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Biomedical subjects

A Essomba

Publications and source records attributed to A Essomba.

15 recordsLinked to original sources
PubMed2006

[Acute abdomens of parasitic origin: retrospective analysis of 135 cases].

OBJECTIVE: To assess acute abdomens incidence of parasitic origin at Yaounde (Cameroon) and evaluate their different management modalities. MATERIALS AND METHODS: Retrospective study from January 1973 to December 2002 of patients managed at Department of Surgery, Central Hospital, Yaounde (Cameroon). RESULTS: Among 3464 acute abdomens managed by laparotomy during this period, 135 patients (3.9%) had a parasitic origin. Ninety-seven patients (79%) were operated on before 1990. Among these 135 patients, 63 (47%) had peritonitis secondary to liver amoebic abscess intraperitoneal rupture, 24 (18%) had acute intestinal obstruction due to an ascaridioma, 21 (15%) had appendicitis of parasitic origin, 15 (11%) had amoebic typhlitis, 4 (3%) had pancreatitis and/or angiocholitis caused by the obstruction of ampulla of Vater by an adult ascaris worm, 4 (3%) had intestinal perforation by ascaris, and 4 (3%) had intussusception (tricocephalus). CONCLUSIONS: Incidence of abdominal emergencies of parasitic origin is unfrequent but not rare at Central Hospital, Yaounde, Cameroon. This incidence is decreasing over time. However, liver amoebic abscess intraperitoneal rupture is the most common cause of peritonitis and is still associated with postoperative high mortality rate. Preoperative diagnosis could lead to non-operative management that may be associated with better prognosis.

Abdomen, Acute↗
PubMed2006

Growing skull fractures.

INTRODUCTION: Growing skull fractures are a rare complication of head injuries (Ersahin et al. in Neurosurg Rev 23:139-144, 2000; Hayashi et al. in Childs Nerv Syst 13:349-351, 1997; Ramamurthi and Kalyanaraman in Neurosurgery 32:427-430, 1970; Zegers et al. in Eur J Pediatr 162:556-557, 2003). Although early diagnosis and prompt treatment are important to prevent the underlying progressive brain damage, the clinical presentation and the morphological investigations are rarely specific or sensitive shortly after the trauma. DISCUSSION: The authors present three cases of growing skull fractures: the use of ultrasonography (US) via the fracture line contributed to early diagnosis and prompt treatment in two cases. US was not performed in the third case, and this delayed management. Treatment consisted of a watertight duraplasty with a free flap of pericranium without cranioplasty. US via the fracture line appears to be a sensitive and reliable method of detecting the dural tears in the early stages of growing skull fractures. CONCLUSION: Duraplasty alone with a flap of pericranium remains the simplest and least expensive method of treatment. Cranioplasty is not necessary in young children.

Child, Preschool↗
PubMed2006

Depressed skull fractures in children: Treatment using an obstetrical vacuum extractor.

INTRODUCTION: A depressed skull fracture is an inward buckling of the skull bones. It is referred to as a ping-pong ball fracture in neonates; in older children, some fractures take a cup shape mimicking 'ping-pong' ball fractures. OBJECTIVE AND METHODS: The aim of this study was to assess the use of an obstetric vacuum extractor to elevate cup-shaped depressed skull fractures in children irrespective of age. All children admitted into the Central Hospital of Yaounde between 1999 and 2004 with a cup-shaped simple depressed skull fracture and treated with the vacuum extractor were included. RESULTS: Nine children aged from 3 months to 17 years were treated with the vacuum extractor. The cosmetic and radiographic results were satisfactory. The procedure was simple and without any complication. CONCLUSION: The elevation of 'ping-pong-ball-like' or 'cup-shaped' skull fractures in older children (beyond the neonatal period) is a simple, effective and safe procedure.

Adolescent↗
PubMed2005

[Abdominal gunshot wound: description of 86 cases in Cameroon].

Abdominal gunshot wound (AGSW) is a trauma emergency. The purpose of this report is to describe our experience with managing AGSW largely without modem investigational modalities. Data was collected retrospectively by reviewing the surgical reports and clinical charts of patients admitted to live hospitals dealing with AGSW over a 5-year period. Incomplete files and wounds not involving the abdomen were not included. A total of 86 files were analyzed. Patients ranged in age from 10 to 63 years ivith mean age of 32 years and a sex ratio of 5.5. Most patients (87%) underwent surgical exploration. Laboratory revealed no lesions in 22.5% of cases, minor lesions in 9.5% and major lesions justifying surgical repair in 68%. A total of 86 visceral lesions were found in the patients who underwent surgical exploration. The lesion involved the small intestine in 31.5% of case, colon in 24.5%, liver in 23.5%, spleen in 7%, stomach in 6%, and uterus in 2%. The kidney, pancreas, mesenteries, large momentum, and transverse mescaline each accounted for 1% of lesions. Conventional operative techniques were used with a mortality of 5.5% and morbidity of 4%. Based on our findings we conclude that when investigational tools (CT-scan, peritoneal lavage and laparoscopy) are unavailable prolonged watchful waiting increases the risk of mortality and morbidity in patients presenting AGSW associated with suspicious clinical signs. Prompt surgical treatment improves prognosis but is associated with a high rate of cases showing no lesions.

