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Papers by Daouda Dia
L'osteoporose gravidique ou post-gravidique est une pathologie rare. Nous en rapportons un ca... more L'osteoporose gravidique ou post-gravidique est une pathologie rare. Nous en rapportons un cas chez une patiente de 26 ans primipare qui avait presente en post-partum des tassements vertebraux lombaires non-traumatiques reveles par des rachialgies aigues sans radiculalgie. Le diagnostic d'osteoporose avait repose sur la radiographie standard et le scanner. L'osteoporose post-gravidique chez notre patiente etait associee a deux affections susceptibles aussi de se compliquer d'osteopathie : le syndrome de Gougerot-Sjogren et une cirrhose post-hepatitique virale B. L'evolution avait ete favorable sous bisphosphonate (etidronate), calcium, vitamine D et hydroxychloroquine avec un recul de 18 mois. Notre observation suggere la possibilite de pathogenies differentes dans l'osteoporose post-gravique.
Open Journal of Gastroenterology, 2021
Background: Portal thrombosis (PT) is a rare pathology. Its prevalence is estimated at 1%. Its co... more Background: Portal thrombosis (PT) is a rare pathology. Its prevalence is estimated at 1%. Its consequences depend on the acute or chronic nature, the extent of the clot and the etiology. In Sub-Saharan Africa, very few studies have been devoted to it. Patients and Method: The objective of our work was to determine the prevalence of PT and to describe its clinical and etiological presentation as well as its therapeutic management in the Hepato-gastroenterology department of the Aristide Le Dantec hospital in Dakar. This was a retrospective, longitudinal and descriptive study during the period from January 1, 2012, to December 31, 2018. It included all patients followed in ambulatory or inpatient, who presented a PT objectively determined by a medical imaging examination (ultrasound and/or CT scan). Age, gender, clinical and radiological aspects, proposed treatments and etiology of PT were collected. Results: We collected 71 observations. The prevalence of PT was 1.9%. The mean age of the patients was 41 years 15 and 75 years. A predominance of men was found with a sex ratio of 2.73. The clinical manifestations were dominated by abdominal pain (74.6%), ascites (35.7%) and gastrointestinal bleeding (25.4%). Imaging allowed the diagnosis to be made in 50 patients on ultrasound and 21 patients on abdominal CT scan. PT was acute in 5 patients and chronic in 66 patients. Thrombosis was complete in 71.4% of cases and extended to the spleno-mesaraic venous trunk and the superior mesenteric vein in 2.8% and 8.4% respectively. Etiological research found cirrhosis complicated by hepatocellular carcinoma in 67.6% of cases, cirrhosis with cruoric
Open Journal of Gastroenterology, 2020
Introduction: The aim of our study was to determine the socio-demographic, diagnostic and therape... more Introduction: The aim of our study was to determine the socio-demographic, diagnostic and therapeutic aspects of ulcerative colitis (UC) in one of the largest gastroenterology departments in Senegal. Patients and Method: This was a retrospective and descriptive study based on the analysis of the records of patients hospitalized in the Hepato-Gastroenterology Department of the Grand Yoff General Hospital (Dakar, Senegal) between January 2013 and December 2019. All cases of UC were collected. Clinical, biological, endoscopic and histological data were collected, as well as treatment options. Results: We observed 24 cases, representing a prevalence of 0.87% of inpatients. The mean age of patients was 36 (ranged 18 to 73) and sex ratio 0.9 (13 females). The mean diagnostic delay was 1.6 years (ranged 4 months to 5 years). The clinical symptomatology was dominated by diarrhea with blood and mucus (18 cases). The Litchiger score on admission averaged 8 and 5 patients (20.8%) had severe acute colitis. Colonoscopy showed pancolonic involvement (Montreal E3) in 11 cases (45.8%) and severe endoscopic lesions (stage 3 of the Mayo endoscopic subscore) in 10 cases (41.6%). Therapeutically, 17 patients (70.8%) were initially treated with corticosteroids. Background therapy was 5-ASA in 17 patients (70.8%) and azathioprine in 7 patients (29.2%). Two cases of death (8.3%) were observed following colectasia with colonic perforations before emergency surgery could be performed. Conclusion: UC in our study was primarily among young adults with a slight female predominance. Diagnosis is often late. The lack of biotherapy requires close collaboration with surgeons for the management of severe forms.
Open Journal of Gastroenterology, 2017
Introduction: Plummer Vinson Syndrome (PVS) is a rare pathology combining dysphagia, an iron defi... more Introduction: Plummer Vinson Syndrome (PVS) is a rare pathology combining dysphagia, an iron deficiency anemia and a cervical esophageal web. It is one of the risk factors of the esophageal cancer. Objectives: To report the epidemiological, clinical, paraclinical and histological characteristics of patients with Plummer-Vinson syndrome associated with esophageal cancer. Patients and Methods: This was a retrospective study carried out at the digestive endoscopy center of Aristide le Dantec hospital in Dakar from January 2008 to December 2015. We included all patients with Plummer-Vinson syndrome associated with esophageal cancer. Results: We included 7 patients. The mean age was 36 years (24-65 years). There were 5 women and 2 men. The mean diagnostic period was 9 months (6 months-15 years). The main clinical manifestations were dysphagia (100%), weight loss (100%) and clinical anemia (71.4%). The biology showed a mean hemoglobin level of 8.8 g/dl (6-11 g/dl), serum iron at 30.8 μg/dl (11-52 μg/dl) and ferritinemia at 6.2 ng/dl (1.5-25 ng/dl). The upper digestive endoscopy revealed a stenosis web of the cervical esophagus in all patients. An endoscopic dilatation was performed in all cases. After dilation, the endoscopy showed a tumor of the middle third of the esophagus in 4 cases and of the lower third in 3 cases. It was about of a squamous cell carcinoma in the tumors of middle third and of an adenocarcinoma in those of the lower third. Conclusion: At Aristide le Dantec hospital of Dakar, PVS is sometimes associated with an epidermoid carcinoma or an adenocarcinoma of the esophagus. The improvement of the prognosis depends on the early realization of an upper gastrointestinal endoscopy (UGI) in case of any dysphagia and the monitoring of the patients.
