17 research outputs found
Usefulness of a clinico-biological Francois’ score in the diagnosis of acute appendicitis. Experience of the University Hospital Center of Parakou, Benin
No full textIntroduction: Diagnostic wanderings of acute appendicitis are responsible for serious complications or abusive appendectomies. Existing Clinico-biological scores are efficient. Objective: To determine the diagnostic efficiency of François’ score in acute appendicitis. Methodology: over 10 months, all the patients admitted in the CHUD-Parakou Emergency Department for pain in the right iliac fossa had been examined by resident students who calculated François’ score. After verification by the surgeon, patients were put into three categories: category 1 score ≥ 2; category 2, score between -6 and 2; category 3, score below -6. Sensitivity and specificity were calculated. Results: out of 54 patients selected (29 men and 25 women), 29 were classified as group 1; 19 as group 2 and 6 as group 3. An ultrasound was performed in all patients in group 2, and signs in favor of appendicitis were found in 12 patients. Of the 41 appendicectomies performed, the histologic analysis of 33 operative specimens found a pathological appendix. Sensitivity, specificity and negative predictive value per group were 100%. It has prevented almost in one every four patients (24.07%) an abusive appendectomy. Conclusion: This score would reduce diagnostic wanderings and target patient groups for imaging studies
Risk factors of surgical site infection at the regional and teaching hospital center of Borgou (Benin)
No full textIntroduction: The reduction of the SSI rate requires knowledge of its risk factors. Objective: To analyze the risk factors of SSI occurrence at CHD-B Methods: Prospective, descriptive and analytical study involving 603 patients undergoing general surgery (218) and obstetrics and gynecology (385) from 1stJanuary to 31st July 2013. Results: 44 patients have developed SSI (7.3%). The SSI frequency was 12.8% in general surgery and 4.2% in gynecology-obstetrics (p significant). The mean age of patients developing SSI was 30.7 ± 15.8 years with a minimum and maximum 5 months and 70 years, respectively; and for general surgery patients, there were 23 men and 5 women (p not significant). The presence of preoperative infectious spot at admission (P = 0.003), the preoperative shaving of the site to be incised (p = 0.000), the ASA score (p = 0.000), the surgery contamination class (p = 0.000), and the NNIS score (p = 0.000) were all significantly related to SSI occurrence. Considering all these factors, the NNIS score ≥2 remained the predictive tool by multiplying by 3.4 the risk of SSI occurrence. Conclusion: NNIS score is the best SSI prediction tool at CHD-B
Epidemiological aspects of surgical site infections in an income country. The case of regional hospital center, Borgou (Benin)
No full textABSTRACT
Background: Surgical site infection is frustrating for the care team and depressing for the patient. Objective: To
determine the epidemiological aspects of surgical site infections in regional hospital, Borgou. Methods: The study
was crossed with prospective data collection. Recruitment was done for six months (from February 2013 to July 2013),
each patient operated in both surgical services (general surgery and maternity) consents to be followed for one month
or year. The surgical site infection was defined according to the CDC/NHSN 2009. Results: The frequency of surgical
site infections was 7.3% (44/603). The mean age was 30.7 ± 15.8 years with minimum and maximum of 5 months and
70 years, respectively. They were significantly (p<0.05) more common in general surgery than that of maternity and
visceral surgery and obstetrics were more concerned (14/44 each); the median time to SSI onset was 7.8 ± 3.8 days.
