Publications by authors named "Ousseini Adakal"

12 Publications

  • Page 1 of 1

Subhepatic appendix: an ectopic topography not to be disregarded: a case report.

J Med Case Rep 2021 May 31;15(1):288. Epub 2021 May 31.

Department of Surgery, Regional Hospital Center of Maradi, Faculty of Health Sciences of the University of Maradi, Maradi, Niger.

Introduction: Subhepatic appendix is most often due to an anomaly of rotation of the primary intestine occurring during embryogenesis. This ectopic topography associated with advanced age can be a serious diagnosis problem at the stage of appendicitis or appendicular peritonitis.

Case Presentation: We report the case of a 60-year-old melanoderm man, with a history of urinary pathology and peptic ulcer, referred from a health district for abdominal pain of the right hypochondrium evolving for about 5 days, secondarily generalized, in whom we suspected peritonitis, the etiology of which remains to be determined. During the surgical intervention, after preoperative resuscitations measures, a phlegmonous perforated appendix was found under the liver. No postoperative complication was noted, and he was discharged home 8 days after his operation.

Conclusion: Subhepatic appendicular peritonitis occurring in an elderly patient poses enormous diagnostic problems. When faced with right upper quadrant pain, considering acute ectopic appendicitis would significantly reduce complications.
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http://dx.doi.org/10.1186/s13256-021-02883-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166013PMC
May 2021

Perioperative management of gastrointestinal surgery in a resource-limited hospital in Niger: Cross-sectional study.

Ann Med Surg (Lond) 2020 Jun 13;54:10-15. Epub 2020 Apr 13.

Department of Surgery and Surgical Specialties, Faculty of Health Sciences, University of Niamey, Niger.

Background: Perioperative management in digestive surgery is a challenge in sub-Saharan Africa. Objective: To describe the process and outcomes of perioperative management in gastrointestinal surgery.

Materials And Methods: This was a single center cross-sectional study over a 4-month period from June 1 to September 30, 2017, in a Nigerien hospital (West Africa). This study included caregivers and patients operated on gastrointestinal surgery.

Results: We collected data for 56 caregivers and 253 patients underwent gastrointestinal surgery. The average age of caregivers was 38.6 ± 8.7. The median length of professional practice was 9 years. Almost 52% of caregivers (n = 29) did not know the standards of perioperative care. The median age of patients was 24 years, and male gender constituted 70% of cases (n = 177) with a sex ratio of 2.32. Patients came from rural areas in 78.2% (n = 198). Emergency surgery accounted for 60% (n = 152). The most surgical procedure was digestive ostomies performed in 28.9% (n = 73), followed by hernia repair and appendectomy in 24.5% (n = 62) and 13.9% (n = 35) respectively. The postoperative course was complicated in 28.1% (n = 71) among which 13 deaths. In the group of caregivers, the poor practice of perioperative management was associated with poor professional qualification, insufficient equipment, insufficient motivation (p < 0.05). The ASA3&ASA4 score, undernutrition, emergency surgery, poor postoperative monitoring, and poor psychological preparation were associated with complicated postoperative outcomes (p < 0.05).

Conclusion: The inadequacy of the technical platform and the lack of continuous training for healthcare staff represented the main dysfunctions of our hospital. The risk factors for complications found in this study need appropriate perioperative management to improve prognosis in gastrointestinal surgery.
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http://dx.doi.org/10.1016/j.amsu.2020.03.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163210PMC
June 2020

Acute Abdomen Revealing an Unusual Case of Intra-Abdominal Testicular Torsion.

Case Rep Urol 2019 28;2019:5815036. Epub 2019 Dec 28.

Department of Surgery and Surgical Specialties, Faculty of Health Sciences, University of Niamey, Niamey, Niger.

. Intra-abdominal testicular torsion is a rare event. We report hereby our experience of the management of a spermatic cord twist on intra-abdominal testis discovered during an acute surgical abdomen. . This was a 42-year-old patient admitted to the emergency department for abdominal pain that had been evolving for a week. The physical examination showed tenderness and guarding in the left iliac fossa with an empty ipsilateral hemiscrotum. Complementary examinations led to the discovery of an intra-abdominal left-lateral mass. The laparotomy found a whitish mass with areas of infarction, which was resected. Anatomopathological examination of the operative specimen identified it as a testis with atrophy of germ cells and necrotic areas without evidence of malignancy. . Intra-abdominal testicular torsion should be considered in case of patients with an acute surgical abdomen with vacuity of one of the bursae.
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http://dx.doi.org/10.1155/2019/5815036DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7024084PMC
December 2019

Oropharyngeal Rhabdomyosarcoma with cranial nerve paralysis in a limited resource setting: a case report and review of literature.