Pan African Medical Journal, 2017
Le cancer de l'oesophage est une tumeur de mauvais pronostic. Sa gravité est liée au retard de di... more Le cancer de l'oesophage est une tumeur de mauvais pronostic. Sa gravité est liée au retard de diagnostic qui se fait le plus souvent au stade de métastase en Afrique. Les métastases costales de ce cancer sont rares. Nous rapportons un cas de carcinome épidermoïde du bas oesophage avec métastases costales lytiques chez une patiente sénégalaise de 38 ans. Il s'agissait de madame TD, âgée de 38 ans admise pour une tuméfaction douloureuse de l'hémithorax droit dans un contexte d'amaigrissement. La patiente signalait par ailleurs une dysphagie d'allure mécanique évoluant depuis 4 mois qui n'avait pas motivé de consultation. L'examen objectivait un mauvais état général, une tuméfaction dure, sensible mesurant 3 cm de grand axe, siégeant sur la face antérolatérale de l'hémithorax droit en regard de la 5 ème côte. Les examens biologiques mettaient en évidence une anémie normochrome normocytaire avec un taux d'hémoglobine à 9,4 g/dl, un syndrome inflammatoire biologique non spécifique et une hypercalcémie (calcémie corrigée= 107 mg/l). L'endoscopie oeso-gastroduodénale objectivait une lésion ulcéro bourgeonnante sténosante à 32 cm des arcades dentaires. L'examen anatomopathologique des biopsies mettait en évidence un carcinome épidermoïde moyennement différencié. La tomodensitométrie thoraco-abdomino pelvienne montrait en plus de la tumeur oesophagienne, une lyse osseuse de l'arc antérieure de la 5 ème côte, des nodules pulmonaires carcinomateuses et un épanchement pleural bilatéral. La ponction exploratrice du liquide pleural ramenait un liquide sérohématique et l'examen cytologique de ce liquide objectivait des cellules carcinomateuses. Le diagnostic de carcinome épidermoïde du bas oesophage avec métastases costales, pleurales et pulmonaires était retenu et un traitement palliatif instauré. L'évolution était marquée par le décès de la patiente survenu 3 mois après la réalisation de la gastrostomie, dans un tableau de détresse respiratoire. L'originalité de cette observation tient au siège atypique des métastases de ce cancer de l'oesophage; mais aussi le terrain de survenue de cette tumeur. Le cancer de l'oesophage du sujet jeune est un problème majeur en Afrique. Le challenge est de déterminer ses facteurs de risque afin de prévenir sa survenue.
Dakar médical, 2008
The diagnosis of diffuse interstitial lung disease non specific in connective tissue disease is d... more The diagnosis of diffuse interstitial lung disease non specific in connective tissue disease is difficult because of many differential diagnoses. Lung involvement can affect functional or vital prognosis. We report 7 cases. We collected data from 60 years old mean patients. Pulmonary localisation was diagnosed after 19 years of evolution of the auto-immune disease. Discovering circumstances were dyspnea and chronic cough. The radiographic and scannographic signs were diffuse because of long diagnosis delay. The underlying auto immune disease was scleroderma, rheumatoid arthritis, Sjögren's syndrome, ankylosing spondylitis, Sharp's syndrome, and multiple autoimmune syndrome. The main treatment was corticosteroids and respiratory physiotherapy. Throughout these 7 cases we discuss clinical, radiological and evolutive aspects and we focus on the need of early diagnosis for a better prognosis.
Dakar médical, 2008
Auto-immune cholangitis appears by a table of cholestatic jaundice without anomalies of the hepat... more Auto-immune cholangitis appears by a table of cholestatic jaundice without anomalies of the hepatic bile ducts. It is a primitive biliary cirrhosis without antimitochondrial antibodies. This disease is reported at adult women in 90 % of cases. We report a 59 years old man case. The patient was admitted for a diffuse melanodermy, a physical asthenia and a slimming which preceded 4 months by a pruritus with cholestatic jaundice. Biology showed a normal rate of transaminase. Alkaline phosphatases and direct bilirubine were high. Hepatitis (B and C) and HIV serologies were negative. Abdominal ultrasound showed a homogeneous liver. There were no dilations of the bile ducts. Antimitochondrial antibodies were negative and the histological examination confirms diagnosis. Progress was good with ursodesoxycholic acid even if interval is short (5 months of evolution).
