This work was a retrospective prospective study carried out in the general surgery department of the Cs ref of commune I from January 2009 to December 2012. Our study aimed to determine the hospital frequency of hemor...This work was a retrospective prospective study carried out in the general surgery department of the Cs ref of commune I from January 2009 to December 2012. Our study aimed to determine the hospital frequency of hemorrhoidal disease, to identify the contributing factors, describe the clinical and therapeutic aspects and analyze the surgical consequences. We collected 73 patients with an average age of 37.8 years (range: 19 years and 77 years) with a sex ratio of 2.5 in favor of men. We operated on 49 patients or 67.1% of cases. 71.2% of our patients were married and lived in Bamako. Schoolchildren and middle managers made up 39.8% of cases. 82.2% of patients were seen in ordinary consultation and 69.9% complained of progressive anal pain in 66.7% of cases. This pain was triggered by defecation in 88.2% of our patients. The contributing factors were dominated by constipation (53.4%), working in a seated position (41.1%) and a sedentary lifestyle (16.4%) of cases. Stage IV external hemorrhoids and hemorrhoidal thrombosis represented 53.8% of surgical indications. The most used surgical technique was that of Milligan-Morgan, i.e. 51.9% of cases and 45.2% of patients treated medically received a combination of transit regulator, venotonics and analgesics. The surgical aftermath was marked by hemorrhage (3 cases), delayed healing (5 cases), urinary retention (1 case) and scarring anal stenosis (1 case). The morbidity rate was 5.48% of cases and a zero mortality rate. The average length of hospitalization was 2 days with extremes of 1 and 5 days.展开更多
This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to...This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the Bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of Bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at Cs Ref CI. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.展开更多
Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to stu...Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to study inguinal hernia in children in the general surgery department of the Reference Health Center of Commune I of the Bamako District;to determine the frequency of inguinal hernia;describe the epidemiological, clinical and therapeutic aspects of inguinal hernias and in order to evaluate the cost of treatment. This was a prospective study from April 2017 to March 2018 during which 60 children with an inguinal hernia were collected. Inguinal hernias in children represented 9.23% of patients operated on in the department. The average age was 59.23 months with extremes of one month and 180 months and a standard deviation of 49.23 years. The male sex was dominant with a sex ratio equal to 9:1. The notion of prematurity was found in 11.7% and was associated with a testicle not in place in 1.7% of cases. 41.7% of our patients were referred by a doctor and 66.7% of patients presented with painless, intermittent inguino-scrotal swelling (83.3% of cases). The hernia was discovered before one week of life in 50% of cases. Inguinal swelling was absent in 11.7% but observed intraoperatively. The inguinal hernia was unilateral in 91.7% of cases and 70% of hernias were discovered by the parents during pushing efforts. The inguinal hernia was located on the right in 61.7% of cases. The hernia swelling was soft, painless, impulsive and reducible in 78.3% of cases. The swelling was inguino-scrotal in 58.3% of cases. The hernia was simple in 95% of patients and hernial strangulation was observed in 3 cases or 5% of cases. 98.3% of patients were ASA I. The treatment was carried out openly in all our patients including closure of the vaginal peritoneal canal in 95% of cases under general anesthesia in 98.3% of cases. The morbidity rate was 8.4% (surgical site infection: 6.7% of cases and hematoma: 1.7%). The immediate consequences were simple in 96.6% of cases. No cases of recurrence occurred during the 6 months after the intervention. The average cost of care was estimated at 69,743 FCFA.展开更多
Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of co...Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of post-operative complications, to identify the factors of occurrence, to describe the clinical aspects, diagnostic and therapeutic in order to assess the additional cost linked to post-operative complications. This study was prospective, carried out in the general surgery department on 300 cases of surgical interventions. It covered all patients aged at least 15 years, operated on and hospitalized or not, and who presented complications during the 30 days postoperatively. Patients under the age of 15 were not included (our general surgery department is not a pediatric surgery department). We collected 300 patients among whom 199 (66.33%) were men and 101 (33.66%) women, i.e. a sex ratio = 1.9. The average age was 38 years with extremes of 15 and 87 years. The main initial diagnoses were: acute appendicitis, peritonitis, occlusions, wall hernias, hemorrhoids, uterine prolapse, uterine myomas, ovarian cysts and acute cholecystitis. Emergencies represented 43% (N = 129) of interventions with 6.98% post-operative complications (POC). Postoperative complications were dominated by surgical site infections, 75% of cases (N = 20), wall hemorrhage 5% (N = 1), testicular necrosis 5% (N = 1) and testicular calcification 5% (N = 1), wire rejection 5% (N = 1) and death 5% (N = 1). The management of postoperative complications was surgical in 95% and medical in 100%. Their occurrence extended the hospital stay by 3.65 days and increased the average cost of care by 60541.85 CFA francs. The mortality index lowered by efficient management of complications (IMAGE) calculated in relation to deaths was 95% of cases. Anemia, ASA score ≥ III, Alteimeir II and IV classes, duration of surgery and post-operative hospitalization were factors contributing to post-operative complications.展开更多
为了探究子午线轮胎面内振动特性,建立了旋转超弹性厚壁REF模型。并在具有随动坐标系的绝对节点坐标法(absolute nodal coordinate formulation,ANCF)框架下,提出平面内旋转环扇单元,对旋转超弹性厚壁弹性基环模型(ring on the elastic ...为了探究子午线轮胎面内振动特性,建立了旋转超弹性厚壁REF模型。并在具有随动坐标系的绝对节点坐标法(absolute nodal coordinate formulation,ANCF)框架下,提出平面内旋转环扇单元,对旋转超弹性厚壁弹性基环模型(ring on the elastic foundation,REF)进行离散。考虑到非线性本构关系和旋转运动中的广义惯性力,建立了该模型的非线性运动微分方程以及线性化运动微分方程。通过与现有文献中的试验结果进行对比,验证了上述模型的有效性,并分析了弹性基参数、环体厚度和旋转角速度对子午线轮胎固有特性的影响规律。展开更多
The inguinal hernia is a very frequent surgical pathology in the world and it represents 95% of the hernias of the groin. This work aimed to determine the frequency of inguinal hernias, describe the clinical and thera...The inguinal hernia is a very frequent surgical pathology in the world and it represents 95% of the hernias of the groin. This work aimed to determine the frequency of inguinal hernias, describe the clinical and therapeutic aspects of inguinal hernias, describe the morbidity and mortality related to inguinal hernias and evaluate the cost of treatment. Our study was conducted from January 2010 to December 2010 in the general surgery department of the Reference Health Center of Commune I in the district of Bamako. We collected 130 cases of inguinal hernias with a sex ratio of 15.25 in favor of the male sex. The mean age was 48.02 years (standard deviation: 17.53 years). Strangulated inguinal hernias accounted for 4.9% of abdominal surgical emergencies and 14.6% of all operated inguinal hernias. More than half of the patients (82%) were operated under local anesthesia. Clinical signs were marked by painless or irreducibly painful inguinal swelling. The diagnosis was clinical in all patients. Some patients benefited from a minimum blood assessment (rhesus grouping, glycaemia, hemoglobin level and hematocrit). The Shouldice technique was performed in 68% of patients. One case of organ resection was performed, i.e. 0.8% of cases. Morbidity was 4.6% due to wall abscess;0.8% scrotal hematoma type. We have not recorded any recurrence or death.展开更多
