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B Fall

Publications and source records attributed to B Fall.

At least 37 records · Page 2Linked to original sources

[Lumbar hernia through the Jean Louis Petit triangle: anatomic and clinical aspects].

Lumbar hernia through Jean Louis Petit Triangles is rare. Usually asymptomatic, it is sometime revealed by lumbar mass or a complication. Surgical treatment consists on parietal repair. This could be done by direct suture, muscular plasty or prothetic material. We hereby, report three cases of lumbar hernia. We get the opportunity to make an update in the anatomical, clinical and therapeutical point to view.

Abdominal Muscles↗

[Giant ovarian cyst and pregnancy (a case report)].

We report a case of giant ovarian cyst in pregnancy of 23 weeks of amenorrhea revealed by digestive and respiratory compression. As the absence of ultrasonographic and biologic malignancy criterias, several punctures of the cyst were done permitting the evolution of pregnancy until the preterm period. An annexectomy done in the immediate post-partum permitted to avoid the frequent mechanical accidents during this period. From this case, we discuss clinical and therapeutic problems of this association.

Abdominal Pain↗

[Epidemiological and clinical aspects of pancreatic cancer in Senegal].

The objective was to verify if the introduction of ultrasonography in our practice has entailed modifications of the epidemiology and the clinic of pancreatic cancer in Senegal. We have performed a retrospective study of cancer of the pancreas diagnosed on the basis of clinical signs, ultrasonography, surgical findings and necropsy from March 92 to October 97. The chi-square test according to Mantel-Haenszel has been used to compare qualitative variables. The routine practice of ultrasonography has allowed to establish the diagnosis of 107 cases of pancreatic cancer within 5 years and half. The sex ratio was 1.05 and the average age was 60 years +/- 13 without significant difference according to the sex. The mean period of diagnosis was 5 months. However the classic form associating thinness and cholestatic jaundice or palpable abdominal mass dominated the clinical symptoms (74.5% of cases). A very deep alteration of the general status has been noticed in 25.5% of cases. At surgery, according to the TNM classification, 22% of our patients were at stage II and 78% from stage III to IV. In Senegal, the prevalence of pancreatic cancer is increasing since the introduction of ultrasonography. This technique has shown that the male predominance is less than reported in previous studies. Nevertheless the diagnosis remains late. As far as we cannot identify risk groups, recent appearance of digestive disturbance even atypical after 50 years old, is enough to suspect the diagnosis.

Adult↗

[A left paraduodenal hernia--a case report].

The left paraduodenal hernia obtains when the small intestine goes through the left paraduodenal fosset. It (the hernia) develops on the left, at the back of the descending mesocolon. The present authors study one case looking at its pathogeny and the clinical and therapeutic problems posed by such a variety of congenital internal hernia. The authors emphasize, in particular, its morbid associations with the volvulus of the pelvic colon. Finally they highlight the importance of a through and careful exploration of the abdominal cavity during any laparatomy following an occlusive syndrome.

Abdominal Pain↗

[Peritoneal pseudocysts: complications of ventriculo-peritoneal shunts. Apropos of 3 cases].

From 1975 to 1995, 335 patients were operated for hydrocephalus in neurosurgical clinic of CHU Fann, and got ventriculo-peritoneal shunt. 3 cases of patients presenting an uncommon complication of ventriculo-peritoneal shunt: abdominal pseudo cyst, are reported and discussed. The digestive symptoms are the first to manifest themselves for a period of time, then confusing with other forms of abdominal cysts. The suggested treatment is to remove the shunt from the peritoneal cavity and perform a ventriculo-atrial shunt, then to proceed to a laparotomy, drain the fluid and resect the cyst wall. The results are excellent.

Adolescent↗

[Tumor seeding of the abdominal wall after fine needle cytologic puncture of the liver. Apropos of a case].

