Biomedical subjects

C T Toure

Publications and source records attributed to C T Toure.

At least 19 recordsLinked to original sources

PubMed2006

[Penetrating wound of the abdomen. Profile of the suffering patient at Dakar teaching hospital].

INTRODUCTION: In Senegal, the rate of penetrating wound of the abdomen seems to be in great progression. The purpose of this study was to make a descriptive analysis of the epidemiological data on the patient suffering from a penetrating wound of the abdomen. MATERIAL AND METHOD: It is about a retrospective study performed on a 5 years period from January 1997 to January 2002. This study covered 90 cases of penetrating wounds of the abdomen listed at the emergency department of Dakar teaching hospital. The rate, age, sex, responsible agent, circumstances of the wound, place of the injury, evacuation mode, time of admission and check-up injury were studied. RESULTS: The average absolute rate of the penetrating wounds of the abdomen was 18 cases per year. The average age was about 27 +/- 10 years with 88 men for 2 women. The responsible agent was a knife (87%), a firearm (6%), a broken glass (4%), a bullock horn (2%) and a piece of iron (1%). Circumstances of the injury was aggression (91%), accident (6%), self-mutilation (2%), suicide attempt (1%). Evacuation was done by firemen (60%), by the ambulances of the medical structures (22%), and by private individuals (18%). The average time of admission was 5 hours. Nearly 61% of the wounds were located in the umbilical, epigastric, left hypochondre and left side areas. Wound was single in 93,4% of cases and linear in 71,8% of cases. We noted an exit of epiploon (38 cases), peritoneal signs (13 cases) and a small bowel evisceration (9 cases). The treatment was a systematic laparotomy (68%) and a simple closure of the wound with a good follow-up for any further aggravation (32%). CONCLUSION: The patient admitted at the surgical emergency unit of Dakar teaching hospital for penetrating wound of the abdomen is generally a young man, victim of aggression by knife, evacuated by firemen within 5 hours, which present a single and linearwound in perish-umbilical area with exit of epiploon and/or small bowel evisceration, which would undertaken a surgical operation in 68% of cases.

Abdominal Injuries↗

PubMed2005

[A case report of intrapelvic foetal osseous remains localization after clandestine caused abortion].

A 26 year old women, unmarried, second gesture, primiparous, had been hospitalized in our departement for the management of a hypogastric mass. Ultrasonography had shown: an uterus of normal size, a normal uterine vacuity line with presence of many osseous and fibrous constituents inside the inter-vesico-uterine area, including one femoral osseous of 18,6 mm corresponding to 15 weeks of amenorrhoea. A few months before, the patient had undergone a clandestine caused abortion on a progressive intrauterine pregnancy of 12 weeks of amenorrhoea certified by ultrasonography. It is an exceptional complication of clandestine caused abortion. It gives the opportunity to us to discuss its etiopathogenic mechanism. It also enables us to point out the complications of the clandestine caused abortion and to insist on the need for its prevention.

Abortion, Illegal↗

PubMed2005

[Liver arterial ischemia after cephalic pancreatico-duodenectomy. A case report].

Cephalic pancreaticoduodenectomy is the best treatment for cephalic pancreas cancers. A rare complication is the liver ischemia after the divison of gastroduodenal artery. This complication can occur when a celiac trunk stenosed by the median arcuate ligamentous is not recognised. We report the case of a 40 old woman who underwent cephalic pancreaticoduodenectomy for an adenocarcinoma of pancreas head. There was no complication immediatly. Two weeks later, she presented two episodes of angiocholitis. An abdominal tomodensitometry showed a liver arterial ischemia associated with a celiac trunk stenosis. There was a left hepatic artery wich came from the left gastric artery. Medical treatment of the angiocholitis was successful. Surgical revascularization was not necessary. Nine months after, arterial revascularization by the left hepatic artery and biological hepatic tests were restored. This case report talks about the importance of angioscanner before pancreatic surgery when celiac and mesenteric angiography is not available. Also, it underlines the importance of the gastroduodenal artery occlusion test before his ligation during pancreaticoduodenectomy.

Adenocarcinoma↗

PubMed2004

[Treatment of incisional hernias].