Abdominal Injuries↗
PubMed1999

[Traumatic jejuno-ileal ruptures: apropos of 18 cases at the Central Hospital of Yaounde].

Eighteen blunt small bowel traumas were reviewed in this retrospective study (1986-1996) concerning 12.8% of laparotomies for blunt abdominal trauma. The clinical presentation at admission was peritonitis (9 cases) or hemoperitoneum (4 cases) whereas 5 cases were diagnosed lately because of non specific signs at the beginning. All patients underwent surgery: simple suture or suture after excision of edges (12 cases); resection anastomosis (6 cases). There were no post-operative complications in most of the cases. The mortality rate was 5%. Blunt small bowel traumas are not frequent in our practice. Their diagnostic is often per-operative. If the clinical signs of intraperitoneal lesion are not present, a clinical follow-up by repeated and thorough physical examination can permit an early diagnosis. The surgical treatment is simple, and the prognosis more linked to severe associated lesions than the bowel lesion.

Accidental Falls↗
PubMed1997

[Blunt trauma of the liver. An analysis of a series of 29 cases].

Twenty nine patients with blunt liver trauma were recorded in the Central Hospital of Yaounde between 1986 and 1996. The average age was 23.4 years, with the 20 to 25 and 5 to 15 age groups being the most affected. The most characteristical clinical presentation was hemoperitoneum with shock. Twenty-three patients were operated (18 in emergency and 5 secondary). While 6 patients benefited from non operative treatment due to their stable hemodynamic state. Exploration of lesions revealed 16 grade I and grade II, 8 grade III and 5 grade IV and V lesions. The operation was a simple suture in 13 cases, selective ligature of hepatic artery in 2 cases and 2 tamponades while in 4 cases the treatment was inactive. The bleeding could not be controlled in 2 cases. Peri-operative mortality was 17.39% and morbidity 21.74%, made up mainly of parietal sepsis. In our practice, blunt liver trauma are generally benign and treatment should be conservative.

Accidents, Traffic↗
PubMed1996

[Liver trauma: analysis of 42 cases in Yaounde].

Forty-two cases of liver trauma were reviewed at the Central Hospital of Yaounde between 1984 and 1994. The mean patient age was 22 years, the most commonly involved age group being between 20 and 35 years. Trauma was blunt in 24 cases (57.1%) and penetrating in 18 cases (42.8%). Diagnosis was achieved most frequently by abdominal needle puncture confirming hemoperitoneum. Emergency surgery was performed in 38 cases. In the remaining 4 cases hemodynamic status was stable and surgery was not required. Lesions were classified as grade I and II in 24 cases, grade III in 5 cases, grade IV in 3 cases, and grade V in 1 case. In the remaining 9 cases the grade of the lesion was not mentioned. Management consisted of simple suture in 26 cases, debridement in one case, packing in 4 cases, and a watchful attitude in 4 cases. In 3 cases hemorrhage was uncontrollable. Overall perioperative mortality was 14.2%. The main complication was parietal sepsis which occurred in 6 cases. In the present African series liver trauma was most often benign. This finding suggests that a conservative surgical approach is indicated.

Adolescent↗
PubMed1994

Preoperative carcinoembryonic antigen level as a prognostic indicator in resected primary lung cancer.

The aim of this study was to evaluate the prognostic significance of elevated preoperative carcinoembryonic antigen (CEA) levels in cases of resected primary lung cancer. Between 1985 and 1989, 152 patients with tumors and CEA levels above 10 ng/mL underwent operation. One hundred twenty-five of them underwent resection of their tumors and the other 27 underwent exploratory thoracotomy only. Fifty-two percent of cancers were adenocarcinomas and 33% were epidermoid. Forty-two resected tumors were classified as stage I, 29 as stage II, 45 as stage IIIa, 7 as stage IIIb, and 2 as stage IV. The 3-year actuarial survival rate was 54% for patients with stage I tumors, 28% for those with stage II, 18% for those with stage IIIa, 44% for those with stage IIIb, and 0% for those with stage IV tumors. The 5 year actuarial survival was 40% for those with stage I tumors, 28% for those with stage II, 7% for those with stage IIIa, and 0% for those with stage IIIb tumors. Preoperative CEA levels increased from stage I to stage IIIa (p < 0.05). However, based on preoperative CEA levels we were not able to predict resectability, because levels were not significantly different between stage IIIa and exploratory thoracotomy-only groups. Adenocarcinoma was not significantly associated with higher CEA levels than was epidermoid, except in stage IIIa disease (p < 0.05). We found a critical unfavorable level of prognostic significance at 30 ng/mL.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1994

[Primary abscess of the psoas. A common disease in tropical countries. Apropos of 87 cases].

