IntroductionLes traumatismes fermés de l’abdomen sont fréquents.MéthodesIl s’agissait d’une étude rétrospective sur 49 dossiers de patients opérés pour traumatisme fermé de l’abdomen en cinq ans à l’Hôpital General de Référence Nationale de N’Djaména au Tchad. Les paramètres épidémiologiques, cliniques et thérapeutiques étaient étudiés.RésultatsC’étaient 42 hommes et 7 femmes d’âge moyen de 21,3 ans. Les étiologies étaient: les accidents de la voie publique dans 61,2% des cas; les écroulements de mur (14,3%); les agressions (8,2%). Les traumatismes fermés de l’abdomen étaient plus fréquents au mois d’Août (14,28%) et Octobre (16,32%). Le délai d’admission à l’hôpital était de 6 à 12h dans 43% des cas. Le moyen d’évacuation des blessés était une voiture privée dans 85,7% des cas. Cliniquement, l’état hémodynamique était souvent stable (55,1%). L’imagerie médicale était dominée par la radiographie directe de l’abdomen (57,1%). Les lésions les plus observées ont été celles du grêle seul (16,32%) ou associées à celle de la vessie (8,16%), et de la rate (2,04%). La laparotomie était négative dans 6,12% des cas. La morbidité (12,2%) était dominée par les abcès de paroi. Le taux de décès était de 6,1%.ConclusionLes accidents de la voie publique sont la première cause de traumatismes fermés de l’abdomen. Le délai diagnostic et thérapeutique est important. Des mesures de sécurité routière devraient prévenir les accidents.

Introduction: Renal colic is a medico-surgical emergency in which complicated forms could progress to renal failure and nonfunctional kidney. The objective of our study is to describe the epidemiological, diagnostic and therapeutic aspects of renal colic at the urology department of the NGRH. Methods: This was a prospective study involving 101 patients followed up for renal colic. The study spanned from July 2015 to July 2016 at the urology department of the NGRH. Results: A total of 101 patients suffering from renal colic were enrolled in the study giving a prevalence of 5.1%. The mean age was 38.89 years with a standard deviation of 14.5 years and a sex ratio of 1:3. Flank or lumbar pain of crushing type (45.5%), constant and of severe intensity (61.4%) were the most frequent clinical characteristics. The plain abdominal radiography (Kidney-Ureter-Bladder) coupled with ultrasonography had a 100% sensitivity for the etiological diagnosis of renal colic. Urinary lithiasis was the most frequent cause with 73.3%. Uroculture revealed a urinary tract infection in 44 patients (43.6%). The most frequent germ isolated on the culture was Escherichia coli (27.7%). Renal function was abnormal in 34 patients (33.7%). Medical treatment was composed of analgesics, NSAIDs and antispasmodic representing 93.1%. Percutaneous nephrostomy was performed in 6.9%. Pyelolithotomy was the most frequently performed surgical procedure and was done in 11 patients that are 39.3%. Fifty seven patients (56.4%) got healed without sequelae; 6 cases (5.

Introduction: The extrinsic compression of the third portion of the duodenum between the superior mesenteric artery and the aorta defines superior mesenteric artery syndrome. It determines an acute or chronic high intestinal obstruction pattern. We report the first observed case in Chad. Observation: HH was a 19 year-old woman with abdominal pain and intermittent postprandial vomiting since she was 5 years old. During last 11 months, postprandial vomiting was more frequent, and non resolved after medical treatment. Unquantified weight loss was reported. Body mass index at hospitalization was 9.8. An injected abdominal scan demonstrated significant gastroduodenal distension, upstream of a stenosis of the third duodenal portion. Aorto-mesenteric space and angle were reduced. At laparotomy internal derivation by duodenojejunostomy was done. Postoperative situation was uneventful. Conclusion: Superior mesenteric artery syndrome determines an acute or chronic intestinal obstruction. Injected abdominal scan is fundamental for diagnosis. The treatment is firstly conservative but the need of surgery is common.

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