Several therapeutic processes were proposed in the repair of incisional hernia, on the basis of simple joining suture go to the installation of prosthetic mesh while passing by aponeurotic autoplasty according to Welti-Eudel technique. The aim of this study was to report the results of our experiment in the treatment of incisional hernias. It was a retrospective study carried out of January 11th 1996 to December 31, 2000, concerning 35 cases of incisional hernias operated during the study period. The following parameters were studied: age, sex, diameter, technique of repair, morbidty, mortality and the remote follow-up. Average age of our patients was 33 years with extremes of 13 and 53 years. It include 30 womens and 5 mens. The initial operation were dominated by Caesarean (57%). The diameter of incisional hernia varied between 3 and 5 cm in 22.9% of patients, between 5 and 10 cm in 62.8% of paitents, higher than 10 cm in 14.3% of patients. The simple joining suture was carried out in 22.9% of cases, the Welti-Eudel technique in 42.9% of cases and the installation of prosthetic mesh in 34.2% of the cases. Mortality was 5.1% and the morbidity was 34.2% made exclusively by suppuration including 5.1% on prosthetic material. We noted 14.3% of recurence which has occured after repair by simple joining. The Welti-Eudel procedure gives good results in the repair of incisional hernia with small and average dimensions. The installation of prosthetic mesh constitute the treatment of choice because the rate of recurence is weak even null.

Adolescent↗

PubMed2004

[Solitary ulcer of the rectum. Report of two cases treated by the Orr-Loygue technique].

We report two cases of solitary ulcer of the rectum treated by Orr Loygue rectopexy technique in a ten-year period at the Surgery Department of Aristide Le Dantec. The first case is about a 39 year-old female who was constipated since approximately seventeen years and had a rectal prolapse associated later to bloody stools. In 1990, she underwent haemorrhoids surgery operation with unsatisfactory results. After the recurrence of the disease, she was admitted at Aristide le Dantec Teaching Hospital, rectoscopy revealed a solitary ulcer. Orr Loygue rectoplexy technique was performed by laparotomy. In the follow up, there was no complication. The second case is about a 43 years old female who suffered from rectal syndrome since twenty years and had pelvis pains with bleeding and phlegmatic diarrhoeas. The physical examination and biologic analysis showed no particularity. Rectoscopy has revealed a solitary ulcer of the rectum which was confirmed by biopsy. Orr Loygue rectoplexy technique was performed. In the follow-up, there was a recurrence and this was confirmed by rectoscopy. The rectopexy alone does not summurize the therapeutic. A final dyskesia or an associated perineal insufficiency must be integrated in a total therapeutic strategy.

Adult↗

PubMed2003

[Uterine leiomyoma at the surgical department of the Teaching Hospital of Dakar. Report of 140 cases operated in two years].

Uterine leiomyomas due to complications in particular mechanical and haemorrhagic constitute a frequent motive of consultation to the surgical department at the university hospital of Dakar. To precise its epidemiologic, clinical and therapeutic aspects, a prospective study of two years (1995-1996) was made. Hundred and forty patients operated for uterine leiomyoma in our department were brought together. Uterine leiomyoma represent 58.82% of the gynaecological disorders operated to the surgical department. These gynaecological affection constitute 15% of the whole surgical pathology. The edge of age most concern was the decade 49-59 years old. The infertility and the low parity were found in 55.14% of the cases. The average delay of consultation was 39 months. The clinical symptoms amounted it metrorrhagia (72%) abdominal or pelvic pains (77.1%) and increase of the volume of the belly (96.4%). The overall reoperating rate was 3.5%. The pelvic ultrasonography allowed to confirm the diagnosis in 84.28% of the cases. The under umbilical laparotomy (90.9%) was the main surgical way. The sub-total hysterectomy was carried out in 35.72% of the cases. The average duration of hospitalization was 9 days and the mortality 0.7%. Main postoperative complications were parietal abscess (16 cases), evisceration (2 cases) and eventration (2 cases). Histological examination realized in 48.06% of the cases confirmed the diagnosis of uterine leiomyoma in every case. In 17.82% of the cases leiomyoma were associated to another lesion and in two cases it was a neoplasm of the uterine cervix. Uterine leiomyomas are frequent in Dakar. Their often impressive volume and metrorrhagia dominant their occasion of diagnosis. Their sufficiently early diagnosis have to noticeably reduce their radical surgery indications in this benign pathology whose association with cervix uterine cancer stays very rare in our daily practical experience.

Adult↗

PubMed2003

[The Burch intervention: report of 24 patients].

The Burch standard colposuspension consist with the suspension of the bladder cervix and the urethral segment to the pectinate ligament from the vaginal wall, in order to reposition the bladder cervix inside the manometric abdominal pression. The aim of this study was to evaluate our results in this technic. It was a retrospective study including all cases of Burch colposuspension, carried out in our departement. This study covered over one 6 years period, from January 1995 to January 2001. Twenty four patients underwent this type of intervention during the study period. The average age of the patients was 45.4 years old. The natural menopause was noted in 45.8% of the cases. The multiparous patients constituted 95.8% of the cases and the 4.2% were the nulliparous ones. A pelvic surgical gesture was carried out in 16.6% of the cases in patient medical past-history. A dystocic childbirth in the patient medical past-history was found in 20.8% of the cases. The missing rate into post-operative near period (urinary incontinence) was 8.4%, therefore 91.6% of good results was observed. The rate of good results into post-operative late period was 84.2%. The Burch colposuspension provides good immediate post-operative results with very little rate of failure. Nevertheless a delayed degradation of long-term results is usual.