Tumor seeding of the abdominal wall during fine needle puncture-aspiration of the liver is a very rare complication. The authors report a case of this complication affecting a 50-year-old Senegalese woman. She underwent echo-guided fine needle cyto-puncture of a hepatocellular carcinoma arising from the left lobe, followed by left lobectomy. The subcutaneous nodule was discovered 42 months after cyto-puncture. Histology following its excision revealed infiltration of carcinomatous hepatocytes between the fibers of rectus abdominis. There was no recurrence and the patient was well 10 months after excision of the subcutaneous nodule. With a review of 10 others cases reported in the literature, the authors feel that, although rare, this complication must be avoided and suggest a system for the protection of structures through which the needle passes.

Biopsy, Needle↗

[Colic occlusions: retrospective study of 62 cases].

The profile of colic occlusions has been drawn from sixty two (62) observations made at the Surgical Clinic between 1970 and 1984. The male sex was slightly more affected (3 men for 2 women) with the age of the patients ranging from 19 to 82 years. The clinical sign could be summed up as following: a montrous ballooning of the abdomen which is asymmetrical in 89% of the cases. The occlusions with a stade of shock represented 58% of our observations. The abdomen plain film exhibited the characteristic signs in 89% of the cases. The etiology is dominated by the volvulus of the pelvic colon in 83% of the cases. The essentially surgical treatment has mostly consisted on a resection-anastomosis. Mortality rate was 9.7%. Late consultation of the patients, the shortage of fully equiped medical infrastructure explain the gravity of the affection.

Adult↗

[Congenital cystic dilatation of the choledochus: apropos of a case diagnosed in an adult Senegalese women].

The authors report a case of congenital cystic dilatation of the choledochus diagnosed on a 37 years old senegalese woman. It is an uncommon affection in Africa. The clinical presentation with various signs is reviewed. Ultrasound or cholangiography confirms the diagnosis. Surgical excision of the cystic dilatation is the best treatment because of the high risk of cancerisation.

Adult↗

[Intestinal obstruction caused by postoperative adhesion. 79 cases].

The intestinal post-operative bridle represents the third most important etiology of obstructions at the clinic of the University Hospital of Dakar, behind hernia strangulations and the volvulus of the digestive tube. Between 1970 and 1989, a retrospective study has led to a sample of 79 patients with post-operative bridle obstructions. The group was made of 47 women and 32 men between 17 and 84 years of age. Stomach ache was by far the most common functional symptomatology, followed by the stoppage of the transit and vomiting. In most cases palpation revealed the presence of tympanism. For almost all the patients, the abdomen without preparation revealed either a hydroaeric level or a diffuse grey area. The initial intervention concerned mainly gynecological affections or pathologies of appendicular type. The resection of the bridles was carried out in most cases. There were 10 deaths. The intestinal obstructions by post-operative bridles continue to be a surgical emergency still characterized by a high mortality rate. The late consultation of the patients, often received when presenting considerable visceral deficiency, is one of the main causes of the high rate of fatalities.

Adolescent↗

[Contribution of echography in the diagnosis ruptured liver abscess (Apropos of 4 cases)].

The authors report 4 cases of ruptured hepatic abscesses in peritoneum (2 cas) and in pleural (2 cases). The cases occurred in 3 men (two of them were alcoholic) and one woman who was in the postpartum period. The cases confirm the classic pictures according to which, ruptures of hepatic abscesses have unclear clinical presentation whether they are amoebic or bacterial in origin! In these cases, ultrasound is very useful in the rapid detection of peritoneal or pleural abscesses which can be confirmed by ultrasonically guided fine needle punction When the channel from the intra hepatic abscess can be visualised, or when they are a coexisting hepatic and peritoneal pleural abscesses, the diagnosis is clear. However when the abscess has been completely emptied of its contents the diagnosis may the difficult.

Adult↗

[Splenic abscess. Apropos of 5 cases].

Spleen abscesses are infrequent, and are encountered in 0.4 to 0.7%-of the autopsy series. They are diagnosed late and their prognosis is poor. The authors report about 5 cases of spleen abscesses observed at Dakar's University Surgical Clinic over a period of 30 years. The patients were young adults, including one case of sickle-cell anemia. In spite of numerous clinical signs in all cases, the abscess was diagnosed late. In three patients, ultrasound allowed establishing the diagnosis and initiating percutaneous treatment, with no success in two cases. The procedure had consisted in total splenectomy in all cases. One patient died 2 months after surgery, after the evacuation of a hematoma in the splenic compartment. The other 4 patients, seen 7, 4, 3 months and 15 years after total splenectomy, no longer presented with any symptom. The authors emphasize the rarity of spleen abscesses; the fact that the diagnosis is often established late, in spite of the progress made in non-invasive medical imaging, including CT and ultrasound; the physiopathology, etiology and treatment of the disease, the latter still being surgical.