The deep incisional infection was the most frequent (34/44). The most encountered organism was Escherichia coli
(64.7%); multidrug resistance was 41.2%. The healing time averaged 30.5 ± 13.8 days with minimum and maximum
of 20 and 92 days. Conclusion: Monitoring measures must be taken to reduce surgical site infection at the Regional
Hospital Centre of Borgou.Background: Surgical site infection is frustrating for the care team and depressing for the patient. Objective: To
determine the epidemiological aspects of surgical site infections in regional hospital, Borgou. Methods: The study
was crossed with prospective data collection. Recruitment was done for six months (from February 2013 to July 2013),
each patient operated in both surgical services (general surgery and maternity) consents to be followed for one month
or year. The surgical site infection was defined according to the CDC/NHSN 2009. Results: The frequency of surgical
site infections was 7.3% (44/603). The mean age was 30.7 ± 15.8 years with minimum and maximum of 5 months and
70 years, respectively. They were significantly (p<0.05) more common in general surgery than that of maternity and
visceral surgery and obstetrics were more concerned (14/44 each); the median time to SSI onset was 7.8 ± 3.8 days.
The deep incisional infection was the most frequent (34/44). The most encountered organism was Escherichia coli
(64.7%); multidrug resistance was 41.2%. The healing time averaged 30.5 ± 13.8 days with minimum and maximum
of 20 and 92 days. Conclusion: Monitoring measures must be taken to reduce surgical site infection at the Regional
Hospital Centre of Borgou
Epidemiological characteristics of deaths related to surgical emergencies in Sub-Saharan Africa: case of Parakou, Benin
No full textBackground: Emergency and resuscitation departments, often on the front lines of the hospital care system, are sadly the site of many deaths. Author aim to study the epidemiological characteristics of deaths related to surgical emergencies at Parakou Teaching Hospital in Benin.Methods: This was a prospective, descriptive study covering 6 months from January 1st to June 31st 2016. It focused on patients admitted to the emergency department and hospitalized in general surgery or resuscitation department during the study period. Three criteria were defined: admission for a surgical emergency, clinical classification of emergency patients (known as CCMU: Classification Clinique des Malades aux Urgences) between 1 and 5 and evolution marked by death.Results: A total of 54 deaths were recorded out of 379 surgical emergencies (14.2%). The sex-ratio was 2.2. The average age was 31±18.8 years old. The average admission time was 75.7±95.2 hours. The CCMU 4 and 5 were the most numerous (77. 7%). Traumatic emergencies were the most likely cause of death (56.6%), with cranio-encephalic trauma being the leading cause (38.9%). for non-traumatic emergencies (44.4%), acute generalized peritonitis is the leading cause of death (18.5%). The average time to surgical management was 87.4 hours, mainly related to the indigence of patients.Conclusions: The reduction of deaths related to surgical emergencies requires the adapted equipment of the different services involved in the care, the continuous training of staff and the creation of a health insurance.</jats:p
Delayed double reading of whole blood clotting test (WBCT) results at 20 and 30 minutes enhances diagnosis and treatment of viper envenomation
No full textAbstract Background The whole blood clotting test (WBCT) is a simple test of coagulation that is often used in the assessment, diagnosis, and therapeutic monitoring of snakebite patients in sub-Saharan Africa. WBCT requires only a clean glass tube and several milliliters of venous blood and is ideal for use in poorly equipped health centers throughout the rural areas where 95% of snakebites occur. However, questions surrounding the accuracy and reliability of the test remain unanswered due to variations in testing conditions and a lack of comparative research with which to validate them. This is the first study to evaluate WBCT results at both 20-min (WBCT20) and 30-min (WBCT30) reading times in the same group of snakebite patients. Methods In order to define the best reading time, the authors compared the results of serial WBCT evaluation at both 20 and 30 min after collection in 23 patients treated for snake envenomation in Bembèrèkè, northern