Pan Afr Med J 2019 25;34:51. Epub 2019 Sep 25.

Department of Ophthalmology, Maradi Reference Center, Maradi, Niger Republic.

Rhabdomyosarcoma (RMS), a tumor of skeletal muscle origin, is the most common soft tissue sarcoma encountered in childhood and adolescence; it is primarily found in the head and neck region, it is relatively uncommon tumors of the oral cavity. Clinical signs depend on the exact location of the lesion in the oral cavity and its development. Authors reported the case of a 14-year-old patient who presented an oropharyngeal mass causing voice dysfunction, after two surgical operation the patient experimented two 2 recurrences of the lesion. The histopathological examination objectifies an oropharyngeal rhabdomyosarcoma. Immediate postoperative outcome was uneventful with improvement in the voice dysfunction and dysphagia one month after surgery. Complementary treatment (chemotherapy and radiotherapy) was not available and accessible to the patient. Twenty months (20) after surgery, the examination found a recurrence of the tumor with pulmonary metastases and neurological complications. Oropharyngeal rhabdomyosarcomas are rare. Their interest lies in the fact that they often affect children and adolescents. The prognosis remains unfavorable in our context, even for cases accessible to surgery since complementary treatment with chemotherapy and / or radiotherapy does not exist. The prognosis depends on tumor size, location, staging, age of patients and especially the quality of the management.
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http://dx.doi.org/10.11604/pamj.2019.34.51.20255DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859058PMC
December 2019

Diagnosis and surgical approach of adult Hirschsprung's disease: About two observations and review of the literature. Case series.

Ann Med Surg (Lond) 2019 Dec 25;48:59-64. Epub 2019 Oct 25.

Pediatric Surgery, National Lamordé Hospital, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niger.

Introduction: Hirschsprung's disease (HD) is uncommon in adulthood. In this study, we describe the management of two cases of adult Hirschsprung's disease treated with transanal colonic pull-through procedure followed by a delayed coloanal anastomosis.

Patients And Methods: This was a retrospective (December 2016 to Jun 2019) study included two cases of adult HD with confirmed Hirschsprung disease who underwent surgery at Zinder National hospital, Niger. The registration number is researchregistry 5174.

Results: These were two patients aged 21 years (male) and 22 years (female) admitted to the emergency department with an acute bowel obstruction. The history finds a delayed passage of meconium at birth with a history of long-standing recurrent constipation since early childhood for the 2 patients. A lateral colostomy was performed urgently in both patients and the barium enema revealed a disparity of the sigmoid colon with corn shaped transition zone. Histologic examination of the biopsy specimen confirmed the diagnosis of HD. Surgery was done according to transanal endorectal pull-through procedure followed by delayed coloanal anastomosis. Patients were regularly followed over a period of 16 months. Constipation was gone, no continence problem was reported and quality of life was rated satisfactory.

Conclusion: The discovery of Hirschsprung's disease is rare in adulthood. Transanal endorectal pull-through procedure followed by delayed coloanal anastomosis with conventional surgery is a suitable option for the treatment of HD and gives a good result.
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http://dx.doi.org/10.1016/j.amsu.2019.10.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6838230PMC
December 2019

[Epidemiological and bacteriological features of surgical site infections (ISO) in the Division of Surgery at the Niamey National Hospital (HNN)].

Pan Afr Med J 2018 14;31:33. Epub 2018 Sep 14.

Faculté de Sciences de la Santé, Laboratoire de Bactériologie Virologie, Université Abdou Moumouni de Niamey, Niger.