Abscess↗

[Bloodless emergent laparotomy for acute abdominal syndrome].

Bloodless laparotomy (BL) is defined as an opened exploration of the abdominal cavity that yields negative results, i.e., "provides no information as to the cause of the clinical and paraclinical symptoms responsible for prompting the surgical investigation". The authors report a retrospective study spanning January 1975 to December 1989, on the incidence of and mortality associated with emergent BL in patients with acute abdominal syndrome, with the intent of reducing its frequency. Over this period, 24 BL occurred in 3480 emergent laparotomies, i.e., 0.63%. These involved 7 men, 5 women, 5 boys and 7 girls, aged 4 to 52 years (mean age = 19.5 years). Indications for surgery were based on clinical signs, as well as on laboratory findings such as chest X-ray and plain radiography and needle-puncture of the abdomen. Surgical data indicated:liver cirrhosis--3 cases; mesenteric adenopathy--3 cases; intestinal parasitosis--1 case; bilateral adnescitis--1 case; polycystic ovaries--1 case; wall abscess--1 case; unexplained pain--14 cases. The mortality rate was 2/24. Use of other paraclinical investigations, namely ultrasonography, laparoscopy and peritoneal lavage, and of computer science methods after a prior clinical examination initiated by history-taking, might help reduce the rate of BLs, which are non-devoid of mortality.

Abdomen, Acute↗

[Penetrating wounds of the chest].

The authors report on 116 chest wound cases. The initial death rate is very high--47.41%. A knife wound is the most common cause (83.64%). Among casualties brought in alive, pure thorax wounds predominated (67.21%) followed by thoraco-abdominal wounds (26.23%) and cervico-thorax wounds (6.56%). Post-mortems attribute death to the seriousness of visceral lesions with the heart wounded in over 41.81% of the cases. The seriousness of chest wounds is stressed, as is the need for full and rapid therapy.

Abdominal Injuries↗

[Pancreatic pseudocyst: diagnosis, treatment. Apropos of 7 cases].

A pseudocyst of the pancreas (PCP) is a rare affliction in Africa despite widespread malnutrition and abdominal disorders. The authors cover 7 PCP observations on 3 men and 2 women between 18 and 32 years, and 2 boys of 5 and 6 years, in the clinical context of abdominal pain (7/7), an abdominal tumour (7/7) and as a sequence to abdominal contusion (4/7). In 5 cases, echotomography led the etiological investigation of the liquid mass to seek a pancreatic origin. Surgical treatment consisted of 2 termino-lateral cystojejunostomies on a shaped flexure++ and 3 latero-lateral cystojejunostomies (of which one had to be drained externally two times); and a corporeo-caudal pancreatectomy. Supervision of between 1 1/2 and 5 years (1 1/2 years: 3 patients; 2 1/2 years: 2 patients; 5 years: 1 patient; 1 patient lost track of) revealed only one recurrence after internal latero-lateral drainage, and that without clinical repercussions. The authors use this short experiment to study the clinical and paraclinical symptomatology, the etiology and the treatment of PCPs. They stress the role of medical pictures in diagnosis, and of interventional radiology in treatment, but above all the primacy of surgery to treat pseudocysts of the pancreas in Africa.

Abdominal Injuries↗

[Complications of Meckel's diverticulum in Dakar (apropos of 2 cases)].

Meckel's diverticula is the most common lesion among the abnormalities resulting from the persistence of the vitelline canal and its vessels. Studying it is interesting, on the one hand, because of the difficulty of detecting it, and, on the other, because of the possibility of accidents dominated by intestinal occlusions and digestive haemorrhages. Two observations on complications in Meckel's diverticula discovered in young men in the casualty unit are covered, and literature on the rare pathology is reviewed.

Abdominal Pain↗