Benin. Results WBCT results were identical at both reading times in patients without coagulopathy or when coagulation was restored permanently following a single dose of antivenom. Out of 17 patients with coagulopathy, 14 showed discrepancies between WBCT20 and WBCT30 results in at least one pair of serial evaluations. These could be completely contradictory results (e.g. normal clot at WBCT20 and no clot at WBCT30) or a marked difference in the quality of the clot (e.g. no clotting activity at WBCT20 and an unstable partial clot at WBCT30). WBCT discrepancies were encountered most frequently in three situations: initial normalization of hemostasis following antivenom therapy, detection of a secondary resumption of coagulopathy, or final restoration of hemostasis after a secondary resumption had occurred. Conclusions This study suggests that the WBCT is robust and that a sequential reading should improve the diagnosis and monitoring of venom-induced coagulopathies. It also indicates the possibility of discrepancies in the sensitivity of WBCT20 and WBCT30 for detecting the resolution or reoccurrence of coagulopathy and identifies how these findings, if confirmed, may be used to increase the efficacy and efficiency of antivenom treatment in the field
Péritonite Biliaire Primitive Chez l’Enfant : À Propos de Deux Cas au CHUD Borgou-Alibori, Parakou
No full textIntroduction : La péritonite aigue généralisée est une urgence médico chirurgicale fréquente dont les étiologies sont diverses. Nous rapportons deux cas rares de péritonite biliaire primitive chez l’enfant dont les suites opératoires ont été simples. Observation clinique : il s’agissait de deux enfants de sexe masculin âgés de 07 et 11ans admis aux urgences pour une douleur abdominale évoluant depuis trois semaines au moins chez qui le diagnostic initial de péritonite aigue généralisée par perforation iléale d’origine typhique probable a été posé. Ils ont tous deux bénéficié d’une laparotomie qui a permis de découvrir une perforation vésiculaire dans le premier cas et une association de perforation vésiculaire et iléale dans l’autre cas. Il a été réalisé une cholécystectomie chez les deux, une résection anastomose iléale chez le second, un lavage et drainage péritonéale Conclusion : la perforation vésiculaire est une lésion rare chez l’enfant et on doit y penser devant une péritonite aigue chez l’enfant.
Introduction: Acute generalized peritonitis is a common medical-surgical emergency with various etiologies. We report two rare cases of primary biliary peritonitis in children at CHUD/B-A whose surgical outcomes were favorable. Clinical observation: These were two male children aged 07 and 11 years admitted to the emergency department for abdominal pain that had been evolving for at least three weeks in whom the initial diagnosis of acute generalized peritonitis by ileal perforation of probable typhic origin was made. They both underwent a laparotomy which revealed vesicular perforation in the first case and a combination of vesicular and ileal perforation in the other. A cholecystectomy was performed in both, an ileal anastomosis resection in the second, and peritoneal lavage and drainage. Conclusion: vesicular perforation is a rare lesion in children and should be considered in the case of peritonitis
Peritonite Biliaire Primitive Chez l’Enfant : À Propos de Deux Cas au CHUD Borgou-Alibori, Parakou
No full textIntroduction : La péritonite aigue généralisée est une urgence médico chirurgicale fréquente chez l’enfant dont les étiologies sont diverses. Nous rapportons deux cas rares de péritonite biliaire primitive chez l’enfant dont les suites opératoires ont été simples. Observation clinique : il s’agissait de deux garçons âgés de 07 et 11ans admis aux urgences pour une douleur abdominale évoluant depuis trois semaines au moins chez qui le diagnostic initial de péritonite aigue généralisée par perforation iléale d’origine typhique probable a été posé. Ils ont tous deux bénéficié d’une laparotomie qui a permis de découvrir une perforation vésiculaire dans le premier cas et une association de perforation vésiculaire et iléale dans l’autre cas. Il a été réalisé une cholécystectomie chez les deux, une résection anastomose iléale chez le second, un lavage et drainage péritonéal. Conclusion : la perforation vésiculaire est une lésion rare chez l’enfant et on doit y penser devant une péritonite aigue chez l’enfant.