La Revue de Médecine Interne, 2003
Estimer la prevalence de la sclErodermie syst~mique (ScS) dans la population adulte gdndrale et s... more Estimer la prevalence de la sclErodermie syst~mique (ScS) dans la population adulte gdndrale et selon l'origine g~ographique. Mdthode : Cette Etude a 6t6 rEalisEe dans le d@artement de ia Seine-Saint-Denis qui compte 1 094 412 adultes (an moins 15 ans) dent 26 % sent originaires de pays non europEens. L'Etude a port6 sur l'annEe 2001. Les cas ont ~t~ identifies par 4 sources : mEdecins g~nEralistes et spEcialistes libdraux, h6pitaux publics et cliniques, Caisse primaire d'assurance maladie, et Association des sclErodermiques de France. La ScS a EtE dEfinie selon les criteres de l'American College of Rheumatology et/ ou ceux 6tablis par LeRoy/Medsger. Tous les cas ont 6t6 classes en trois categories : formes limitEe, cutanEe limit~e et cutanEe diffuse. Afin de corriger le manque d'exhaustivit6 du recensement des patients, la mEthode de capture-recapture (CR) a Et6 appliquEe. R~sultats : Cent dix-neuf patients ont 6t~ identifies par les diverses sources. La mdthode de CR a estim~ le nombre total de cas 5 173,2. Ainsi, la prevalence (/1 000 000 adultes) de la ScS a Et6 estimEe 5 158,3 (IC 95 %, 129-187) dont 32,3 (16-48) pour les formes limitEes, 83,1 (66-101) pour les formes cutanEes limitEes et 42,9 (25-60) pour les formes cuta-nEes diffuses ; la prevalence darts la population europ~enne et non euro-p~enne 6tant respectivement de 140,2 (112-170) et 210,8 (128-293). Conclusion : Cette Etude a permis d'estimer la prevalence de la ScS en Seine-Saint-Denis. La plus grande prevalence chez les sujets non europeens peut suggErer une infuence de l'origine ethnique darts la pathogEnie de la ScS, mais cette difference n'est pas statistiquement significatire.
Dakar médical, 2007
Pulmonary hypertension (PH) is a complication of autoimmune diseases which worsen the prognosis. ... more Pulmonary hypertension (PH) is a complication of autoimmune diseases which worsen the prognosis. In Senegal, a few cases of PH have been previously reported in patients with systemic sclerosis. We report two cases of patients with PH that revealed autoimmune diseases (Sharp' syndrome and Sjögren syndrome). Epidemiological, clinical, evolutive and laboratory data were analyzed. Evolution of disease was favourable for one patient and fatal for the other. These two cases show necessity of early diagnosis of systemic diseases in our countries. PH should be screened in each patient with autoimmune disease before installation of irreversible pulmonary arterial lesions that respond to treatment. New therapy used in idiopathic PH are not yet accessible for our patients.
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2008
Renal involvement determines the prognosis of systemic lupus erythematosus (SLE). The aims of thi... more Renal involvement determines the prognosis of systemic lupus erythematosus (SLE). The aims of this study were to assess the clinical, laboratory and therapeutic aspects of lupus nephritis (LN) in Senegal in order to improve its management. We included all patients presenting with SLE followed-up in the Internal Medicine and Dermatology Clinics of the Aristide Le Dantec University Teaching Hospital of Dakar, from January 1993 to December 2002. Patients with SLE without evidence of LN (defined by proteinuria more than 0.5 g/24 hours and/or hematuria) were excluded. A total of 74 patients with a diagnosis of SLE were studied, 42 of whom (56.75%) had features of LN. Their mean age was 29.6 years and male-female ratio was 0.13. The nephrotic syndrome was seen in 45.23% of the cases and renal insufficiency in 37.71%. Renal biopsy was performed in 52.38% of the cases, which showed predominantly WHO classes IV and V lesions. The main treatment modality employed was corticosteroids, while im...
Dakar médical, 2002
The authors report two hepatobiliary distomatosis cases on patients living in Senegal and Cape Ve... more The authors report two hepatobiliary distomatosis cases on patients living in Senegal and Cape Verde islands. No similar case has been reported in Senegal so far. The first case was a 41 years old woman who presented enlarged, painful liver with hypereosinophilia. There was no fever. Ultrasound and CT Scan demonstrated the presence of three poorly limited and heterogeneous masses, located on the liver right lobe. The percutaneous biopsy was not suggestive. Because of the fear ofhepatocellular carcinoma, a hepatectomy was performed and eosinophilic abcesses were found in the piece of resected liver with Fasciola eggs. The second case was a 32 years old man who presented a febrile enlarged liver with hypereosinophilia. Ultrasound revealed an heterogenous process of the liver fourth segment Serology study using Fasciola hepatica antigen was positive. The treatment with Praziquantel was successful. The clinical and epidemiological inquiry in both cases has found stays in Cape Verde isla...
Dakar médical, 2003
We report epidemiological and clinical characteristics of 17 consecutives patients with Behçet di... more We report epidemiological and clinical characteristics of 17 consecutives patients with Behçet disease during 26 years in Dakar(Sénégal). All the patients were black, with a mean age of 27.5 years (11- 42 years) and the disease was more common between 20 and 30 years. The sex ratio was 2.4 (12 men -5 women). The majority live in cost area (64.7). Clinical features frequencies were as follow muco-cutaneous (94.11%), ocular (58.82%) neurological (47.05%) articular (47.05) psychiatric (41.17%) vascular (35.29%) digestives (11.76%). Epidemiological characteristics of Behçet disease in Sénégal are common however, the important frequency of neuropsychiatrics manifestations is remarkable.
Dakar médical, 2003
Our goals were to describe the epidemiological, clinical and endoscopic aspects of gastrointestin... more Our goals were to describe the epidemiological, clinical and endoscopic aspects of gastrointestinal ulcer and to determine the frequency of H. pylori, we included 140 gastrointestinal peptic ulcers from January 1999 to June 2000. Diagnosis of ulcerous disease delt with the presence of an ulcer discovered during a high digestive endoscopy. Gastro-duodenal ulcers bleeding or with stenosis have been excluded as well as patients who were under anticoagulant treatment or antibiotics or under pump of protons inhibitors during the previous month. Data were collected from a unique questionnaire specifying the sociodemographic characteristic, the history of the ulcerous disease, the antecedents, the style of life, and the endoscopic findings. Five biopsies were done using sterile grips and a fast urease test and the direct exam of the smear. The prevalence of gastro-duodenal ulcers in our population of survey was 6.2%. One hundred twenty eight duodenal ulcers (91.4%), and 12 gastric ulcers (...
