Background: Groin hernia is one of the most common conditions in surgical pathology. Worldwide, more than 20 million patients undergo groin hernia repair annually with a prevalence 4.6% in Africa. The purpose of this study was to describe the epidemiological, clinical and management aspects of groin hernias in the general surgery department of the regional hospital of Boke. Material and methods: This was a prospective cross-sectional descriptive study of 24 months (January 2019 to December 2020), conducted at the regional hospital of Boke, on consecutive patients who had surgery for groin hernia. Results: During these two years, groin hernias represented 19.90% (n=418) of all surgical admissions (n=2100). The mean age of the patients was 46.05 years. The male gender was the most predominant (87.08%). The average time to consultation was 36.4 months. In 17.83% of cases, the hernia was strangulated. The Bassini technique was the most used method of cure (87.56%). Morbidity was dominated by surgical site infection (26.08%), persistent groin pain (14.11%). Mortality was nil. At six months postoperative follow-up, we observed 29 recurrences (6.94%). Conclusion: Groin hernias are still a concern in our rural populations and their adequate management requires continuous training of surgical staff on tensionfree cure techniques and acquisition of prosthetic materials.

Purpose: Digestive or gastrointestinal fistula is one of the most feared postoperative complication along with dehiscence and infection. The aim of this study was to determine the etiological, clinical and therapeutic aspects of enterocutaneous fistulas in a disadvantaged surgical setting. Methods: This was a retrospective study covering a period of three years (January 2018 to December 2020) including records of patients managed for postoperative enterocutaneous fistula in the general surgery department of the Ignace DEEN national hospital in Conakry (Guinea). Results: During the three years of study, we compiled 69 records of patients with postoperative enterocutaneous fistulas, representing 14.68% of all postoperative abdominal complications registered in the department (n=468). The mean age of the patients was 29.61±17.32 years. In this series, 53 patients (76.81%) were initially operated in private health facilities and then referred to our department after the occurrence of the fistula. The most frequent indications for initial surgery were typhoid ileal perforation (37.68%) followed by appendicitis (26.09%) and sigmoid colon volvulus (15.94%). Spontaneous closure of the fistula was obtained in 41 patients (59.42%) with a mean time of 23 days. We noted 18 deaths (26.09%). Conclusion: Postoperative enterocutaneous fistula is a severe complication whose management in our environment is difficult and desperate for both patient and surgeon.

Introduction: We report the clinical observation of 2 cases of volvulus with sigmoid necrosis in children. Observation: Two male patients, aged 12 and 15, were hospitalized with acute mechanical bowel obstruction. There was an asymmetric, motionless meteorism and rectal emptiness. X-rays of the abdomen revealed an arch. Laparotomy found volvulus with necrosis of the sigmoid colon. The Hartmann-type colostomy and the ideal colectomy were the surgical procedures. Conclusion: Sigmoid volvulus is a rare abdominal emergency in children and severe in the necrosis stage.

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We report the case of a 28-month-old male child with no particular history who was admitted to the emergency room for severe abdominal pain associated with vomiting, asthenia and fever at 39.1˚C that had progressed for 4 days. He was conscious, polypneic at 32 cycles/min on admission. On palpation the abdomen was distended, painful as a whole, more pronounced in the epigastrium. There was abdominal contracture, generalized defense, a cry with sudden decompression of the umbilicus. On abdominal auscultation, there was a disappearance of prehepatic dullness, a decrease in the dullness of the flanks and absence of hydro-aeric noises. On the digital rectal examination, Douglas's cul de sac was bulging and sensitive. An unprepared X-ray of the abdomen revealed diffuse grayness, lateral gas crescent pneumoperitoneum under diaphragm. The preoperative resuscitation consisted of the placement of a nasogastric tube, a urinary catheter, a peripheral venous route and the fluid electrolyte rebalancing adapted according to the blood ionogram, early antibiotic therapy with broad aero and anaerobic spectrum. Surgical management under general anesthesia found at laparotomy a perforation of the anterior surface of the duodenal bulb which we estimate to be 1 cm in diameter with fibrin deposits. The gesture was the toilet of the peritoneal cavity; suture of the bank and the operative consequences were simple.