Introduction: Acute generalized peritonitis is a common medical-surgical emergency with various etiologies. We report two rare cases of primary biliary peritonitis in children at CHUD/B-A whose surgical outcomes were favorable. Clinical observation: These were two male children aged 07 and 11 years admitted to the emergency department for abdominal pain that had been evolving for at least three weeks for whom the initial diagnosis of acute generalized peritonitis by ileal perforation of probable typic origin was made. They both underwent a laparotomy which revealed vesicular perforation in the first case and a combination of vesicular and ileal perforation in the other. A cholecystectomy was performed in both, an ileal anastomosis resection in the second, and peritoneal lavage and drainage. Conclusion: vesicular perforation is a rare lesion in children and should be considered in the case of peritonitis
Aspects Épidémiologiques, Diagnostiques Et Thérapeutiques Des Traumatismes Abdominaux À Bembéréké-Nord Bénin
No full textObjective: describe the epidemiological, diagnostic aspects and therapeutic approaches at Bembereke in northern Benin. Patients and methods: all victims of abdominal trauma received in the department of surgery between 1 st January 2010 and 30 July 2013 and with complete records were included in this retrospective study. Results: The abdominal trauma accounted for 1.1% of hospitalization and 10% of abdominal emergencies. The average age of patients was 28.04 ± 22.25 years with extremes of 02 and 67 years. The sex ratio equaled to 7.17. Half of the patients were children under 15 years. The first three circumstances abdominal trauma was road traffic accidents 31 (31.63%) cases, animal aggression 27 (27.55%) cases and falls from a tree 14 (14,29%) cases. Contusions were found in 73 (74.50%) cases and wounds in 25 (25.50%) cases. Fifty four (55.10%) laparotomy were performed. The rate of white laparotomy is 5.55% with 3 cases. The spleen was the most affected organ (15%) followed by small bowel (13%). Morbidity was 8.16% dominated by parietal suppuration. The rate of mortality was 2.04%. Mean hospital stay was 10.7 days. Conclusion: abdominal trauma interested young adult male in northern Benin. Road traffic accidents and animal injuries were the leading cause
Delayed double reading of whole blood clotting test (WBCT) results at 20 and 30 minutes enhances diagnosis and treatment of viper envenomation
No full textPéritonite Biliaire Primitive Chez l’Enfant : À Propos de Deux Cas au CHUD Borgou-Alibori, Parakou
No full textIntroduction : La péritonite aigue généralisée est une urgence médico chirurgicale fréquente dont les étiologies sont diverses. Nous rapportons deux cas rares de péritonite biliaire primitive chez l’enfant dont les suites opératoires ont été simples. Observation clinique : il s’agissait de deux enfants de sexe masculin âgés de 07 et 11ans admis aux urgences pour une douleur abdominale évoluant depuis trois semaines au moins chez qui le diagnostic initial de péritonite aigue généralisée par perforation iléale d’origine typhique probable a été posé. Ils ont tous deux bénéficié d’une laparotomie qui a permis de découvrir une perforation vésiculaire dans le premier cas et une association de perforation vésiculaire et iléale dans l’autre cas. Il a été réalisé une cholécystectomie chez les deux, une résection anastomose iléale chez le second, un lavage et drainage péritonéale Conclusion : la perforation vésiculaire est une lésion rare chez l’enfant et on doit y penser devant une péritonite aigue chez l’enfant.
Introduction: Acute generalized peritonitis is a common medical-surgical emergency with various etiologies. We report two rare cases of primary biliary peritonitis in children at CHUD/B-A whose surgical outcomes were favorable. Clinical observation: These were two male children aged 07 and 11 years admitted to the emergency department for abdominal pain that had been evolving for at least three weeks in whom the initial diagnosis of acute generalized peritonitis by ileal perforation of probable typhic origin was made. They both underwent a laparotomy which revealed vesicular perforation in the first case and a combination of vesicular and ileal perforation in the other. A cholecystectomy was performed in both, an ileal anastomosis resection in the second, and peritoneal lavage and drainage. Conclusion: vesicular perforation is a rare lesion in children and should be considered in the case of peritonitis