Dakar médical, 1999
The authors present a case of a 36 years old woman applied to them for a follow up of sponge kidn... more The authors present a case of a 36 years old woman applied to them for a follow up of sponge kidney disease and in whom they discovered a primary hyperparathyroidism. Further investigations discovered a medullary thyroid carcinoma. So this patient present multiple endocrine neoplasia (MEN) type 2A confirmed by microscopic and genetic analysis. This observation enlarged the discussion upon the nature of the relationship between kidney disease and primary hyperparathyroidism. Elsewhere it recommended to check systematically genetic markers of MEN type 2A if there is an association with sponge kidney disease and primary hyperparathyroidism.
Dakar médical, 2006
haemorrhoidal disease symptoms lead frequently to medical consultation. The aims of our study wer... more haemorrhoidal disease symptoms lead frequently to medical consultation. The aims of our study were to determine its epidemiological, clinical and endoscopic characteristics in Dakar. we conducted a prospective multicentric study in the hospitals and in the private offices with endoscopic unit in Dakar from November 2nd 2003 to July 31 2004. A questionnaire with clinical and epidemiological features was applied to patients who presented haemorrhoid to the endoscopic exam. We included those who accepted the questionnaire. We recruited 168 patients. The mean age was 39.6 years. The sex ratio was 1.66 (male to female). The mean duration of symptoms was 6 years (range 1 month - 32 years). The symptoms that lead to medical visit were mainly: rectal haemorrhage (50.5%), anal pain (23.2%), constipation (13.1%) and anal tumefaction (9.5%). At the anamnesis the most frequently symptoms noted were constipation (80.4%), anal tumefaction (74.4%), anal pain (73.8%), rectal haemorrhage (64.9%) and...
Journal Africain d'Hépato-Gastroentérologie, 2010
La prévalence des ulcères gastroduodénaux (UGD) est en baisse dans les pays développés depuis l'u... more La prévalence des ulcères gastroduodénaux (UGD) est en baisse dans les pays développés depuis l'utilisation des traitements d'éradication d'Helicobacter pylori. Objectif : L'objectif de notre étude était de réévaluer les aspects épidémiologiques des UGD dans le centre d'endoscopie digestive du CHU Aristide-Le-Dantec, après une quinzaine d'années d'utilisation de ce type de traitements. Patients et méthodes : Durant la période allant du 4 juin 2008 au 9 janvier 2009, nous avons inclus tous les ulcéreux gastroduodénaux sur une population de 951 patients reçus pour une endoscopie digestive. Résultats : Cent dix-huit parmi eux présentaient un ulcère gastrique (UG) et/ou duodénal, soit 12,4 %. Il y avait 60 ulcéreux duodénaux (UD), 50 ulcéreux gastriques et huit patients ayant une double localisation gastrique et duodénale. L'âge moyen des UD était de 39 ans et celui des ulcéreux gastriques de 49 ans. La symptomatologie clinique était essentiellement constituée par des épigastralgies, et un syndrome ulcéreux typique était retrouvé dans 22 % des cas. Les aspects endoscopiques étaient classiques. L'examen anatomopathologique a permis de mettre en évidence une infection à H. pylori dans 83,6 % des cas chez les patients testés. Conclusion : La prévalence des UGD, qui était de 23,5 à 24,6 % au début des années 1990 dans les deux principaux centres d'endoscopie digestive de Dakar, est passée à 12,4 % à l'hôpital Aristide-Le-Dantec. Une pareille modification de l'aspect épidémiologique des UGD a été observée en Occident et dans certains pays asiatiques, suite à la diffusion des traitements d'éradication d'H. pylori. Pour citer cette revue : J. Afr. Hépatol. Gastroentérol. 5 (2011). Mots clés Ulcère gastroduodénal • Helicobacter pylori • Épidémiologie • Sénégal
Journal Africain d'Hépato-Gastroentérologie, 2009
ABSTRACT Le nodule de Sœur-Marie-Joseph est une métastase cutanée ombilicale d’un cancer profond.... more ABSTRACT Le nodule de Sœur-Marie-Joseph est une métastase cutanée ombilicale d’un cancer profond. Les auteurs rapportent l’observation d’une telle lésion chez une Sénégalaise de 68 ans. Ce nodule, associé à des métastases hépatiques et péritonéales probables, était secondaire à un adénocarcinome du côlon transverse. L’évolution chez cette patiente était défavorable. Il s’agit d’une manifestation clinique rare. L’anatomopathologie, après la ponction à l’aiguille fine de la biopsie, en apporte la certitude diagnostique. Son pronostic est en général péjoratif malgré des moyennes de plus en plus importantes grâce aux progrès thérapeutiques. The Sister-Marie-Joseph nodule is an umbilical cutaneous metastasis of a deep cancer. The authors report a case presenting in a 68-year-old Senegalese woman. This nodule, associated with probable hepatic and peritoneal metastases, was secondary to an adenocarcinoma of the transverse colon. The evolution in this patient was unfavourable. Such clinical cases are rare. Anatomopathology after fine needle aspiration biopsy confirms the diagnosis. The prognosis is generally poor, despite increasingly significant means and progress in treatment options.
