Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer (PC) is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.

Introduction: Acute generalized peritonitis is a life-threatening emergency. It is most often secondary to a perforation of the digestive organ and or to the spread of an intra-abdominal septic area. Methodology: We carried out a descriptive retrospective study lasting from January 1, 2018 to December 31, 2018 on the contribution of imaging in the management of acute generalized peritonitis general surgery department of the hospital Chinese-Guinean. Were included in our study, all records of patients with acute generalized peritonitis will be confirmed by imaging. We carried out an exhaustive recruitment of all complete files. Our variables were analyzed using the Epi-info 7.2 software. Result: Out of 578 hospitalized patients, peritonitis represented 8.8% of cases. We noted a male predominance with 60.8% and a Sex-ratio: M / F = 1.6 whose mean age was 41.9 ± 13.5 years; extremes ranging from 17 and 67 years with a modal class ≥ 30 years or 88.3%. Housewives were the most collected with 25.5% Abdominal pain was the main reason for consultation, i.e., 90.2%, the physical sign was dominated by a convex and sensitive Douglas-fir, i.e., 27.5%. The clinical diagnosis was supported by abdomen without preparation and abdominal ultrasound; performed in 84.3% and 15.7% of patients, respectively. We noted a morbidity rate of 15.7% dominated by septic shock (15.7%). Conclusion: Our study made it possible to determine the contribution of imaging in the management. In addition, in our study, the abdomen without preparation and the abdomino-pelvic ultrasound were revealed as a key link in the management of acute generalized peritonitis.

Abstract:Icterus or jaundice is a yellow staining of the skin and mucous membranes which occurs secondary to elevated bilirubin levels in the blood. Obstructive jaundice corresponds to a mechanical obstacle in the biliary pathways. The definitive diagnosis of obstructive jaundice in preoperative patients remains a challenge. The aim of this study was to present a number of epidemiological aspects to highlight the problems faced with diagnosis and treatment in order to ameliorate the management and prognosis of patients with obstructive jaundice. It was a retrospective study conducted on 17 male patients and 16 female patients with an average age of 51-54 years, who were surgically treated for obstructive jaundice. The main clinical presentation was characterized by icterus, pruritus and abdominal pain. Pancreatic head tumors are most commonly responsible for the presentation of obstructive jaundice (63.64%), followed by jaundice secondary to choledocholithiasis (9.06%), and stones in vesicular system (6.06%). The surgical intervention of choice was a palliative choledochoduodenostomy to divert flow of biliary juices.

The aim of this case report is to share our experience in the management of this this rare case of traumatic diaphragmatic rupture in the visceral surgery department of the Hospital of Conakry. Traumatic diaphragmatic rupture is an unfamiliar diagnosis to make and exceptionally seen in some cases of high velocity injuries which involve the abdomen. The high energy from blunt trauma transmitted across the abdomen gives rise to an excessively high pressure in the abdominal cavity which causes shearing of the diaphragmatic muscle. It is indeed considered as a surgical emergency as impaired diaphragmatic movement has a big impact on ventilation and oxygenation of blood. The delay in making appropriate diagnosis due to the lack of overt clinical signs relating to this type of injury accounts for the high mortality rates reaching 31%. We are reporting on a case concerning a 28-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 left sided traumatic diaphragmatic rupture associated with eventration of viscera into the thoracic cavity and contusion of the ascending colon. The mechanism of rupture was determined as a force vector directed frontally and was transmitted across the diaphragmatic wall. A clinical diagnosis was made and confirmed by radiological imaging preoperatively. Prompt surgical intervention was provided within the 1 st 24 hours from the time of admission. No complications had been encountered during the post-operative recovery period. The best way to evaluate traumatic diaphragmatic rupture in a patient is through a well-devised systematic approach. It is not advised to perform lengthy imaging tests in a hemodynamically unstable patient and thus, compromising the success of the surgical outcome.

No abstract