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L'objectif de cette étude était de déterminer la fréquence et les facteurs associés à la dénutrition chez les patients opérés en chirurgie viscérale en 2014. Il s'est agi d'une étude transversale, descriptive et analytique couvrant la période du 11septembre 2014 au 11 décembre 2014. La population d'étude était constituée des patients opérés en chirurgie viscérale au Centre National Hospitalier Universitaire Hubert Koutoucou MAGA de Cotonou. La dénutrition a été définie pour un indice de masse corporelle inférieur à 18,5 kg/m2. Au total 90 patients avaient été inclus dans l'étude, 57,78 % (52 patients) étaient de sexe masculin. La moyenne d'âge des patients était 55±6,32 ans. La dénutrition était observée chez 42 patients (46,67%). Les facteurs associés à la dénutrition chez les patients en postopératoire étaient : l'âge supérieur ou égal à 50 ans, les apports énergétique, protéique et hydrique faibles, la diarrhée, la présence de cancer, la chirurgie sur le tractus digestif, la chirurgie urgente, une perte de poids significative et l'hyperleucocytose. La dénutrition est fréquente chez les patients en postopératoire. Elle nécessite un dépistage et une prise en charge précoces.

Background Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4–6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p

The authors describe a case of perinoscrotal gangrene in a patient who had been bitten by a snake. He was treated with antivenom immunotherapy and surgery. The outcome was good. They present a brief review of the literature regarding the epidemiological, clinical, and treatment issues.

Introduction: Obstetric fistula is a serious injury resulting from obstructed labor causing significant maternal morbidity in women in developing countries. In order to maximize probability of successful surgical repair, it is important to identify women at-risk for poor surgical outcomes so that they can be given appropriate care. The goal of this study is to explore additional factors associated with fistula repair outcomes, as well as determine whether statistical modeling can be used to create a clinical decision-making tool for predicting a successful repair. Methods: Medical records for 82 patients surgically treated for obstetric fistula in Benin were retrospectively reviewed to collect demographic and clinical information related to their condition and procedure. Individuals were grouped into 3 main outcomes: successful closure with continence, successful closure with residual incontinence, and failed repair. A backwards stepwise selection methodology and logistic regression were used to select factors and examine their associations with the surgical outcomes. Structural equation modelling was used to develop a prediction tool for successful repair. Results: Location of fistula (vesicovaginal, vesicouterine, ureteroalvaginal, ureterouterine, and rectovaginal) (OR=7.6 (2.39, 24.36)), being married (OR=3.45 (1.09, 10.90)), parity of 1 to 3 (OR=2.99 (0.94, 9.49)), duration of fistula less than 10 years (OR=2.07 (0.88, 8.25)), and no previous repair attempt (OR=2.40 (0.79, 7.25)) were found to favor a successful closure with continence. We developed a prediction tool to sort women with obstetric fistula into 5 different categories based on probability of success. Our model suggests that marital status affects successful repair through a mediating factor not yet identified. Conclusion: This study classified fistulous women into clinically relevant categories based on the probability of a successful repair. The results from the present study may inspire further research on identifying fistulas with poor prospect of success, which might benefit from more specialized care.

Background: 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.

Background: Non-traumatic small bowel perforation is common condition in our income countries. This study aims to determine the pattern of non-traumatic intestinal perforation in our environment. Methods: The demographics, clinical features, relevant investigations, surgery performed and outcome of all the patients confirmed at surgery with intestinal perforation were collected for five years and the data analyzed using version 3.5.1 of Epi Info. Results: Out of the 69 cases involved in this study, there were 46 (66.7%) males and 23 (33.3%) females with a male/female ratio of 2; their mean age was 22.5±13.7 years (range 2 - 68 years). Young people in school constituted 23 (33,34%) of the cases and typhoid intestinal perforation was responsible for 64 (92.8%) cases while ischemic perforation as a result of postoperative flange, strangulated hernia and acute intussusception was responsible in 5 (7.2%) cases. The average duration before presentation in the hospital was 3 days while the average duration between presentation at the hospital and surgery was 2 days. The surgery offered was simple closure after freshening the edges in 35 (50.7%) cases, resection and anastomosis in 28 (40.5%) cases and resection with ileostomy in 6 (8.8 %) cases. The immediate postoperative course was uneventful in 64 (92.8%) case while the mortality was 10 (14.5%). The cause of death was not identified in 3 cases. The average hospital stay was 14.5±12.8 days with extremes of 7 and 55 days. Conclusions: NTIP is relatively common among the causes of widespread acute peritonitis in sub-Saharan Africa and its management remains difficult with high mortality.

Objective. The aim of this study was to describe the indications and results of exploratory burr hole performed at the Departmental Teaching Hospital of Borgou (Benin). Methods. It was a retrospective study performed from January 2008 to February 2011. It concerned patients with a closed traumatic brain injury (TBI) in which an exploratory burr hole was performed. The selection criteria were unilateral mydriasis associated with neurological deficits on the opposite side or the occurrence of a decreased consciousness associated with the appearance of a motor deficit after a lucid interval. Results. Amongst the 74 patients operated, 23 (31%) underwent an exploratory burr hole for which the average age was 24.8 ± 17.3 years. Sex ratio male/female was 3.6. TBI was due to road traffic accident (56.5%), a fall (26.1%), and an assault (17.4%). It was severe (47.8%), moderate (39.1%), and mild (13.1%). Mydriasis was observed in 69.6% of cases as well as neurological deficit in all patients. A lesion was observed in 15 (65.2%) cases. Conclusion. The exploratory burr hole seemed as an old practice, still no longer performed in full practice in Benin, and is a diagnosis and therapeutic approach. Better technical conditions would allow more relevant therapeutic options.

Objective: 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 causes