PLoS ONE, 2014
Helicobacter pylori has probably infected the human stomach since our origins and subsequently di... more Helicobacter pylori has probably infected the human stomach since our origins and subsequently diversified in parallel with their human hosts. The genetic population history of H. pylori can therefore be used as a marker for human migration. We analysed seven housekeeping gene sequences of H. pylori strains isolated from 78 Senegalese and 24 Malagasy patients and compared them with the sequences of strains from other geographical locations. H. pylori from Senegal and Madagascar can be placed in the previously described HpAfrica1 genetic population, subpopulations hspWAfrica and hspSAfrica, respectively. These 2 subpopulations correspond to the distribution of Niger-Congo speakers in West and most of subequatorial Africa (due to Bantu migrations), respectively. H. pylori appears as a single population in Senegal, indicating a long common history between ethnicities as well as frequent local admixtures. The lack of differentiation between these isolates and an increasing genetic differentiation with geographical distance between sampling locations in Africa was evidence for genetic isolation by distance. The Austronesian expansion that started from Taiwan 5000 years ago dispersed one of the 10 subgroups of the Austronesian language family via insular Southeast Asia into the Pacific and Madagascar, and hspMaori is a marker for the entire Austronesian expansion. Strain competition and replacement of hspMaori by hpAfrica1 strains from Bantu migrants are the probable reasons for the presence of hspSAfrica strains in Malagasy of Southeast Asian descent. hpAfrica1 strains appear to be generalist strains that have the necessary genetic diversity to efficiently colonise a wide host spectrum.
L'osteoporose gravidique ou post-gravidique est une pathologie rare. Nous en rapportons un ca... more L'osteoporose gravidique ou post-gravidique est une pathologie rare. Nous en rapportons un cas chez une patiente de 26 ans primipare qui avait presente en post-partum des tassements vertebraux lombaires non-traumatiques reveles par des rachialgies aigues sans radiculalgie. Le diagnostic d'osteoporose avait repose sur la radiographie standard et le scanner. L'osteoporose post-gravidique chez notre patiente etait associee a deux affections susceptibles aussi de se compliquer d'osteopathie : le syndrome de Gougerot-Sjogren et une cirrhose post-hepatitique virale B. L'evolution avait ete favorable sous bisphosphonate (etidronate), calcium, vitamine D et hydroxychloroquine avec un recul de 18 mois. Notre observation suggere la possibilite de pathogenies differentes dans l'osteoporose post-gravique.
Open Journal of Gastroenterology, 2021
Background: Portal thrombosis (PT) is a rare pathology. Its prevalence is estimated at 1%. Its co... more Background: Portal thrombosis (PT) is a rare pathology. Its prevalence is estimated at 1%. Its consequences depend on the acute or chronic nature, the extent of the clot and the etiology. In Sub-Saharan Africa, very few studies have been devoted to it. Patients and Method: The objective of our work was to determine the prevalence of PT and to describe its clinical and etiological presentation as well as its therapeutic management in the Hepato-gastroenterology department of the Aristide Le Dantec hospital in Dakar. This was a retrospective, longitudinal and descriptive study during the period from January 1, 2012, to December 31, 2018. It included all patients followed in ambulatory or inpatient, who presented a PT objectively determined by a medical imaging examination (ultrasound and/or CT scan). Age, gender, clinical and radiological aspects, proposed treatments and etiology of PT were collected. Results: We collected 71 observations. The prevalence of PT was 1.9%. The mean age of the patients was 41 years 15 and 75 years. A predominance of men was found with a sex ratio of 2.73. The clinical manifestations were dominated by abdominal pain (74.6%), ascites (35.7%) and gastrointestinal bleeding (25.4%). Imaging allowed the diagnosis to be made in 50 patients on ultrasound and 21 patients on abdominal CT scan. PT was acute in 5 patients and chronic in 66 patients. Thrombosis was complete in 71.4% of cases and extended to the spleno-mesaraic venous trunk and the superior mesenteric vein in 2.8% and 8.4% respectively. Etiological research found cirrhosis complicated by hepatocellular carcinoma in 67.6% of cases, cirrhosis with cruoric
Open Journal of Gastroenterology, 2020
Introduction: The aim of our study was to determine the socio-demographic, diagnostic and therape... more Introduction: The aim of our study was to determine the socio-demographic, diagnostic and therapeutic aspects of ulcerative colitis (UC) in one of the largest gastroenterology departments in Senegal. Patients and Method: This was a retrospective and descriptive study based on the analysis of the records of patients hospitalized in the Hepato-Gastroenterology Department of the Grand Yoff General Hospital (Dakar, Senegal) between January 2013 and December 2019. All cases of UC were collected. Clinical, biological, endoscopic and histological data were collected, as well as treatment options. Results: We observed 24 cases, representing a prevalence of 0.87% of inpatients. The mean age of patients was 36 (ranged 18 to 73) and sex ratio 0.9 (13 females). The mean diagnostic delay was 1.6 years (ranged 4 months to 5 years). The clinical symptomatology was dominated by diarrhea with blood and mucus (18 cases). The Litchiger score on admission averaged 8 and 5 patients (20.8%) had severe acute colitis. Colonoscopy showed pancolonic involvement (Montreal E3) in 11 cases (45.8%) and severe endoscopic lesions (stage 3 of the Mayo endoscopic subscore) in 10 cases (41.6%). Therapeutically, 17 patients (70.8%) were initially treated with corticosteroids. Background therapy was 5-ASA in 17 patients (70.8%) and azathioprine in 7 patients (29.2%). Two cases of death (8.3%) were observed following colectasia with colonic perforations before emergency surgery could be performed. Conclusion: UC in our study was primarily among young adults with a slight female predominance. Diagnosis is often late. The lack of biotherapy requires close collaboration with surgeons for the management of severe forms.