This study aims to evaluate the epidemiological and bacteriological features of bacterial strains isolated from surgical site infections (ISO) at the Niamey National Hospital. We conducted a retrospective, descriptive study over a period of 24 months. All strains isolated from bacteriological samplings from patients with a surgical site infection have been identified and tested for antibiotic sensitivity according to conventional methods. The bacteriological analysis allowed the isolation of 126 bacterial strains with a predominance of S.aureus (n=39, 31%) followed by Escherichia coli (n=29, 23%) and Pseudomonas aeruginosa (n=12, 9.5%). The strains of Escherichia coli were 100% sensitive to imipenem. They showed marked ampicillin, amoxicillin, clavulanic acid and ticarcillin resistance. They had variable resistance to aminoglycoside antibiotics (62% to gentamycin, and 78% to amikacin) and to fluoroquinolones (nalidixic acid 74%, pefloxacine 33%, ofloxacin 69%, ciprofloxacin 61%). All enterobacterial isolates were sensitive to imipenem. The strains of S.aureus showed resistance to penicillin G (88.6%) and oxacillin (83%). They also showed resistance to vancomycin and teicoplanin (37% and 57% respectively). By contrast, they were sensitive to lincomycin and aminoglycoside antibiotics tested. In the light of these results, we believe that it will be necessary to improve prophylaxis protocol and probabilistic antibiotic therapy in the Surgical Division and to conduct periodic surveillance studies of the ISO.
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http://dx.doi.org/10.11604/pamj.2018.31.33.15921DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430836PMC
April 2019

Isolated Right-Sided Posttraumatic Diaphragmatic Hernia.

Case Rep Surg 2018 19;2018:8758021. Epub 2018 Feb 19.

Pediatric Surgery Department, National Hospital of Lamordé, Niamey, Niger.

Diaphragm is a compliant musculoaponeurotic barrier located between thoracic and abdominal cavities. Traumatic diaphragmatic rupture is a rare clinicopathological entity. We report a case of right-sided posttraumatic hernia in a child following blunt trauma to highlight diagnostic difficulties and therapeutic specific aspects. A 10-year-old boy was admitted to the emergency surgical department with thoracic trauma following pedestrian accident. At admission a haemothorax was suspected and treated by pleural drainage. The diagnosis of a right-sided diaphragmatic rupture was made after computed tomographic scan forty-eight hours later. At surgery, a reduction of herniated abdominal content and a suture of diaphragmatic defect were performed. The postoperative recoveries were uneventful and the patient was followed up for 12 months without symptoms. The possibility of a diaphragmatic rupture should be kept in mind and sought after any trauma of the thoracoabdominal junction as the diagnosis can be challenging in emergency department.
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http://dx.doi.org/10.1155/2018/8758021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836446PMC
February 2018

Acute mechanical intestinal obstruction in children at zinder national hospital, Niger: Aetiologies and prognosis.

Afr J Paediatr Surg 2017 Jul-Sep;14(3):49-52

Department of Postoperative and Intensive Care, National Hospital of Zinder, University of Zinder, Zinder, Niger.

Background: To describe the aetiological and prognostic aspects of acute mechanical intestinal obstruction (AMIO) in children at Zinder National Hospital (Niger).

Materials And Methods: This was a cross-sectional study on a period to January 2013-June 2015. The database included all children under 15 years of age with a surgical diagnosis of mechanical intestinal obstruction. P < 0.05 was considered statistically significant for analysis.

Results: AMIOs represent 21.78% (n = 78) of child digestive surgical emergencies (n = 358). Median age was 12 months (range: 1 day-15 years). Fifteen (19.23%) were neonates and sixty children (76.92%) had ≤60 months. The sex ratio (male/female) was 2.8. The mean time from onset to presentation was 39.96 ± 36.22 h. Intussusception and strangulated hernias were the main causes of AMIO with, respectively, 43.59% (n = 34) and 29.48% (n = 23). Anorectal malformations represent 17.95% (n = 14) of cases of AMIO. Intestinal resection was made in 22.08% and colostomy in 19.23% of patients. The average length of hospital stay was 6.44 ± 4.30 days. The post-operative complications were recorded in 26 patients (33.33%), mostly surgical site infections. Overall mortality of AMIO was 15.38% (n = 12). It was higher in the neonates (33.33%) (P = 0.032). Deaths were associated with delay of admission (P = 0.0005) and waiting time for surgery (P = 0.019).

Conclusion: Intussusception and strangulated hernia are the most common cause of AMIO in children. Diagnostic and therapeutic delays, lack of paediatric intensive care and post-operative complications are prognostic factors.
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http://dx.doi.org/10.4103/ajps.AJPS_96_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881286PMC
June 2018

Pattern of Lower Intestinal Ostomies in a Low-Income Country: Case of Southeast of Niger Republic.

