The anesthesiological management of acute surgical abdomens remains a delicate exercise for anesthesiologists and resuscitators, given the major volume disturbances, the delay in diagnosis with its corollary of septic shock, and the dysfunction of the emergency departments with which they are confronted. The objectives of this work were to study clinical and anesthesiological aspects, as well as intraoperative morbidity and mortality related to acute surgical abdomens. We conducted a prospective 12-month study. In this study was included Any patient received in the emergency room of the C.H.U Gabriel Touré in whom the diagnosis of acute surgical abdomen had been retained on the basis of clinical and paraclinical signs who agreed to participate. Results: During our study period, acute surgical abdomens represented 631/1335 cases of all emergency surgeries. Fifty-six of them were referred to intensive care immediately after surgery. Peritonitis represented 376 cases (61%) followed by intestinal obstruction (135/631), appendicitis (76/631) and hemoperitoins (33/631). The clinical presentation on admission was dominated by signs of hypovolemic and infectious delay. The average hemoglobin level was 12.03g / dl. Renal impairment (clearance <50 ml / ml) was detected in 50 patients. The mean operating time was 134.32 min regardless of the diagnosis. In the intensive care group, the reason for admission was dominated by states of shock 24 out of 56 cases (i.e. 42.9%), delayed awakening 5/56 cases, bronchial inhalation 4/56, cardio circulatory arrest 2/56 . In this group 14 patients received artificial ventilation ≥12h. Vasoactive support coupled with macromolecular filling was required in 17/56 cases. Eleven patients were reoperated x 25 during their stay in intensive care. The major postoperative complications were septic shock in 11 cases, hemorrhagic shock in 6 cases and 1 cardiogenic shock. The overall mortality from acute surgical abdomens was 2.24% patients (30 patients). Conclusion: The management of abdominal surgical emergencies must be multidisciplinary in order to further reduce the morbidity and mortality rate which remains significant today.                                                                                                                                 Keywords: Anesthesia, perioperative, abdominal surgical emergency, Gabriel Touré University Hospital

In Mali, chest injuries remain a real public health problem and are associated with heavy morbidity and mortality. Faced with a resurgence of urban civil violence and the explosion of road accidents, we decided to conduct this study in order to describe the epidemiological, clinical and therapeutic aspects of thoracic trauma in the emergency department. Method and Material: This is a descriptive prospective study over a period of one year in the emergency department of the CHU Gabriel Touré. Including all patients admitted for thoracic trauma. Analysis and Entry: Data were entered and analyzed on SPSS software version 20.0. The test was significant for a p value < 0.05. Results: We recorded 21,090 appeals in our structure among which 1284 patients were suspected of thoracic trauma. The diagnosis of thoracic trauma was retained in 119 (0.56%) patients. All patients were transported to the emergency room without prehospital medicalization. Clinical presentation was dominated by dyspnea in 54.6% of patients, however pain was the almost constant symptom in conscious victims. Various traumatic mechanisms had caused these lesions of the thorax, of which road traffic accidents represented half of the causes, followed by urban civil violence in 28.

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Introduction: Hospitalization in intensive care is a source of stress and anxiety for close to the patients. Anxio-depressive symptoms appear to be common in intensive care and their prevalence is poorly evaluated. The objective of this study was to evaluate the prevalence of anxio-depressive symptoms in families. Materials and method: Observational prospective study in families of patients hospitalized in the intensive care unit for a period of 5 months. Symptoms of anxiety and depression were measured using Hospital Anxiety and Depression Scale (HADS) during hospitalization. Anxiety and depression were defined by a score greater than 10. Factors associated with the onset of anxious-depressive symptoms were sought. The prevalence of post-traumatic stress disorder in close relatives was measured by the Impact Event Scale-Revised scale (IES-R). Results: A total of 107 patients were admitted to the intensive care unit, of which 49 families agreed to participate in our study. Overall mortality was 32.2% during this period. Fifty-eight (58) patients were not included for the following reasons: death or hospitalization of less than 48 hours, refusal of families, institution, and lack of parents speaking French. Forty-nine (49) relatives completed the HADS questionnaire. Forty-three families completed the IES-R questionnaire, a return rate of 87.7%. The prevalence of anxiety was 61.2% among parents in early hospitalization. The level of anxiety was significantly associated with male parents