Open Journal of Gastroenterology, 2017
Introduction: Plummer Vinson Syndrome (PVS) is a rare pathology combining dysphagia, an iron defi... more Introduction: Plummer Vinson Syndrome (PVS) is a rare pathology combining dysphagia, an iron deficiency anemia and a cervical esophageal web. It is one of the risk factors of the esophageal cancer. Objectives: To report the epidemiological, clinical, paraclinical and histological characteristics of patients with Plummer-Vinson syndrome associated with esophageal cancer. Patients and Methods: This was a retrospective study carried out at the digestive endoscopy center of Aristide le Dantec hospital in Dakar from January 2008 to December 2015. We included all patients with Plummer-Vinson syndrome associated with esophageal cancer. Results: We included 7 patients. The mean age was 36 years (24-65 years). There were 5 women and 2 men. The mean diagnostic period was 9 months (6 months-15 years). The main clinical manifestations were dysphagia (100%), weight loss (100%) and clinical anemia (71.4%). The biology showed a mean hemoglobin level of 8.8 g/dl (6-11 g/dl), serum iron at 30.8 μg/dl (11-52 μg/dl) and ferritinemia at 6.2 ng/dl (1.5-25 ng/dl). The upper digestive endoscopy revealed a stenosis web of the cervical esophagus in all patients. An endoscopic dilatation was performed in all cases. After dilation, the endoscopy showed a tumor of the middle third of the esophagus in 4 cases and of the lower third in 3 cases. It was about of a squamous cell carcinoma in the tumors of middle third and of an adenocarcinoma in those of the lower third. Conclusion: At Aristide le Dantec hospital of Dakar, PVS is sometimes associated with an epidermoid carcinoma or an adenocarcinoma of the esophagus. The improvement of the prognosis depends on the early realization of an upper gastrointestinal endoscopy (UGI) in case of any dysphagia and the monitoring of the patients.
Pan African Medical Journal, 2017
Le cancer de l'oesophage est une tumeur de mauvais pronostic. Sa gravité est liée au retard de di... more Le cancer de l'oesophage est une tumeur de mauvais pronostic. Sa gravité est liée au retard de diagnostic qui se fait le plus souvent au stade de métastase en Afrique. Les métastases costales de ce cancer sont rares. Nous rapportons un cas de carcinome épidermoïde du bas oesophage avec métastases costales lytiques chez une patiente sénégalaise de 38 ans. Il s'agissait de madame TD, âgée de 38 ans admise pour une tuméfaction douloureuse de l'hémithorax droit dans un contexte d'amaigrissement. La patiente signalait par ailleurs une dysphagie d'allure mécanique évoluant depuis 4 mois qui n'avait pas motivé de consultation. L'examen objectivait un mauvais état général, une tuméfaction dure, sensible mesurant 3 cm de grand axe, siégeant sur la face antérolatérale de l'hémithorax droit en regard de la 5 ème côte. Les examens biologiques mettaient en évidence une anémie normochrome normocytaire avec un taux d'hémoglobine à 9,4 g/dl, un syndrome inflammatoire biologique non spécifique et une hypercalcémie (calcémie corrigée= 107 mg/l). L'endoscopie oeso-gastroduodénale objectivait une lésion ulcéro bourgeonnante sténosante à 32 cm des arcades dentaires. L'examen anatomopathologique des biopsies mettait en évidence un carcinome épidermoïde moyennement différencié. La tomodensitométrie thoraco-abdomino pelvienne montrait en plus de la tumeur oesophagienne, une lyse osseuse de l'arc antérieure de la 5 ème côte, des nodules pulmonaires carcinomateuses et un épanchement pleural bilatéral. La ponction exploratrice du liquide pleural ramenait un liquide sérohématique et l'examen cytologique de ce liquide objectivait des cellules carcinomateuses. Le diagnostic de carcinome épidermoïde du bas oesophage avec métastases costales, pleurales et pulmonaires était retenu et un traitement palliatif instauré. L'évolution était marquée par le décès de la patiente survenu 3 mois après la réalisation de la gastrostomie, dans un tableau de détresse respiratoire. L'originalité de cette observation tient au siège atypique des métastases de ce cancer de l'oesophage; mais aussi le terrain de survenue de cette tumeur. Le cancer de l'oesophage du sujet jeune est un problème majeur en Afrique. Le challenge est de déterminer ses facteurs de risque afin de prévenir sa survenue.
Dakar médical, 2008
The diagnosis of diffuse interstitial lung disease non specific in connective tissue disease is d... more The diagnosis of diffuse interstitial lung disease non specific in connective tissue disease is difficult because of many differential diagnoses. Lung involvement can affect functional or vital prognosis. We report 7 cases. We collected data from 60 years old mean patients. Pulmonary localisation was diagnosed after 19 years of evolution of the auto-immune disease. Discovering circumstances were dyspnea and chronic cough. The radiographic and scannographic signs were diffuse because of long diagnosis delay. The underlying auto immune disease was scleroderma, rheumatoid arthritis, Sjögren's syndrome, ankylosing spondylitis, Sharp's syndrome, and multiple autoimmune syndrome. The main treatment was corticosteroids and respiratory physiotherapy. Throughout these 7 cases we discuss clinical, radiological and evolutive aspects and we focus on the need of early diagnosis for a better prognosis.
Dakar médical, 2008
Auto-immune cholangitis appears by a table of cholestatic jaundice without anomalies of the hepat... more Auto-immune cholangitis appears by a table of cholestatic jaundice without anomalies of the hepatic bile ducts. It is a primitive biliary cirrhosis without antimitochondrial antibodies. This disease is reported at adult women in 90 % of cases. We report a 59 years old man case. The patient was admitted for a diffuse melanodermy, a physical asthenia and a slimming which preceded 4 months by a pruritus with cholestatic jaundice. Biology showed a normal rate of transaminase. Alkaline phosphatases and direct bilirubine were high. Hepatitis (B and C) and HIV serologies were negative. Abdominal ultrasound showed a homogeneous liver. There were no dilations of the bile ducts. Antimitochondrial antibodies were negative and the histological examination confirms diagnosis. Progress was good with ursodesoxycholic acid even if interval is short (5 months of evolution).