Adult↗

PubMed2002

Endoscopic surgery in Senegal. Benefits, costs and limits.

BACKGROUND: Evaluating the introduction of endoscopic surgery in Senegal may be useful for assessing the role of this technology in developing countries. METHODS: The endoscopic surgery performed at the Hospital Principal and the Hospital Le Dantec, Dakar, from January 1995 to December 2000 was evaluated retrospectively. Operative time, postoperative stay, patients, and hospital costs were compared in samples of 100 patients treated endoscopically and 80 patients treated with open techniques. RESULTS: Altogether, 826 endoscopic procedures were performed (11.6% of elective surgical activity). Of these, thoracoscopic (34%) and laparoscopic (14%) vagotomy, cholecystectomy (21%), fundoplication (12%), and diagnostic laparoscopy (11%) were selected for comparisons. Operative time proved to be reduced by endoscopic surgery except for laparoscopic fundoplication (+40 min). After endoscopic surgery, postoperative hospitalization was 3.7 days shorter, and patient fees were consequently reduced. In 6 years, 87% of the hospital investment (36,000 Euro) was recovered. CONCLUSIONS: Developing countries can benefit from endoscopic surgery. First-world countries might supply staff training.

Cost-Benefit Analysis↗

PubMed2002

[Emergency care in tropical areas: status report based on surgical emergencies in Senegal].

Management of surgical emergencies in Senegal is characterized by a mismatch between supply of facilities and demand for care. The situation has been complicated by runaway urban growth. Two situations can be distinguished in rural zones and in the major city of Dakar. The common features in both locations are chronic underfunding, absence of pre-hospital emergency and rescue services, and inadequacy of health care facilities to manage emergency situations. In urban and rural areas, hospital are oversollicited, poorly designed and managed in terms of infrastructure and equipment, and understaffed in terms of surgeons and qualified paramedical personnel. The main differences between urban and rural areas involve the volume and type of surgical emergencies with a constantly increasing number of trauma emergencies in cities. Solving these problems will require a specific national plan to develop emergency care services in general. This plan will require coordination of funding, re-organisation of hospital facilities, and hiring and training of qualified personnel (surgeons and paramedical staff).

Delivery of Health Care↗

PubMed2002

[Televised education: experience in Senegal].

As a possible response to the shortage of qualified teachers in Africa, a promising pilot study using television is being carried out at the A. Le Dantec University Hospital in Dakar, Senegal. Trainees at the Dakar Medical School receive long-distance coaching mainly in video-assisted surgery from experts at several partner centers in Europe, namely: Rangueil Hospital in Toulouse, France, IRCAD in Strasbourg, France and Saint Peter's Hospital in Brussels, Belgium. Results support more widespread use of televised courses.

Education, Distance↗

PubMed2002

[Nodular euthyroid goitre: value of ultrasonography versus scintigraphy in the initial assessment].

PURPOSE: The aim of this study was to show that in exploration of nodular goiter with euthyroidy ultrasonography was higher than scintiscanning. MATERIAL AND METHODS: It was to show that when it was necessary to specify the topography and the number of thyroid nodules, the proportion of right results was larger with ultrasonography than with scinticanning. These proportions being respectively indicated Pe and Ps, hypothesis of search was formulated H1: Pe > Ps. Null hypothesis was written H0: Pe < Ps. Twenty three patients (21 women and 2 men with an average age of 41 years) carrying thryroïd nodules with euthyroidy had respectively undergone a scintiscanning (scintiscanning with sweeping after ingestion of iode 131) and an ultrasonography (conventional ultrasonography with a probe of 7.5 MZ) of the thyroid gland between February 26, 1996 and June 19, 1997. Per-operativedatahaving beenused as references from which the results of scintiscanning and ultrasonography were appreciated nominally, discreet: right results or false results. In this way, proportions of right and false results were collected respectively for scintiscanning and for ultrasonography, which made it possible to test null hypothesis (H0: Pe < Ps). The results were distributed on a 2 x 2 cotigence table. The chi 2 test was applied with a risk error of 5%. RESULTS: For all patients the scintiscanning found on the whole a minimum number of 39 nodules contrary with ultrasonography and surgical exploration which respectively found a minimum number of 56 and 59 nodules. Comparison of right and false results had shown a superiority of ultrasonography (17 right and 6 false) on the scintiscanning (10 right and 13 false) with statistically significant difference (P < 0.05). CONCLUSION: Ultrasonography is more precise when it is necessary to specify the number and the topography of the thyroid nodules. In addition ultrasonography is alleviating and less expensive compared to scintiscanning.

