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PURPOSE: The purpose of this study was to describe the nature and reasons for the fall, the injuries caused and their prognosis. PATIENTS AND METHODS: This was a descriptive cross-sectional study over a period of 9 years. Patients admitted for abdominal trauma from a fall from a height during the study period were included. Ultrasound and CT scan allowed diagnosis of the lesion. Patients in shock who do not respond to resuscitation are considered to have unstable hemodynamics. RESULTS: fifty-three cases of abdominal trauma by falling from a height, including 11 adults and 42 children, were collected. They were 46 men and 7 women. The average age was 11.6 years. In 86.8% (n=46) of the cases it was a fall from the top of a tree. There were 83% (n=44) abdominal contusion and 17% (n=9) open trauma. Other lesions were associated in 28.3% (n=15) of cases. There were 26 splenic lesions (49%), 14 liver (22.6%) and 6 hollow organs (11.3%). Non-operative treatment was applied in 79.2% (n=42) of cases. Morbidity was 9.4% (n=5) and mortality 5.7% (n=3). CONCLUSION: Abdominal trauma from a fall from a height was dominated by falls from the top of fruit trees, and occurred in young male subjects.

BUT: Le but de cette étude était de décrire la nature et les raisons de la chute, les lésions engendrées et leur pronostic. PATIENTS ET MÉTHODES: il s'est agi d'une étude transversale descriptive sur une période de 9 ans. Les patients admis pour traumatisme abdominal par chute de hauteur au cours de la période d'étude ont été inclus. L'échographie et le scanner ont permis de poser le diagnostic lésionnel. Les patients en état de choc ne répondant pas à la réanimation ont été considérés à hémodynamie instable. RÉSULTATS: cinquante-trois cas de traumatisme abdominal par chute de hauteur dont 11 adulteset42 enfants, ont été colligés. Il s'agissait de 46 hommes et de 7 femmes. L'âge moyen était de 11,6 ans. Dans 86,8% (n=46) des cas il s'agissait d'une chute du haut d'un arbre. Il y avait83%(n=44) de contusion abdominale et 17% (n=9) de traumatisme ouvert. D'autres lésions étaient associées dans 28,3% (n=15) des cas. Il y avait 26 lésions spléniques (49%), 14 hépatiques (22,6%) et 6 d'organes creux (11,3%). Le traitement non opératoire avait été appliqué dans 79,2% (n=42) des cas. La morbidité était de 9,4% (n=5) et la mortalité de 5,7% (n=3). CONCLUSION: Les traumatismes de l'abdomen par chute de hauteur étaient dominés par les chutes du haut d'arbres fruitiers, et étaient le fait des sujets jeunes de sexe masculin.

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AIMS: The aim was to describe the diagnostic and therapeutic aspects of biliary peritonitis. PATIENTS AND METHODS: This was a descriptive cross-sectional study with retrospective collection over a period of 10 years including patients operated on for biliary peritonitis. RESULTS: We collected 10 cases of biliary peritonitis with an average age of 38 years with a sex ratio of 2.3. Two patients presented with an abdominal contusion following a road traffic accident. Maximum abdominal pain in the right hypochondrium was present in three patients, signs of peritoneal irritation in all patients, positive Widal and Felix serodiagnosis in eight patients. At midline laparotomy, the gallbladder was perforated in three patients, gangrenous in five, phlegmonous in one, sclero-atrophic in one. Cholecystectomy was performed in all patients. Biliary peritonitis was of traumatic origin in two patients, and typhoid in eight. Postoperatively, there were four cases of sepsis and three cases of parietal suppuration. Three patients died. CONCLUSION: Biliary peritonitis discovered during laparotomies for peritonitis, was secondary to typhoid cholecystitis, and had a high morbidity and mortality.

BUTS: Le but était de décrire les aspects diagnostiques et thérapeutiques des péritonites biliaires. PATIENTS ET MÉTHODES: Il s'est agi d'une étude transversale descriptive à collecte rétrospective sur une période de 10 ans incluant les patients opérés pour péritonite biliaire. RÉSULTATS: Nous avons colligé 10 cas de péritonite biliaire d'un 'âge moyen de 38 ans avec un sex-ratio de 2,3. Deux patients présentaient une contusion abdominale par suite d'un accident de la circulation routière. Une douleur abdominale maximale à l'hypochondre droit était présente chez trois patients, des signes d'irritation péritonéale chez tous les patients, un sérodiagnostic de Widal et Félix positif chez huit patients. À la laparotomie médiane la vésicule biliaire était perforée chez trois patients, gangrénée chez cinq, phlegmoneuse chez un, scléro-atrophique chez un. La cholécystectomie a été réalisée chez tous les patients. La péritonite biliaire était d'origine traumatique chez deux patients, et typhique chez huit. En post opératoire on notait quatre cas de sepsis, et trois cas de suppuration pariétale. Trois patients sont décédés. CONCLUSION: les péritonites biliaires découvertes lors de laparotomies pour péritonite, étaient secondaires à des cholécystites typhiques, et avaient une forte morbi-mortalité.

