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Pyothoraxes, also called thoracic empyemas, are defined by the presence between the two layers of the pleura, of a frankly purulent liquid, or of a shady or clear liquid but containing a majority of altered polynuclear cells with germs direct examination. They are said to be traumatic when they follow a thoracic trauma whatever the mechanism; usually a pre-existing post-traumatic pleural effusion. The general objective of this study was to help identify the epidemiological and prognostic factors in the management of post-traumatic pyothorax in the Thoracic Surgery Department of the Donka National Hospital. Methodology: This was a descriptive retrospective study covering a period of 2.5 years from 01/06/2016 to 31/12/2018 carried out in the Thoracic Surgery Department of the Donka National Hospital. Results: During the study period, 17 cases of post-traumatic pyothorax were observed among the 288 files of admitted and hospitalized patients. In the course of this study, a rate was 5.90%. The most affected age group was 1 to 5 years old. The male sex was in the majority (76.5%). The most common occurrence was the fall, i.e. 41.2%. 47% of patients consult after 60 days. Chest pain and dyspnea were the main symptoms during our study (82.3%). Antibiotics and analgesics dominated the medical treatment used in 100% of the cases and pleural drainage was the first line surgical treatment practiced in 88.2% of the cases. The prognosis is favorable without sequelae in 52.9% of cases with an average hospital stay of 9 days. Post-traumatic pyothorax is a serious pathology involving the vital and functional respiratory prognosis, hence the need to diagnose and treat it early.

Introduction: The ileosigmoid node is a double volvulus involving the sigmoid and the small intestine. The preoperative diagnosis is difficult in our practice setting. We report a case of ileosigmoid node that we discuss with data from the literature. Observation: This was a 40-year-old man admitted for diffuse abdominal pain of progressive onset, paroxysmal, accompanied by cessation of materials and gas, profuse vomiting of food and hiccups, progressing for 24 hours. With a history of persistent constipation and episodes of sub-occlusion, clinical examination noted pain, abdominal distension and dullness of the flanks and inaudible peristalsis. The digital rectal examination noted an emptiness of the rectal bulb and a bulging of the Douglas. The biological assessment was unremarkable. The ASP showed an arched image. Confirmation was intraoperative with a small bowel volvulus around the sigmoid in the form of a node producing double ileal and sigmoid necrosis. We performed an ileo-ileal anastomosis resection and a left iliac colostomy using the Hartman technique. The postoperative follow-up was simple, the patient was discharged on D10 postoperative. Six weeks later the patient was readmitted for restoration of colonic continuity. Five months later, no complaints were reported. Conclusion: The ileo-sigmoid node is a rare cause of intestinal obstruction, difficult to diagnose preoperatively in our exercise setting, the progression is rapid towards digestive necrosis. The availability of emergency CT examinations and early management of this condition would improve the prognosis.

The aim of this is to make our contribution to the study of Gastrointestinal trichobezoard Introduction: The digestive bezoar is a conglomerate of indigestible substances trapped in the gastrointestinal tract. Aim: The aim was to report an exceptional case of a gastrointestinal trichobezoard revealed by acute intestinal obstruction by ileo-ileal intussusception and to discuss it with data from the literature. Methodology This was a 7-year-old girl who was referred to us from the Nutritional Institute at Donka National Hospital. She presented paroxysmal abdominal pain, vomiting, anorexia and physical asthenia without notion of gas stoppage, evolving for four months. On examination, the patient was in poor general condition with sunken eyeballs. The abdomen was the site of an epigastric mass, mobile and painful. The digital rectal examination noted an emptiness of the rectal bulb. The biological assessment revealed hyperleukocytosis (11.8giga/l); normochromium-normocytic anemia (10g/l). Abdominal ultrasound showed prominent images of distended loops, with material stasis, forming a mass syndrome consistent with a reducible and unstable invagination coil. The diagnosis of acute intussusception was ultrasound. Surgery confirmed intussusception, which was secondary to the entrapment of a trichobezoar in the gastrointestinal lumen. Intestinal disinvagination and extraction of trichobezoar by gastrotomy was the indication. Results the operative consequences were simple. Conclusion: Trichobezoar is a rare condition and the preoperative diagnosis difficult when the notion of trichophagia has not been mentioned. Its treatment is surgical, its prevention requires regular monitoring and psychiatric care.

Introduction: The goal was to highlight the issue of management of digestive surgical emergencies in our department. Methods: This was a prospective study that brought together patients treated for digestive surgical emergencies over a 10-month period (January - October 2014). Results: We collected 135 patients or 21% of all abdominal surgical conditions during the period (N=649). The average age of our patients was 34 years (range: 11 and 80); The sex ratio was 2.19. Public transport was the means used by patients. The reasons for consultation were: abdominal pain (89.63%), vomiting (77.78%), cessation of materials and gas (60%). The average consultation time was 6 days (range: 2 hours and 21 days). Acute generalized peritonitis was the most common (44.44%). The average time to treatment was 11 hours (range: 1 and 29 hours). The management was medico-surgical. The postoperative consequences were simple in (50.37%), the postoperative complications were dominated by parietal infection (30.53%), evisceration (3.70%) and scrotal hematoma (2.96%). One death was noted in (17.04%). The average length of stay was 12 days (range: 1 and 54 days). Conclusion: The management of digestive surgical emergencies remains a challenge. Morbidity and mortality would be revised downwards by reducing the diagnostic delay due to dysfunction of the care system and problems of access to care.