Acute peritonitis is most often secondary to perforation of the digestive organ and/or the spread of an intra-abdominal septic focus. The objectives of this work were to study acute peritonitis in the general surgery ...Acute peritonitis is most often secondary to perforation of the digestive organ and/or the spread of an intra-abdominal septic focus. The objectives of this work were to study acute peritonitis in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of peritonitis, to describe the epidemiological, clinical and therapeutic aspects in order to analyze the surgical consequences and to assess the additional cost of treating acute peritonitis. This study was prospective, descriptive, cross-sectional involving 40 patients received in the surgery department of the Cs ref of commune I for acute peritonitis from January 1, 2018 to December 31, 2018. There were 40 patients among whom 28 (70%) were men and 12 were women (30%), i.e. a sex ratio = 2.3. The average age was 25 years with extremes varying between 16 and 54 years and a standard deviation of 11.78. Abdominal pain was the main reason for consultation. Clinical examination alone made it possible to make the diagnosis in 75% of cases. Surgical treatment depended on the intraoperative etiology. The clinical diagnosis was supported by ASP and abdominal ultrasound;performed respectively in 10% and 90% of patients. Appendiceal peritonitis was the intraoperative diagnosis observed in 50% of cases. All our patients benefited from a peritoneal toilet with drainage. We noted a morbidity rate of 5% dominated by parietal suppuration. The average cost of care was 175,000 FCFA.展开更多
Acute intestinal obstructions are defined as a complete and persistent cessation of materials and gases in a segment of the digestive tract. They constitute a medical-surgical emergency. Our work aimed to study acute ...Acute intestinal obstructions are defined as a complete and persistent cessation of materials and gases in a segment of the digestive tract. They constitute a medical-surgical emergency. Our work aimed to study acute intestinal obstructions, to determine the hospital frequency, to describe the aspects (epidemiological, clinical and therapeutic), to analyze the surgical consequences and to evaluate the cost of the management of obstructions. acute intestinal infections in the general surgery department of the reference health center of commune I of Bamako in Mali. Our retrospective, longitudinal and descriptive study took place from January 1, 2015 to December 31, 2019 in the general surgery department of the reference health center in commune I of Bamako. The average age was 47.72 years with extremes of 15 and 78 years and a standard deviation of 16.07. Our sex ratio (56 men/15 women) was 3.38. The clinical signs were dominated by abdominal pain (100%), vomiting (52.9%), cessation of materials and gases (25.4%) and meteorism (35.3%). The main etiologies found intraoperatively were strangulated hernia (54.9%), bands and/or adhesions (21.1%), sigmoid volvulus (12.7%), colorectal tumor (7%), small bowel volvulus (2.8%) and acute intestinal intussusception (1.4%). Hernia repair was the most performed surgical procedure, i.e. 54.9%. The overall mortality rate was 1.4%.展开更多
文摘This work was a retrospective prospective study carried out in the general surgery department of the Cs ref of commune I from January 2009 to December 2012. Our study aimed to determine the hospital frequency of hemorrhoidal disease, to identify the contributing factors, describe the clinical and therapeutic aspects and analyze the surgical consequences. We collected 73 patients with an average age of 37.8 years (range: 19 years and 77 years) with a sex ratio of 2.5 in favor of men. We operated on 49 patients or 67.1% of cases. 71.2% of our patients were married and lived in Bamako. Schoolchildren and middle managers made up 39.8% of cases. 82.2% of patients were seen in ordinary consultation and 69.9% complained of progressive anal pain in 66.7% of cases. This pain was triggered by defecation in 88.2% of our patients. The contributing factors were dominated by constipation (53.4%), working in a seated position (41.1%) and a sedentary lifestyle (16.4%) of cases. Stage IV external hemorrhoids and hemorrhoidal thrombosis represented 53.8% of surgical indications. The most used surgical technique was that of Milligan-Morgan, i.e. 51.9% of cases and 45.2% of patients treated medically received a combination of transit regulator, venotonics and analgesics. The surgical aftermath was marked by hemorrhage (3 cases), delayed healing (5 cases), urinary retention (1 case) and scarring anal stenosis (1 case). The morbidity rate was 5.48% of cases and a zero mortality rate. The average length of hospitalization was 2 days with extremes of 1 and 5 days.
