The volvulus of the sigmoid is known since ancient Egypt. In the 5th century BC, hippocrates laid the foundations for its management. The first observation of this condition was not reported until 1836 by Von Rokitans...The volvulus of the sigmoid is known since ancient Egypt. In the 5th century BC, hippocrates laid the foundations for its management. The first observation of this condition was not reported until 1836 by Von Rokitansky, and then in 1859, Melchior described its physiopathological consequences. It was the Norwegian Brusgaard who reported, for the first time, in 1947, the effectiveness of a non-operative treatment. Purpose: Describe morbidity, mortality and the impact of co-morbidity factors on the choice of operative techniques. Patients and Methods: This is a retrospective cross-sectional study performed at the Fousseyni Daou Hospital in Kayes from January 2014 to December 2021. We included all patients operated for sigmoid volvulus without necrosis. The parameters studied were the comorbidity factor, surgical modalities, morbidity and mortality. Results: We collected 31 patients, of whom 29 were men and 2 were women, for a sex ratio of 14.5. The mean age was 55 years with extremes (29 - 78 years). Sigmoidectomy with colorectal anastomosis was performed in 19 cases (61.3%), the average age of these patients was 46.16 years, the comorbidity factor was 1 case (3.2%), the postoperative course was simple in 12 cases (63.1%), the morbidity was 6 cases (26.3%) and mortality 1 case (3.2%). Untwisting with colopexy was performed in 11 cases (35.5%), the average age was 65.91 years, comorbidities were present in 9 cases (82%), the postoperative course was simple in 9 cases (82%), morbidity was 1 case (9%) and mortality 1 case (9%). Hartman colostomy was performed in 1 case (3.2%), the age was 60 years, the morbidity was nil. Overall, the postoperative course was simple in 22 cases (71%), the overall morbidity was 7 cases (22.6%) and mortality 2 cases (6.4%). Conclusion: At the end of our study, we can note that the choice of the operative technique for the volvulus of the sigmoid without necrosis can be influenced by the presence of major comorbidity and the morbi-mortality depends on it.展开更多
The issue of wound care has always played an important role in the practice of medicine. This is evidenced by Ambroise Paré’s decision to publish his first work on this subject, “La manière de traiter les ...The issue of wound care has always played an important role in the practice of medicine. This is evidenced by Ambroise Paré’s decision to publish his first work on this subject, “La manière de traiter les Plaies” (The Way of Treating Wounds) in 1545. Objective: To evaluate the therapeutic methods we practice and to describe the impact of the pathology on socio-economic and professional development. Patients and Method: This was a retrospective study carried out at the Fousseyni Daou Hospital in Kayes from January 1, 2018, to December 31, 2020. We included all patients with an ulcero-necrotic wound on immunocompetent terrain hospitalized in the department. Patients with ulcerative necrotic wounds of diabetes, HIV, or cancerous origin were not included. The parameters studied were: etiologies, local care, sequelae, and socio-economic and professional aspects. Results: We collected 57 patients of whom 43 were men and 14 were women, i.e. a sex ratio of 3. The mean age was 40.7 years with a standard deviation of 8.4 with extremes (7 years and 80 years). The average consultation time was 25.1 days. The most represented socio-professional stratum was agropastoralism in 37 cases (65%). The predominant etiological factor was neglected traumatic wounds in 34 cases (59.6%). The site was the lower limb in 39 cases (68.5%). The germ found was Staphylococcus aureus in 21 cases (36.8%). The particularity during local care was the use of table sugar in 9 cases (15.7%) and maggot therapy in 2 cases (3.5%). Hyperthermia was the clinical sign of aggravation in 22 cases (38.6%) and we diagnosed 2 cases (3.5%) of tetanus. The mortality rate was 15.7% (9 cases) and 30 cases (52.7%) of sequelae after recovery. The average length of hospitalization was 38 days. Hospital care was provided by the social welfare service in 35 cases (61.4%). Nineteen (19) patients (39.5%) were unable to resume their socio-professional activity. Conclusion: Ulcero-necrotic wounds are complex to manage and can have a lifelong influence on the socio-professional and economic activity of patients.展开更多