La Revue de Médecine Interne, 2003
Estimer la prevalence de la sclErodermie syst~mique (ScS) dans la population adulte gdndrale et s... more Estimer la prevalence de la sclErodermie syst~mique (ScS) dans la population adulte gdndrale et selon l'origine g~ographique. Mdthode : Cette Etude a 6t6 rEalisEe dans le d@artement de ia Seine-Saint-Denis qui compte 1 094 412 adultes (an moins 15 ans) dent 26 % sent originaires de pays non europEens. L'Etude a port6 sur l'annEe 2001. Les cas ont ~t~ identifies par 4 sources : mEdecins g~nEralistes et spEcialistes libdraux, h6pitaux publics et cliniques, Caisse primaire d'assurance maladie, et Association des sclErodermiques de France. La ScS a EtE dEfinie selon les criteres de l'American College of Rheumatology et/ ou ceux 6tablis par LeRoy/Medsger. Tous les cas ont 6t6 classes en trois categories : formes limitEe, cutanEe limit~e et cutanEe diffuse. Afin de corriger le manque d'exhaustivit6 du recensement des patients, la mEthode de capture-recapture (CR) a Et6 appliquEe. R~sultats : Cent dix-neuf patients ont 6t~ identifies par les diverses sources. La mdthode de CR a estim~ le nombre total de cas 5 173,2. Ainsi, la prevalence (/1 000 000 adultes) de la ScS a Et6 estimEe 5 158,3 (IC 95 %, 129-187) dont 32,3 (16-48) pour les formes limitEes, 83,1 (66-101) pour les formes cutanEes limitEes et 42,9 (25-60) pour les formes cuta-nEes diffuses ; la prevalence darts la population europ~enne et non euro-p~enne 6tant respectivement de 140,2 (112-170) et 210,8 (128-293). Conclusion : Cette Etude a permis d'estimer la prevalence de la ScS en Seine-Saint-Denis. La plus grande prevalence chez les sujets non europeens peut suggErer une infuence de l'origine ethnique darts la pathogEnie de la ScS, mais cette difference n'est pas statistiquement significatire.
Dakar médical, 2007
Pulmonary hypertension (PH) is a complication of autoimmune diseases which worsen the prognosis. ... more Pulmonary hypertension (PH) is a complication of autoimmune diseases which worsen the prognosis. In Senegal, a few cases of PH have been previously reported in patients with systemic sclerosis. We report two cases of patients with PH that revealed autoimmune diseases (Sharp' syndrome and Sjögren syndrome). Epidemiological, clinical, evolutive and laboratory data were analyzed. Evolution of disease was favourable for one patient and fatal for the other. These two cases show necessity of early diagnosis of systemic diseases in our countries. PH should be screened in each patient with autoimmune disease before installation of irreversible pulmonary arterial lesions that respond to treatment. New therapy used in idiopathic PH are not yet accessible for our patients.
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2008
Renal involvement determines the prognosis of systemic lupus erythematosus (SLE). The aims of thi... more Renal involvement determines the prognosis of systemic lupus erythematosus (SLE). The aims of this study were to assess the clinical, laboratory and therapeutic aspects of lupus nephritis (LN) in Senegal in order to improve its management. We included all patients presenting with SLE followed-up in the Internal Medicine and Dermatology Clinics of the Aristide Le Dantec University Teaching Hospital of Dakar, from January 1993 to December 2002. Patients with SLE without evidence of LN (defined by proteinuria more than 0.5 g/24 hours and/or hematuria) were excluded. A total of 74 patients with a diagnosis of SLE were studied, 42 of whom (56.75%) had features of LN. Their mean age was 29.6 years and male-female ratio was 0.13. The nephrotic syndrome was seen in 45.23% of the cases and renal insufficiency in 37.71%. Renal biopsy was performed in 52.38% of the cases, which showed predominantly WHO classes IV and V lesions. The main treatment modality employed was corticosteroids, while im...
Dakar médical, 2002
The authors report two hepatobiliary distomatosis cases on patients living in Senegal and Cape Ve... more The authors report two hepatobiliary distomatosis cases on patients living in Senegal and Cape Verde islands. No similar case has been reported in Senegal so far. The first case was a 41 years old woman who presented enlarged, painful liver with hypereosinophilia. There was no fever. Ultrasound and CT Scan demonstrated the presence of three poorly limited and heterogeneous masses, located on the liver right lobe. The percutaneous biopsy was not suggestive. Because of the fear ofhepatocellular carcinoma, a hepatectomy was performed and eosinophilic abcesses were found in the piece of resected liver with Fasciola eggs. The second case was a 32 years old man who presented a febrile enlarged liver with hypereosinophilia. Ultrasound revealed an heterogenous process of the liver fourth segment Serology study using Fasciola hepatica antigen was positive. The treatment with Praziquantel was successful. The clinical and epidemiological inquiry in both cases has found stays in Cape Verde isla...
Dakar médical, 2003
We report epidemiological and clinical characteristics of 17 consecutives patients with Behçet di... more We report epidemiological and clinical characteristics of 17 consecutives patients with Behçet disease during 26 years in Dakar(Sénégal). All the patients were black, with a mean age of 27.5 years (11- 42 years) and the disease was more common between 20 and 30 years. The sex ratio was 2.4 (12 men -5 women). The majority live in cost area (64.7). Clinical features frequencies were as follow muco-cutaneous (94.11%), ocular (58.82%) neurological (47.05%) articular (47.05) psychiatric (41.17%) vascular (35.29%) digestives (11.76%). Epidemiological characteristics of Behçet disease in Sénégal are common however, the important frequency of neuropsychiatrics manifestations is remarkable.