Adult↗

PubMed2002

[Long term course after thyroidectomy for euthyroid nodular goiter].

Every patient operated for nodular goiter by a partial surgery is exposed to recurrence. In order to verify this idea, the authors followed 36 patients operated on for nodulargoiterat least 10 years ago. A clinical examination for all the patients and echographic study for 24 of them allowed the detection of recurrence and the evaluation of survival and recurrence without any opotherapy. It seemed that clinical recurrence is observed in 16.65% of cases whereas echographic study revealed recurrence in 50% of patients examined. Only two patients were reoperated on. The predictive factors of the recurrence are geographic endemic origin and ethny, partial surgery and vesicular goiters. With 66.65% of survival without recurrence at 18 years without opotherapy, the authors argue about the utility of such treatment.

Adult↗

PubMed2001

[Vaginal hysterectomy for hysterocele (report of 36 cases)].

Vaginal total hysterectomy get to better qualily of lite to patients who have genital prolapse. It gives no abdominal scar. The feeding and rising are early. Among a serie of 36 total vaginal hysterectomies for hysteroceles we performed, we report few complications. One patient presented a plentiful peroperative haemorrhage : three others present a vesical wound. We report one case of releasing suture, one had setting of bladderand one case of vaginal infection. One patient died from a cause not reliable to the procedure. The mean duration of the hospital stay was 8.36 days. After 4 years following up, 2 patients have elytrocele recurrence, and one other presents a bad reducing of cystocele. We hope to pursue this serie strenghen then our results.

Adult↗

PubMed1998

[Total vaginal hysterectomy for genital prolapse apropos of 10 cases].

There are many variants in vaginal hysterectomy procedures owing to precises indications. We have performed a total vaginal hysterectomy procedure which technique is described herein. Our procedure was using the preexisting anatomic structures. It allows a solid cure adapted to each compound of the genital prolapse. Among a series of 10 cases, we report few complications. An important peroperative bleeding occurred in one case. The postoperative morbidity included 1 case of genital infection and 1 case of urinary fistula. One patient died from a cause not reliable to the procedure. The mean duration of the hospital stay was 10 days. After 2 years follow up, 9 of our patients have good anatomical and functional results. The shortness of this series does not allow us to concluded definitively. However, our results are comparable with those reported in the literature.

Evaluation Studies as Topic↗

PubMed1993

[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↗

PubMed1992

[Christopherson's tumor. Review of the literature apropos of a retroperitoneal localization].

Alveolar soft-part sarcoma is rare, and its retroperitoneal localization in psoas major muscle, exceptional. Concerning a case occurred in a young woman, the authors focus on the characters of this tumor of unknown histogenesis which affects predominantly young adults, mainly females. This disease, which symptomatology is poor and which evolution is particularly long for such a neoplasm, leads inexorably to death despite surgical treatment that represents to date, the unique efficient therapeutic modality.

Adult↗

PubMed1991

[Genital prolapse in Dakar].

Genital prolapses are the result of musculo-ligamentary alterations often caused or complicated by traumatic delivery and senible atrophy of the tissues. From 1969 to 1988, we gathered 104 files of patients with genital prolapses. The age of the patients ranged from 20 to 70 years with an average age of 30. The subject between the ages of 20 and 39 were the most affected (64%). The average number of children per woman was 4. 60 patients had 5 children. No case of prolapses was found among virgin or mulliparous women. In 48 cases delivery was dystocic. The clinical symptomatology was a feeling of intravaginal globus, pelvic algia and discomfort (57 cases). Straingul urinary incontinence wax manifest in 15 patients. Colpocystocele (88 cases), rectocele (66 cases) and hysterocele (50 cases) were among the most frequently evidence lesions. On the therapeutic matter, the low passage was used 58 times and the high passage 32 times. An urinary gesture was made 33 times. There was no operatory fatality. Urinary troubles related to infection, acute retention of urine and strainful urinary incontinence were observed. Later 10 cases of recurrence were observed within an average time interval of 2 years. This work is characterized by the young age of the patients. It denotes the noticeable role played by obstétrical traumatisms in the genesis of genital prolapses in the African context. The senescence and atrophy of the tissues seem to have a less important role in contrast with the developed countries. Finally, the surgical treatment of these patients must take into account, among other things, the child bearing desire of the patients, given the social and psychological weight of maternity in our society.

Adult↗

PubMed1990

[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↗