文摘The volvulus of the sigmoid is known since ancient Egypt. In the 5th century BC, hippocrates laid the foundations for its management. The first observation of this condition was not reported until 1836 by Von Rokitansky, and then in 1859, Melchior described its physiopathological consequences. It was the Norwegian Brusgaard who reported, for the first time, in 1947, the effectiveness of a non-operative treatment. Purpose: Describe morbidity, mortality and the impact of co-morbidity factors on the choice of operative techniques. Patients and Methods: This is a retrospective cross-sectional study performed at the Fousseyni Daou Hospital in Kayes from January 2014 to December 2021. We included all patients operated for sigmoid volvulus without necrosis. The parameters studied were the comorbidity factor, surgical modalities, morbidity and mortality. Results: We collected 31 patients, of whom 29 were men and 2 were women, for a sex ratio of 14.5. The mean age was 55 years with extremes (29 - 78 years). Sigmoidectomy with colorectal anastomosis was performed in 19 cases (61.3%), the average age of these patients was 46.16 years, the comorbidity factor was 1 case (3.2%), the postoperative course was simple in 12 cases (63.1%), the morbidity was 6 cases (26.3%) and mortality 1 case (3.2%). Untwisting with colopexy was performed in 11 cases (35.5%), the average age was 65.91 years, comorbidities were present in 9 cases (82%), the postoperative course was simple in 9 cases (82%), morbidity was 1 case (9%) and mortality 1 case (9%). Hartman colostomy was performed in 1 case (3.2%), the age was 60 years, the morbidity was nil. Overall, the postoperative course was simple in 22 cases (71%), the overall morbidity was 7 cases (22.6%) and mortality 2 cases (6.4%). Conclusion: At the end of our study, we can note that the choice of the operative technique for the volvulus of the sigmoid without necrosis can be influenced by the presence of major comorbidity and the morbi-mortality depends on it.
文摘The issue of wound care has always played an important role in the practice of medicine. This is evidenced by Ambroise Paré’s decision to publish his first work on this subject, “La manière de traiter les Plaies” (The Way of Treating Wounds) in 1545. Objective: To evaluate the therapeutic methods we practice and to describe the impact of the pathology on socio-economic and professional development. Patients and Method: This was a retrospective study carried out at the Fousseyni Daou Hospital in Kayes from January 1, 2018, to December 31, 2020. We included all patients with an ulcero-necrotic wound on immunocompetent terrain hospitalized in the department. Patients with ulcerative necrotic wounds of diabetes, HIV, or cancerous origin were not included. The parameters studied were: etiologies, local care, sequelae, and socio-economic and professional aspects. Results: We collected 57 patients of whom 43 were men and 14 were women, i.e. a sex ratio of 3. The mean age was 40.7 years with a standard deviation of 8.4 with extremes (7 years and 80 years). The average consultation time was 25.1 days. The most represented socio-professional stratum was agropastoralism in 37 cases (65%). The predominant etiological factor was neglected traumatic wounds in 34 cases (59.6%). The site was the lower limb in 39 cases (68.5%). The germ found was Staphylococcus aureus in 21 cases (36.8%). The particularity during local care was the use of table sugar in 9 cases (15.7%) and maggot therapy in 2 cases (3.5%). Hyperthermia was the clinical sign of aggravation in 22 cases (38.6%) and we diagnosed 2 cases (3.5%) of tetanus. The mortality rate was 15.7% (9 cases) and 30 cases (52.7%) of sequelae after recovery. The average length of hospitalization was 38 days. Hospital care was provided by the social welfare service in 35 cases (61.4%). Nineteen (19) patients (39.5%) were unable to resume their socio-professional activity. Conclusion: Ulcero-necrotic wounds are complex to manage and can have a lifelong influence on the socio-professional and economic activity of patients.
