La perforation stercorale du côlon est une affection rare touchant les malades constipés chroniques, âgés et souvent fragiles. Elle peut aussi survenir chez des patients jeunes. Les auteurs rapportent l'observation d'un patient de 42 ans qui a consulté pour des douleurs abdominales géné-ralisées apparues quatre jours plutôt. Ce patient était VIH positif traité par trois antirétroviraux (lamivudine, névira-pine, stavudine). L'examen clinique notait un arrêt des matières et des gaz et un syndrome péritonéal. Sur le cliché de l'abdomen sans préparation, on avait un volumineux pneumopéritoine et une image en double jambage caractéris-tique d'un volvulus du côlon sigmoïde. À la laparotomie, on découvrait une péritonite pyostercorale, une double perforation du côlon transverse et du côlon sigmoïde, un volvulus du côlon sigmoïde et un fécalome qui s'étendait du rectum à l'angle colique droit. Le patient a eu une hémicolectomie gauche avec colostomie de type Hartmann. Il est décédé à j2 postopératoire d'un choc toxi-infectieux. L'association d'un fécalome géant, d'un volvulus sigmoïdien et d'une perforation stercorale bifocale font l'intérêt de ce cas clinique, jamais rapporté dans la littérature à notre connaissance. Pour citer cette revue : J. Afr. Hépatol. Gastroentérol. 5 (2011).
Mots clés Constipation · Perforation colique stercorale · Volvulus · Fécalome géantAbstract Stercoral perforation of the colon is rare and usually occurs in elderly patient suffering from chronic constipation. It can also occur in younger patient. The authors report on the case of a 42-year-old patient who presented to emergency department with acute abdomen. Initial resuscitation was performed and the patient underwent urgent laparotomy. He was found to have a massive fecal impaction which extended from the rectum to right flexure of the colon and resulted primarily in feculent peritonitis, which lead to a double perforation of the sigmoid colon and the transverse colon, and secondarily in a volvulus of the sigmoid colon. The patient underwent left hemicolectomy with Hartmann colostomy. He died two days after surgery. The size of the fecaloma together with the double perforation and the volvulus of the sigmoid colon make the interest in this case, which is never reported in the literature, at least to our knowledge. To cite this journal: J. Afr. Hépatol. Gastroentérol. 5 (2011).
Background: Acute intestinal invagination or intussusception is the most common abdominal surgical emergency in infants, but it can occur at any age. Performing an ultrasound scan at the slightest clinical suspicion contributes to early diagnosis and therapeutic management. Objective: To show the relevance of ultrasound in the therapeutic management of the child's intussusception through a correlation between the ultrasound diagnosis and the clinical and/or per operative diagnosis. Patients and Methods: It was a retrospective study of 24 cases from July 2017 to September 2020 (30 months) in the Medical Imaging and Paediatric Surgery departments of Teaching Hospital of Bouaké. We included only patients from 0 to 15 years old who had digestive symptoms, an abdominal ultrasound scan. These patients were eligible for surgery. Data analysis was performed with Epi info 7 software. Results: Median age was 17.2 months [02 -120]. Male gender predominated (83.3%). Clinico-biological data were dominated by abdominal pain (79.2%), vomiting (75%) and rectorragies (33.3%), with Ombredanne's triad in 33.3% and hyperleukocytosis (70.8%). Ultrasonography showed invaginated coves (95.8%) sitting in the right angl iliac fossa, peri-umbilical and right flank in 73.9%. Cockade image coupled with the sandwich image accounted for 95.6%. Superficial adenopathies (45.8%) and peri-lesional fluid effusion (20.8%
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