文摘This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the Bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of Bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at Cs Ref CI. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.
文摘Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to study inguinal hernia in children in the general surgery department of the Reference Health Center of Commune I of the Bamako District;to determine the frequency of inguinal hernia;describe the epidemiological, clinical and therapeutic aspects of inguinal hernias and in order to evaluate the cost of treatment. This was a prospective study from April 2017 to March 2018 during which 60 children with an inguinal hernia were collected. Inguinal hernias in children represented 9.23% of patients operated on in the department. The average age was 59.23 months with extremes of one month and 180 months and a standard deviation of 49.23 years. The male sex was dominant with a sex ratio equal to 9:1. The notion of prematurity was found in 11.7% and was associated with a testicle not in place in 1.7% of cases. 41.7% of our patients were referred by a doctor and 66.7% of patients presented with painless, intermittent inguino-scrotal swelling (83.3% of cases). The hernia was discovered before one week of life in 50% of cases. Inguinal swelling was absent in 11.7% but observed intraoperatively. The inguinal hernia was unilateral in 91.7% of cases and 70% of hernias were discovered by the parents during pushing efforts. The inguinal hernia was located on the right in 61.7% of cases. The hernia swelling was soft, painless, impulsive and reducible in 78.3% of cases. The swelling was inguino-scrotal in 58.3% of cases. The hernia was simple in 95% of patients and hernial strangulation was observed in 3 cases or 5% of cases. 98.3% of patients were ASA I. The treatment was carried out openly in all our patients including closure of the vaginal peritoneal canal in 95% of cases under general anesthesia in 98.3% of cases. The morbidity rate was 8.4% (surgical site infection: 6.7% of cases and hematoma: 1.7%). The immediate consequences were simple in 96.6% of cases. No cases of recurrence occurred during the 6 months after the intervention. The average cost of care was estimated at 69,743 FCFA.
文摘Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of post-operative complications, to identify the factors of occurrence, to describe the clinical aspects, diagnostic and therapeutic in order to assess the additional cost linked to post-operative complications. This study was prospective, carried out in the general surgery department on 300 cases of surgical interventions. It covered all patients aged at least 15 years, operated on and hospitalized or not, and who presented complications during the 30 days postoperatively. Patients under the age of 15 were not included (our general surgery department is not a pediatric surgery department). We collected 300 patients among whom 199 (66.33%) were men and 101 (33.66%) women, i.e. a sex ratio = 1.9. The average age was 38 years with extremes of 15 and 87 years. The main initial diagnoses were: acute appendicitis, peritonitis, occlusions, wall hernias, hemorrhoids, uterine prolapse, uterine myomas, ovarian cysts and acute cholecystitis. Emergencies represented 43% (N = 129) of interventions with 6.98% post-operative complications (POC). Postoperative complications were dominated by surgical site infections, 75% of cases (N = 20), wall hemorrhage 5% (N = 1), testicular necrosis 5% (N = 1) and testicular calcification 5% (N = 1), wire rejection 5% (N = 1) and death 5% (N = 1). The management of postoperative complications was surgical in 95% and medical in 100%. Their occurrence extended the hospital stay by 3.65 days and increased the average cost of care by 60541.85 CFA francs. The mortality index lowered by efficient management of complications (IMAGE) calculated in relation to deaths was 95% of cases. Anemia, ASA score ≥ III, Alteimeir II and IV classes, duration of surgery and post-operative hospitalization were factors contributing to post-operative complications.