Over a 4 years period, 87 cases of primary abscesses of the psoas were treated surgically at the Central Hospital in Yaoundé. The psoas muscle was involved in 10.17% of the cases with myositis. Most patients were in young male and the abscesses were in an advanced stage. Staphylococcus was the most frequently encountered germ (78.4%) and enterobacteria were only found in 3.07%. The diagnosis was based on clinical and echographic findings. There was 1 patient with acquired immunodeficiency syndrome (AIDS). Most cases were treated by extraperitoneal drainage. Morbidity and mortality were low and generally occurred in debilitated patients (AIDS, involvement of several muscle groups, diabetes).

AIDS-Related Opportunistic Infections↗
PubMed1993

[Treatment of postoperative incisional hernias by a composite prosthesis (polyester-polyglactin 910). Clinical and experimental study].

Because of complications resulting from the use of intraperitoneal prosthetic materials, the authors studied a new double Layered composite mesh (formed by a Dacron mesh, and a polyglactin 910 mesh). The experimental study (40 rats) compared the composite mesh with Dacron mesh. Statistical analysis demonstrated the following conclusions. At 6 months, the poor fibroblastic activity with the composite mesh, indicated the absence of replacement of the polyglactin 910 mesh by a neo-tissue. The Dacron mesh remained in contact the abdominal viscera and contracted with them as many adhesions as when Dacron mesh was used alone. The composite mesh showed poor biological tolerance, lower than that of Dacron mesh. The clinical study concerned 24 patients, 3 recurrences were observed. In one case, we observed migration of the mesh in the small bowel. The unfavorable results of the experimentation, and the risk of visceral migration lead us to avoid the use of composite mesh in intraperitoneal sites.

Animals↗
PubMed1992

[Prosthesis used in the surgery of the abdominal wall. Focus on a comparative experimental protocol: difficulties and limits].

During many years the use of prosthesis for abdominal wall repair was not accepted by all surgeons. Now the laparoscopic repair has brought some surgeons to do it nearly systematically and industry proposes new materials. To allow comparing new materials the authors have developed an experimental proceeding of which they analyse technical difficulties and limits.

Abdominal Muscles↗
PubMed1991

[Short hospital stay, a step towards ambulatory surgery for hernia repair in 1990?].

In the first part the authors report their experience in Hernia surgery from 1980 to 1989. The comparison between 4 personal series shows that local anesthesia favoured short hospital stay, that the length of hospital stay decreased from 95% of more than 7 days hospitalization to 49% of less than 2 days; local anesthesia has almost suppressed post-anesthetic functional, respiratory and urinary troubles; no patient operated under local died; lastly the recurrence rate has not been related to hospital stay duration. Comments follow on Ambulatory surgery in general, technical and deontological principles. Ambulatory and short stay hospitalization in Hernia Surgery, and on advantages and pitfalls of these type of Surgery. The authors conclude on the feasibility, acceptability, benefits and usefulness of to day ambulatory surgery in hernia repair in the frame of a Universitary Hospital Center.

Ambulatory Surgical Procedures↗
PubMedDate not supplied

[The role of exclusion gastrectomy in gastroduodenal pathology].

Following a gastrectomy for exclusion performed 13 years ago with an excellent result at the time of an ulcerous recurrence after vagotomy, the authors have extended that indication to the "large stenosis" characterized by a huge gastric bag down to the pelvis minor including a plentiful stasis liquid, and by presenting some non-reversible sclerotic lesions. The results obtained have confirmed the merits of such technics of which the indications have been clearly expressed. The technic consists of not dissecting the ulcer, but to do stitches on the 2 cm stump, its mucous membrane having been resected, of the pyloric antrum. So stump complications are eliminated as well as biliary-pancreatic risks. The authors' experience is based on 54 case reports (6 females and 48 males) with a follow-up of an average of more than 7 years. 13 patients underwent in November 1987 an endoscopic control. Gastrectomy for exclusion with resection of the mucous membrane of the pyloric antrum appears to the authors as a permissible indication in treating "large African stenosis" as well as stenotic recurrence following a "Dragstedt" operation.

Adult↗