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Purpose: To discuss the difficult diagnosis of a rare case of post-cesarean peritonitis complicated by abdominal wall gangrene. Case Report: Mrs. A.D, 25 years old, admitted on 9/24/2018 for fluid flow through the operative wound, abdominal pain, fever, cough. Evolution 6 days. Onset: edema, redness, blisters of the abdominal wall then fluid flow through the surgical wound of a cesarean section (breech presentation) at 38 weeks, performed on 9/15/2018 in a medico-communal center in Conakry. Patient readmitted on D6: abdominal necrosis+blisters: dressing of the operative wound, Ampicillin 1 g, Perfalgan 1 g then referred to visceral surgery at Donka National Hospital. No specific background. No known allergy. Use of dermocorticoids for skin depigmentation for the duration of 2 years. G2, P2, Cesarean section 1, Alive 1, Died 1. Patient conscious, hypocoloured in teguments and conjunctivae: BP=110/70 mm Hg, pulse=104/min, FR=24 cycles/min, temperature=37.8°C. Abdomen: wound extending from the hypogastrium up to 3 cm above the umbilical bone, also involving the flanks, with necrotic background+foulsmelling whitish pus. TV: vulva covered with sero-hematic secretions. Leukocytes 16 G/l Hb 9 g/l VS accelerated. At laparotomy: necrotic areas of the skin at the parietal peritoneum, discharge of 1 liter of foul-smelling purulent fluid. Then midline above and below umbilical incision connecting the transverse incision: deposits of fibrin throughout the cavity, intact uterine sutures: removal of fibrin. Peritoneal toilet. Aponeurotic approximation. Stripping of necrotic tissue. Parietal washing, dressing. Peritoneal fluid: Staphylococcus aureus, ceftriaxone 1 g IV twice a day. postoperative follow-up: iterative necrosectomies, complete healing on postoperative eventration. Conclusion: Possibility of post-cesarean peritonitis with progression to abdominal gangrene.

Introduction: The aim of this study was to assess the epidemiological aspect and the difficulties associated with the surgical management of hyperthyroidism in our context. Hyperthyroidism is an over function of the thyroid gland resulting in thyrotoxicosis. Thyroidectomy is one of the Main treatments. It also uses synthetic antithyroid drugs, radioactive iodine. Methodology:We carried out a descriptive 6-year retrospective from January 1, 2011 to December 31, 2017 inclusively. Our study variables were qualitative and quantitative, Results:During our study, 26 cases were collected between January 2011 and August 2017 with a predominance of 73% female and an average age of 52, 78 years. The clinic was dominated by the signs of thyrotoxicosis which were found in all patients. The exploration identified 14 cases of toxic multi-hetero nodular goiter, ie 53.84%; 9 cases of basal disease 34, 66% and 3 cases of toxic adenoma 11, 54%. Medical preparation was required in all our patients Total thyroidectomy was performed in one patient, i.e. 4%, and Lobo isthmectomy in 24 patients, ie 96%. Postoperatively, complications were collected: 1 case of intraoperative hemorrhage 20%; 1 case of postoperative hematoma 20%; 1 case of dysphonia 20%. Conclusion:Surgery for toxic goiter known to be hemorrhagic and adherent should be performed after obtaining euthyroidism and double vigilance to minimize the morbidity represented mainly by laryngeal paralysis and hyperparathyroidism

Introduction:The aim of this study is to investigate, the etiologies, the results of management of acute generalized peritonitis of appendicular origin. Acute generalized peritonitis of appendicular origin is defined as acute inflammation of the peritoneum resulting from either perforation of the appendix or spread of a peri-appendicular abscess. Methodology:The visceral surgery department of the Sino-Guinean Friendship Hospital served as the framework for this work. All patients admitted and operated on for acute generalized peritonitis of appendicular origin whose records were complete were included in this study. Results:During our study we recorded 23 cases of appendicular peritonitis, the sex ratio of nearly 3.6 reflected a clear male predominance of the condition. We noted 15 cases of appendicular perforation, 8 cases of appendicular gangrene, 2 cases of surgical site infection, 2 cases of evisceration and 2 cases of death. Conclusion:Appendicular peritonitis is a frequent disease, the management is medico-surgical

The arteriovenous fistula (AVF) for hemodialysis, consists of surgically creating an anastomosis between an artery and a superficial vein in the arm. This study aims to mark our contribution to the study of arteriovenous fistulas for hemodialysis during our internship in Morocco Methodology: We carried out a six years retrospective study from January 1st, 1994, to December 31st, 1999, inclusively. The study involved 1,531 arteriovenous fistulas performed during our studying period on 2,361 consultations. All the adequate files were included in our study. The other inadequate files were excluded. Results: The study involved 833, that is 44.8% of men and 698, or 37.6% of women. Sex ratio 1.19. Thus, we counted right radial FAV 388 cases; Ulnar FAV 5 cases; FAV of the elbow crease 137 cases. In the left upper limb, 1,321 procedures, or 71.1%, distributed as follows: Left radial FAV 1,080 cases Cubital FAV 7 cases Elbow fold AVF 234 cases. According to the Vascular Seats (arteries and veins), the anastomoses were performed between Arteries and radial veins 388 or 20.9% Left radial arteries and veins 1080 cases or 58.1%, Humero-basilica 194 or 10.4%, Humero-cephalic 154 cases or 8.2%. Anastomoses on ulnar and other arteries 2, 5% straight 388 or 20.9% Left radial arteries and veins Conclusion: For patients with end-stage chronic kidney disease, arteriovenous fistulas are the last hope for their survival.

This study aims to evaluate the immediate post-operative results of this particular case report. Accidents at the workplace are frequent in Africa due to lack of adequate protective equipment. The traumatic injuries sustained can be potentially life-threatening. Impalement injuries related to these accidents are even more rarely encountered in surgical practice. We are reporting on a particular case of a 14-year old male patient who was admitted at the department of visceral surgery at the National Hospital of Donka, Conakry, Guinea, for emergency evaluation and treatment of a penetrating abdominal injury by impalement on a wooden bar that had occurred following a fall from a building at a construction site. The bar penetrated from the left flank and exited through the right flank, resulting in evisceration and incarceration of the small bowel. An emergency operation was performed to remove the foreign object and to reestablish anatomic continuity in the patient and resection of a 90cm-long necrotic segment of the terminal ileum.

Mucinous cystadenocarcinoma in men is very rare; we reported 1 case of mucinous cystadenocarcinoma in the pancreatic disease institute of Wuhan union hospital in China. The aim of the study was to focus our attention on the gender of this patient. The mucinous cystadenocarcinoma is a pathology frequently seen among women. The clinical presentation of this patient is a characteristic which deserves to be described.

The aim of this study is to reveal the etiologic link that exists between pancreatic cancer and chronic pancreatitis through our unicentric experience. The clinical and cyto-pathological results of 300 patients were studied prospectively from January to December 2014 in the pancreatic center of Wuhan union hospital in china. Of the 300 pancreatic lesions patients, 196 were male and 104 female with a sex ratio of 1.8:1 (p=0.001). The factors assessed for the determination of etiologic link were the age, gender, the diameter of the lesion, the antecedents of disease (such as ulcer,cholecystectomy, smoking ,alcohol abuse ),the pancreatic lesion site, the diabetic link, the clinical presentations, the level of transaminases (GGT, ALP), peripheral blood analysis and cytopathological results of both PC and CP groups . According to the clinical data along with the respective results of the examinations, causal factors that link CP and PC are illustrated and it opens the pathway for further detailed studies as an investment for the future.