文摘为了探究子午线轮胎面内振动特性,建立了旋转超弹性厚壁REF模型。并在具有随动坐标系的绝对节点坐标法(absolute nodal coordinate formulation,ANCF)框架下,提出平面内旋转环扇单元,对旋转超弹性厚壁弹性基环模型(ring on the elastic foundation,REF)进行离散。考虑到非线性本构关系和旋转运动中的广义惯性力,建立了该模型的非线性运动微分方程以及线性化运动微分方程。通过与现有文献中的试验结果进行对比,验证了上述模型的有效性,并分析了弹性基参数、环体厚度和旋转角速度对子午线轮胎固有特性的影响规律。
文摘The inguinal hernia is a very frequent surgical pathology in the world and it represents 95% of the hernias of the groin. This work aimed to determine the frequency of inguinal hernias, describe the clinical and therapeutic aspects of inguinal hernias, describe the morbidity and mortality related to inguinal hernias and evaluate the cost of treatment. Our study was conducted from January 2010 to December 2010 in the general surgery department of the Reference Health Center of Commune I in the district of Bamako. We collected 130 cases of inguinal hernias with a sex ratio of 15.25 in favor of the male sex. The mean age was 48.02 years (standard deviation: 17.53 years). Strangulated inguinal hernias accounted for 4.9% of abdominal surgical emergencies and 14.6% of all operated inguinal hernias. More than half of the patients (82%) were operated under local anesthesia. Clinical signs were marked by painless or irreducibly painful inguinal swelling. The diagnosis was clinical in all patients. Some patients benefited from a minimum blood assessment (rhesus grouping, glycaemia, hemoglobin level and hematocrit). The Shouldice technique was performed in 68% of patients. One case of organ resection was performed, i.e. 0.8% of cases. Morbidity was 4.6% due to wall abscess;0.8% scrotal hematoma type. We have not recorded any recurrence or death.
文摘Acute peritonitis is most often secondary to perforation of the digestive organ and/or the spread of an intra-abdominal septic focus. The objectives of this work were to study acute peritonitis in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of peritonitis, to describe the epidemiological, clinical and therapeutic aspects in order to analyze the surgical consequences and to assess the additional cost of treating acute peritonitis. This study was prospective, descriptive, cross-sectional involving 40 patients received in the surgery department of the Cs ref of commune I for acute peritonitis from January 1, 2018 to December 31, 2018. There were 40 patients among whom 28 (70%) were men and 12 were women (30%), i.e. a sex ratio = 2.3. The average age was 25 years with extremes varying between 16 and 54 years and a standard deviation of 11.78. Abdominal pain was the main reason for consultation. Clinical examination alone made it possible to make the diagnosis in 75% of cases. Surgical treatment depended on the intraoperative etiology. The clinical diagnosis was supported by ASP and abdominal ultrasound;performed respectively in 10% and 90% of patients. Appendiceal peritonitis was the intraoperative diagnosis observed in 50% of cases. All our patients benefited from a peritoneal toilet with drainage. We noted a morbidity rate of 5% dominated by parietal suppuration. The average cost of care was 175,000 FCFA.
文摘Acute intestinal obstructions are defined as a complete and persistent cessation of materials and gases in a segment of the digestive tract. They constitute a medical-surgical emergency. Our work aimed to study acute intestinal obstructions, to determine the hospital frequency, to describe the aspects (epidemiological, clinical and therapeutic), to analyze the surgical consequences and to evaluate the cost of the management of obstructions. acute intestinal infections in the general surgery department of the reference health center of commune I of Bamako in Mali. Our retrospective, longitudinal and descriptive study took place from January 1, 2015 to December 31, 2019 in the general surgery department of the reference health center in commune I of Bamako. The average age was 47.72 years with extremes of 15 and 78 years and a standard deviation of 16.07. Our sex ratio (56 men/15 women) was 3.38. The clinical signs were dominated by abdominal pain (100%), vomiting (52.9%), cessation of materials and gases (25.4%) and meteorism (35.3%). The main etiologies found intraoperatively were strangulated hernia (54.9%), bands and/or adhesions (21.1%), sigmoid volvulus (12.7%), colorectal tumor (7%), small bowel volvulus (2.8%) and acute intestinal intussusception (1.4%). Hernia repair was the most performed surgical procedure, i.e. 54.9%. The overall mortality rate was 1.4%.