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Introduction : le but de ce travail était d'étudier les suites opératoires précoces des péritonites opérées dans notre milieu africain. Patients et méthode : Il s'est agi d'une étude descriptive à collecte rétrospective menée dans le service de chirurgie générale et viscérale du CHU Sourô Sanou sur une période de 12 mois. Ont été inclus tous les cas de péritonites aigues généralisées opérées, les péritonites post-opératoires ont été exclues. Résultats : Nous avions collecté 233 cas de péritonites aigues généralisées dont 198 ont fait l'objet de cette étude. Le sex-ratio était de 3,3. L'âge moyen était de 35 ans. Les étiologies étaient l'origine appendiculaire (36,3%), la perforation gastrique ou duodénale (33,8%) et autres étiologies (29,7%). Les suites opératoires avaient été favorables dans 64,7% et une durée d'hospitalisation moyenne de 4 jours. Elles étaient compliquées dans 35,3%. Il s'agit principalement de 32,8% de suppuration pariétale, 30% de péritonites post opératoires, 11,4% d'éviscération fixée et 8,5% d'hyperthermie sans cause retrouvée. Pour les cas compliqués, la durée d'hospitalisation était en moyenne 10,5 jours. Le score de Mannheim était supérieur à 26 pour 24,2% des patients et la mortalité était 11,5% soit 22 cas. Conclusion : Les suites opératoires précoces des péritonites sont caractérisées par une forte morbidité dominée par les suppurations pariétales, les péritonites postopératoires et les éviscérations fixées entrainant une augmentation de la durée d'hospitalisation. La mortalité postopératoire reste élevée

Introduction: the aim of this work was to study the early operative consequences of peritonitis operated on in our African environment. Patients and method: This was a descriptive study with retrospective collection carried out in the general and visceral surgery department of Sourô Sanou University Hospital over a period of 12 months. All cases of acute generalized peritonitis operated on were included; postoperative peritonitis was excluded. Results: We collected 233 cases of acute generalized peritonitis, 198 of which were the subject of this study. The sex ratio was 3.3. The average age was 35 years old. The etiologies were appendicular origin (36.3%), gastric or duodenal perforation (33.8%) and other etiologies (29.7%). The surgical outcomes were favorable in 64.7% and an average hospitalization duration of 4 days. They were complicated in 35.3%. This mainly concerns 32.8% of parietal suppuration, 30% of post-operative peritonitis, 11.4% of fixed evisceration and 8.5% of hyperthermia with no cause found. For complicated cases, the duration of hospitalization was on average 10.5 days. The Mannheim score was greater than 26 for 24.2% of patients and mortality was 11.5% or 22 cases. Conclusion: Early operative consequences of peritonitis are characterized by high morbidity dominated by parietal suppurations, post-operative peritonitis and fixed eviscerations leading to an increase in the length of hospitalization. Postoperative mortality remains high.

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BACKGROUND: Advanced stages of plantar acral lentiginous melanoma are common in Africa. Inguinal lymph node dissection (ILND) in these cases plays a critical role in disease-free and overall survival. Our study aims to share our experience in ILND for advanced plantar melanomas. Methods and Study Design. Four-year prospective study. Patients. We included all documented cases of advanced stage plantar melanoma with clinically detectable inguinal lymph node metastasis. Twenty-two of 27 patients identified-with mean age 56 years-underwent ILND. Studied Variables. Tumor patterns and stage, surgery, morbidity, oncologic pathology, and evolution were studied. Statistical software assessed the overall survival (OS). RESULTS: Plantar lesions were all excised with a cancer-free margin (3 cm). ILND was performed for 22 patients with visible (n = 11), palpable (n = 7), and ulcerous (n = 4) lymphadenopathies. It was performed through an S-shaped (n = 11) or ellipse-shaped skin incision (n = 11). The tumors were AJCC stage III (n = 18) and IV (n = 2). We found high Breslow index tumor thickness (>3 mm) and an advanced Clark IV stage (n = 20). All operative wounds healed within 46 days (21-90). Wound healing was delayed by suture failure (n = 16), lymphorrhoea (n = 22), and infection (n = 18). After 29 months, three patients had complete remissions, seven had recurrences, and twelve patients had died. The overall survival (OS) at one year was 56%. In two patients with AJCC stage III disease, the OS was better (22 months). CONCLUSION: In low-income countries, ILND in advanced stages of plantar foot melanoma is a valuable surgical treatment option. Alongside ILND adjuvants, treatment must be available and accessible to improve survival.

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INTRODUCTION: Dermatofibrosarcoma (DFS) is a common dermic sarcoma. It is a local malignant tumor occurring in young adults. The recurrence potential justifies an R0-type surgery with a three centimeters margin. We report our experience of the management of locally advanced DFS by resection and reconstructive surgery. METHODS: It is an ongoing descriptive study spanned from June 2005 to December 2018. We included all DFS cases treated by curative resection and reconstruction. A total of eight cases of DFS among 108 soft tissue sarcomas were studied. All patients were males. The mean age was 41.8 years [32-60]. Carcinologic results, cosmetic results, and outcomes were analyzed. RESULTS: R0-type resection was performed in six cases. In two cases, the resection was R1-type and resulted in amputation. In four cases, it was an iterative surgery. Average desease duration was 4 years [1-8]. Reconstructive surgery was needed for wound closure in six cases. Wounds healed in 28 days [18-90]. Outcomes showed hyperchromic keloid scars (N=2) at the trunk localization. CONCLUSION: DFS is a common cancer with a good outcome if managed earliest. Delayed diagnoses and inadequate first-time surgery led to tumor extension and recurrences. Locally advanced tumors management needs extensive resections and reconstructive surgery. In addition to surgery, Imatinib and radiotherapy improve outcomes, but are not available in our context.

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Amniotic band syndrome is a rare congenital disorder. The authors report the first cases documented at Souro Sanou University Hospital in Bobo-Dioulasso (CHUSS) in 2 male new borns. The malformations found at birth, were worn only on limbs and were in the form of skin furrow necking with a major lymphedema downstream. In both cases, the constriction furrow at member pelvic was associated with a club foot and a pseudosyndactyly in one case. Surgical treatment consisted of a section of the constrictor ring and a Z-plasty. The functional outcome was satisfactory with the acquisition of a plantar support for both children. Through these two observations, epidemiological, diagnostic, and particularities of the management of this condition are discussed in the Burkina-Faso.

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