World J Surg 2018 06;42(6):1581-1589

Department of General Surgery, Niamey National Hospital, University of Niamey, Niamey, Niger.

Background: Intestinal ostomies are common surgical procedures performed in visceral surgery as part of management for several gastrointestinal diseases. This study aims to report the socio-demographic characteristics, indications and prognosis of intestinal ostomies in low-income country.

Methods: This was a 4-year retrospective study (January 2013 to December 2016) at Zinder National Hospital (Niger). All patients with a digestive ostomy on an ileum or colic segment were included in the study.

Results: During the study period, 2437 patients underwent digestive surgery, including 328 gastrointestinal stomas (13.5%). Patients classified ASA3 were 60.7% (n = 199). The median age was 12 years (IQ: 7-25). Children represent 64% (n = 210) of patients with ostomy. The sex ratio was 2.60. The stoma was performed in emergency in 96.3% (n = 316) of cases. Acute peritonitis was the main indication of the stoma in 70.73% (n = 232). The ileostomies accounted for 75.61% (n = 248). Ostomy was intended as temporary in 97.3% of cases (n = 319). Complications were observed in 188 patients (57.3%). Mortality was 14.02% (n = 46). The indigent status (OR: 4.15 [2.20-7.83], P = 000), ASA score 4 (OR: 2.53 [1.54-4.15], P = 0.0003), Altemeier class IV (OR: 4.03 [2.10-7.73], P = 0.0000) and ileostomy (OR: 2.7853 [1.47-5.29], P = 0.0018) were statistically associated with the occurrence of major complications. The mean time for stoma closure was 59.3 ± 14.5 days.

Conclusion: Acute peritonitis was the main indication of digestive ostomy. The occurrence of major complications was associated with bad socioeconomic status, ASA4 score, Altemeier class IV and ileostomy.
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http://dx.doi.org/10.1007/s00268-017-4338-3DOI Listing
June 2018

["Handlebar" hernia: a rare type of traumatic parietal hernia].

Pan Afr Med J 2016 25;25:110. Epub 2016 Oct 25.

Département de Chirurgie et Spécialités Chirurgicales, Hôpital National de Zinder, Niger.

We report the case of a 20-year old patient with a personal history of fall over his motorcycle handlebar occurring 28 days earlier. He was admitted in emergency surgery with abdominal pain. Clinical examination showed a circular impact area at the level of the left hypochondrium associated with painful swelling, irreducible and with no impulse on coughing The diagnosis of traumatic parietal strangulated hernia was established. The patient underwent surgical treatment using midline laparotomy revealing parietal breach associated with incarceration of a portion of the omentum which was necrotic. The necrotic omentum was resected and the breach was sutured. The postoperative course was simple and the patient was discharged on d5.
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http://dx.doi.org/10.11604/pamj.2016.25.110.10808DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325498PMC
March 2017

A Simplified Technique for Drainage of Chronic Calcified Pleural Empyema.

Thorac Cardiovasc Surg 2017 Oct 28;65(7):586-588. Epub 2017 Jan 28.

Department of General Surgery, HNN, Niamey, Niger.

Chronic pleural pocket has well-known diagnosis and treatment principles since first described by Hippocrates 2,400 years ago. However, its treatment remains constant even though its causes, severity during management, and terrain vary considerably. In well-structured health care systems, posttuberculous empyema has become rare; its well-codified medical treatment relies on early diagnosis and adapted antibiotherapy, punctures/drainage, and appropriate intrapleural antifibrinolytics. In developing countries, a poor health organizational system increases the incidence of pleural pocket, which can progress until surgery is indicated. In such a context, the general principles of treatment include pleural decortication along with pulmonary resection. This technique remains difficult, risky, and, sometimes, impossible due to the chronicity of the lesion. In patients debilitated by several months of septic evolution, a simplified thoracostomy technique permits complete resection of the pocket.
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http://dx.doi.org/10.1055/s-0036-1597592DOI Listing
October 2017

[Supra bladder internal hernia, a rare cause of acute intestinal obstruction].

Pan Afr Med J 2015 7;21:14. Epub 2015 May 7.

Service de Chirurgie Générale, Hôpital National de Zinder, Zinder, Niger.

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http://dx.doi.org/10.11604/pamj.2015.21.14.6735DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561139PMC
June 2016
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