Inguinal hernia is the spontaneous or progressive, temporary or permanent passage of viscera or part of viscera out of the cavity that normally contains it. This passage is made through an anatomically preformed area of weakness in the inguinal canal. The diagnosis of inguinal hernia is primarily clinical (inguinal swelling). Objectives: To study the epidemiological, diagnostic and therapeutic aspects of inguinal hernias in the general surgery unit of the Centre de Santé de Référence (CSRéf) in Fana. Results: 431 surgical interventions. 147 inguinal hernias including 12 cases of strangulation, The frequency of hernia was 34.11% in relation to surgical procedures, The 15-29 age group accounted for 32.7% of cases, The sex ratio was:35.75 in favour of men, In our study, farmers accounted for 53.06% of the total, Bilateral inguinal hernia which accounted for 57.14%, Patients who underwent para-rectal inguinotomy accounted for 88.4%, The Bassini technique was used in 70.75% of our patients, The operative follow-up was complicated in 19.73% of our patients, We recorded one case of death (0.7%). Conclusion: Inguinal hernia is a common surgical condition, preferentially affecting the male subjects and farmers, with a predominance of young people aged 15 to 25 years.

The aim is to study acute appendicitis in the surgery department of the Markala Reference Health Center. Patients and Methods: We conducted a retrospective study in the general surgery department of the reference health center which took place over a period of 35 months from October 1, 2019 to October 30, 2021. The retrospective period was from the month of October 2019 in October 2020 then follows the prospective period until October 2021. Inclusion criteria: Were included in our study; all patients with appendicitis or its complicated forms in the general surgery department of the Csréf in Markala. Non-inclusion criteria: Were not included in our study; cases of appendicitis outside the general surgery department of the Csréf. -Appendicitis accounted for 58.2% of hospitalizations or 31% of emergency surgeries performed during the study period. 85.4% of the patients were without medical-surgical ATCD, on the other hand the oldest of our patients was 61 years old; the average age was 29 years old and the youngest was 13 years old. Furthermore, we note that there was no age of onset of appendicitis. The treatment received by all of our patients was appendectomy (93 cases were operated on urgently and the 10 cases were first cooled and then operated on 3 months after the medical treatment). No major complication was noted in our patients, apart from three cases of infection of the surgical site related to the fact that it was an appendicular abscess. Conclusion: Acute appendicitis is one of the most common surgical emergencies in digestive surgery. Its diagnosis is essentially clinical, sometimes made difficult by the absence of anatomo-clinical parallelism linked to the polymorphism of the lesions and the variations in the position of the organ in the abdominal cavity. Untreated, it can progress to serious complications (generalized peritonitis). It is a condition with low morbidity and mortality subject to early diagnosis and surgical treatment.

Necrotizing fasciitis is an infection of the skin and deep subcutaneous tissues, spreading along the fasciae and adipose tissue, mainly caused by Group A streptococcus (Streptococcus pyogenes) but also by other bacteria such as Vibrio vulnificus, Clostridium perfringens or Bacteroides fragilis. Objective: To report a case of Necrotizing Fasciitis received at the Markala Reference Health Center. Clinical observation: It was a 45-year-old rice farmer with no known medical-surgical history received for an extensive wound on the right upper limb evolving for three months with impaired general condition and consciousness. The onset of the symptomatology dates back to about 3 months marked by a paronychia of the pulp of the right thumb extended secondarily to the right forearm. The physical examination finds an extensive necrotic wound of the right upper limb presenting voluminous blisters of brown color with a black background filled with purulent and smelly serosities. The diagnosis of Necrotizing Fasciitis was strongly suspected due to the presence of Pyogenic Streptococcus (Sensitive to gentamycin and Amoxicillin) in the pus sample. The patient was therefore put on antibiotic therapy combining Clavulanic acid at a rate of 2g x 3 per day and gentamicin at a rate of 160 mg per day with wide excision of necrotic tissues under general anesthesia in the operating room followed by a daily dressing with 30V hydrogen peroxide and Polyvidone iodine. The evolution was very favorable with a directed healing on D16. Conclusion: Necrotizing fasciitis is distinguished by its increasingly increasing and worrying frequency, its clinical severity and its detrimental character from a functional and vital point of view, which is why its management must be early.

The aim was to carry out an epidemioclinical and therapeutic study of fractures of the penis at the Csréf in Markala. Patients and methods: This is a retrospective prospective descriptive study of 13 cases of fracture of the penis during four years at the Csréf of Markala from 01 January 2019 to 01 January 2023. All patients who had a treated penis fracture were included in our study. All patients who had other forms of trauma to the penis other than a penis fracture were excluded. Results: The frequency of fracture of the penis was 14.8% compared to other urological injuries. The average age of our patients was 36.30 years with extremes ranging from 25 to 54 years. 53.8% of our patients were single. The average consultation time was 14.8 hours, with extremes ranging from 3 hours to 47 hours. The approach was longitudinal in some cases and in other cases a circumferential incision or at the level of the balano preputial fold. The most frequent complications were penis bending, with 15.5% (2 patients), urethral fistula was observed in one patient (7.7%), and we also noted cases of fibrosis of the erectile bodies (23.1%). Conclusion: The fracture of the penis is a real uro-andrological emergency, and the treatment must be rapid and effective in order to avoid irreversible after-effects, which may even lead to erectile dysfunction or urethral stricture in these patients. The approach must be appropriate in order to prevent short, medium and late complications.

The aim was to study the epidemiological, clinical and therapeutic aspects of paraphimosis at the CSRéf of Markala. Patients and Methods: We conducted a prospective and descriptive study of five patients who had consulted for paraphimosis in the operating theatre of the Markala referral health centre from 1er January 2019 to 31 December 2021, i.e. a two-year period. Our study included all patients who consulted for paraphimosis at the CSRéf of Markala with a usable medical file. The criteria for non-inclusion were: Phimosis without other pathologies of the penis. The records were not usable, as this was a prospective study. Results: The frequency of paraphimosis was 2.1% out of 235 patients hospitalized and operated on at the CSRéf of Markala during the study period. Four of our patients had no particular medical or surgical history, but the oldest of our patients had already undergone a hernia repair and an appendectomy at the time ; the average age of our patients was 15.3 years, with extremes ranging from 3 years to 53 years . However, we note that there is no specific age of onset of paraphimosis The treatment received by all our patients was posthectomy. No major complication was noted in our patients, however we deplore a loss of sight in two of our patients for a long term follow-up in order to identify other unknown aspects in the management of paraphimosis. Conclusion: Paraphimosis is a true urological emergency that occurs in uncircumcised men when the foreskin is trapped behind the glans crown, which can lead to long-term strangulation of the glans and compromise its vascularity hence their immediate management paraphimosis.