina Faso: About 76 Cases

Background: Postpartum eclampsia is a life-threatening obstetric emergency. Its management is multidisciplinary. Despite measures taken to accelerate the reduction of maternal, fetal and infant mortality in Burkina Faso, maternal deaths related to postpartum eclampsia persist. The aim of the study was to investigate the epidemiological, clinical and prognostic aspects of postpartum eclampsia in the obstetrics department of the Sourô Sanou University Hospital in Bobo-Dioulasso. Method: This was a descriptive cross-sectional study with retrospective data collection covering the period from June 1, 2018 to May 31, 2019. We included 76 patients in the study;the variables studied were the epidemiological, clinical and prognostic aspects. The data collected were entered on a microcomputer and analyzed with the EPI info version 7.2 software. Results: The prevalence of postpartum eclampsia was 0.87% compared to admissions to the obstetrics department. The average age of the patients was 23 years old with the extremes of 15 and 39 years old. Primiparas accounted for 39.47%, housewives 53%, and home births accounted for 15.79%. Seizures accounted for 55% of the reasons for admission, the average time to onset of these seizures postpartum was 3.8 days with extremes of 1 and 30 days with 45% of seizures occurring postpartum immediately. Maternal complications were noted in 42.10% of cases with 5 cases of Hellp syndrome, 3 cases of renal failure, and 3 cases of acute pulmonary edema. We recorded 4 cases of maternal death, representing a case fatality rate of 5.2%. Conclusion: Postpartum eclampsia is common in the obstetrics department of the Souro Sanou University Hospital Center with a significant case fatality rate. Emphasis should be placed on monitoring and prevention, especially women at risk of developing postpartum eclampsia for better maternal prognosis.

Hemangioblastoma Incidentally Discovered at CT Scan in Bamako: About a Case

Hemangioblastomas are benign vascular tumors of the brain. These are rare tumors, usually located in the cerebellum and most often affecting young adults. The aim was to study the value of CT in the management of hemangioblastoma through observation. We report the case of a 38-year-old patient referred to the radiology and Medical Imaging Department of the Marie Curie Medical Clinic in Bamako, Mali, for an orbito-cerebral CT scan in a context of bilateral eyelid edema. The examination was performed using multi-slice computed tomography (16 slices) with reconstruction in the 3 planes of space without and with the injection of an iodinated contrast agent. The CT scan was crucial in making the diagnosis of hemangioblastoma incidentally, which allowed for adequate management. The patient was operated on, and the radiological outcome was favorable, without significant cystic formation, after postoperative control and clinical signs were resolved. CT can be an interesting alternative in countries like ours despite MRI being the examination of choice in hemangioblastomas.

Fournier’s Gangrene in a Child Hospitalised in the Paediatric Emergency Department of the Gabriel Touré Teaching Hospital

Fournier’s gangrene is a form of necrotizing fasciitis that has multiple causes and is relatively uncommon in children. We report a case of Fournier’s gangrene of infectious origin in a 12-month-old infant following an insect bite. A rapid diagnosis and multidisciplinary care saved the patient.

Palpebral Reconstruction in a Secondary Ophthalmology Center in Mali: About a Case

Introduction: Significant trauma to the periocular region can seriously damage ocular structures and their adnexa. The eyelids can be damaged during these traumas. The most frequent lesions are lacerations, the surgical treatment of which is generally simple. In some cases, there are complex traumas where there is a loss of tissue, which is difficult to treat. We report the case of a 26-year-old young man, farmer with no medical and surgical history, referred by the odontostomatology and maxillofacial surgery department for burns to the left hemi face by the exhaust pipe of his motorbike which occurred following a public road accident (AVP). Observation: A 26-year-old young man with no medical-surgical history, visual acuity was 5/10 with good mobility of the globe. In collaboration with the maxillofacial surgeon, a graft of the hemi face was performed using a flap from the inner side of the thigh first. In the second time we carried out a recovery by a flap which consisted in taking a supra-superciliary flap and suturing it at the level of the palpebral edges which, in spite of a fragile vitality of the tissues. Conclusion: The reconstruction of the eyelid is a real problem in our service because of the technical platform and the availability of consumables, which limits us in the choice of the operating technique.

Etiological Factors of Infective Endocarditis in Children Aged 1 Month to 15 Years Hospitalised in the Paediatric Department of CHU Gabriel Touréof Bamako (Mali)

Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.

Epidemiological and Clinical Study of Cardiac Diseases in the Pediatric Department of the University Hospital Gabriel Touré(UH GT), Bamako (Mali)

Introduction: Children’s heart disease is a major public health problem in developing countries and especially in Mali. The purpose of our work was to determine frequency, different types of heart disease and their short term evolution in the pediatric department. Methods: We performed a retrospective study among children aged 0 to 15 years, hospitalized in the pediatric department from January to December 2015 and whose diagnosis was confirmed using trans-thoracic echocardiography. Results: We included 103 cases of heart disease out of a total of 8613 admissions in the pediatric department, giving an hospital prevalence of 1.2%. Mean age was 4.1 years (from 1 day to 15 years) and children under 5 years were the most affected with 73.80% of cases. Male predominance was noted (sex ratio = 1.2). Respiratory distress was the most common circumstance of discovery (93.20%). Cardiac murmur and tachycardia were the most common cardiac signs with respectively 88.35% and 83.50%. Congenital heart disease accounted for 70.87% and was dominated by ventricular septal defect (VSD) with 30.13%. Acquired heart disease (29.13% of the sample) was dominated by mitral regurgitation (MR) with 56.67%. Mortality rate was 31.9% for congenital heart disease and 11.1% for acquired heart disease. Conclusion: children’s heart disease is responsible for high mortality. Early detection improves the management of this pathology, which remains frequent.