Dakar médical, 2003
Our goals were to describe the epidemiological, clinical and endoscopic aspects of gastrointestin... more Our goals were to describe the epidemiological, clinical and endoscopic aspects of gastrointestinal ulcer and to determine the frequency of H. pylori, we included 140 gastrointestinal peptic ulcers from January 1999 to June 2000. Diagnosis of ulcerous disease delt with the presence of an ulcer discovered during a high digestive endoscopy. Gastro-duodenal ulcers bleeding or with stenosis have been excluded as well as patients who were under anticoagulant treatment or antibiotics or under pump of protons inhibitors during the previous month. Data were collected from a unique questionnaire specifying the sociodemographic characteristic, the history of the ulcerous disease, the antecedents, the style of life, and the endoscopic findings. Five biopsies were done using sterile grips and a fast urease test and the direct exam of the smear. The prevalence of gastro-duodenal ulcers in our population of survey was 6.2%. One hundred twenty eight duodenal ulcers (91.4%), and 12 gastric ulcers (...
Dakar médical, 1999
The authors present a case of a 36 years old woman applied to them for a follow up of sponge kidn... more The authors present a case of a 36 years old woman applied to them for a follow up of sponge kidney disease and in whom they discovered a primary hyperparathyroidism. Further investigations discovered a medullary thyroid carcinoma. So this patient present multiple endocrine neoplasia (MEN) type 2A confirmed by microscopic and genetic analysis. This observation enlarged the discussion upon the nature of the relationship between kidney disease and primary hyperparathyroidism. Elsewhere it recommended to check systematically genetic markers of MEN type 2A if there is an association with sponge kidney disease and primary hyperparathyroidism.
Dakar médical, 2006
haemorrhoidal disease symptoms lead frequently to medical consultation. The aims of our study wer... more haemorrhoidal disease symptoms lead frequently to medical consultation. The aims of our study were to determine its epidemiological, clinical and endoscopic characteristics in Dakar. we conducted a prospective multicentric study in the hospitals and in the private offices with endoscopic unit in Dakar from November 2nd 2003 to July 31 2004. A questionnaire with clinical and epidemiological features was applied to patients who presented haemorrhoid to the endoscopic exam. We included those who accepted the questionnaire. We recruited 168 patients. The mean age was 39.6 years. The sex ratio was 1.66 (male to female). The mean duration of symptoms was 6 years (range 1 month - 32 years). The symptoms that lead to medical visit were mainly: rectal haemorrhage (50.5%), anal pain (23.2%), constipation (13.1%) and anal tumefaction (9.5%). At the anamnesis the most frequently symptoms noted were constipation (80.4%), anal tumefaction (74.4%), anal pain (73.8%), rectal haemorrhage (64.9%) and...
Journal Africain d'Hépato-Gastroentérologie, 2010
La prévalence des ulcères gastroduodénaux (UGD) est en baisse dans les pays développés depuis l'u... more La prévalence des ulcères gastroduodénaux (UGD) est en baisse dans les pays développés depuis l'utilisation des traitements d'éradication d'Helicobacter pylori. Objectif : L'objectif de notre étude était de réévaluer les aspects épidémiologiques des UGD dans le centre d'endoscopie digestive du CHU Aristide-Le-Dantec, après une quinzaine d'années d'utilisation de ce type de traitements. Patients et méthodes : Durant la période allant du 4 juin 2008 au 9 janvier 2009, nous avons inclus tous les ulcéreux gastroduodénaux sur une population de 951 patients reçus pour une endoscopie digestive. Résultats : Cent dix-huit parmi eux présentaient un ulcère gastrique (UG) et/ou duodénal, soit 12,4 %. Il y avait 60 ulcéreux duodénaux (UD), 50 ulcéreux gastriques et huit patients ayant une double localisation gastrique et duodénale. L'âge moyen des UD était de 39 ans et celui des ulcéreux gastriques de 49 ans. La symptomatologie clinique était essentiellement constituée par des épigastralgies, et un syndrome ulcéreux typique était retrouvé dans 22 % des cas. Les aspects endoscopiques étaient classiques. L'examen anatomopathologique a permis de mettre en évidence une infection à H. pylori dans 83,6 % des cas chez les patients testés. Conclusion : La prévalence des UGD, qui était de 23,5 à 24,6 % au début des années 1990 dans les deux principaux centres d'endoscopie digestive de Dakar, est passée à 12,4 % à l'hôpital Aristide-Le-Dantec. Une pareille modification de l'aspect épidémiologique des UGD a été observée en Occident et dans certains pays asiatiques, suite à la diffusion des traitements d'éradication d'H. pylori. Pour citer cette revue : J. Afr. Hépatol. Gastroentérol. 5 (2011). Mots clés Ulcère gastroduodénal • Helicobacter pylori • Épidémiologie • Sénégal
Journal Africain d'Hépato-Gastroentérologie, 2009
ABSTRACT Le nodule de Sœur-Marie-Joseph est une métastase cutanée ombilicale d’un cancer profond.... more ABSTRACT Le nodule de Sœur-Marie-Joseph est une métastase cutanée ombilicale d’un cancer profond. Les auteurs rapportent l’observation d’une telle lésion chez une Sénégalaise de 68 ans. Ce nodule, associé à des métastases hépatiques et péritonéales probables, était secondaire à un adénocarcinome du côlon transverse. L’évolution chez cette patiente était défavorable. Il s’agit d’une manifestation clinique rare. L’anatomopathologie, après la ponction à l’aiguille fine de la biopsie, en apporte la certitude diagnostique. Son pronostic est en général péjoratif malgré des moyennes de plus en plus importantes grâce aux progrès thérapeutiques. The Sister-Marie-Joseph nodule is an umbilical cutaneous metastasis of a deep cancer. The authors report a case presenting in a 68-year-old Senegalese woman. This nodule, associated with probable hepatic and peritoneal metastases, was secondary to an adenocarcinoma of the transverse colon. The evolution in this patient was unfavourable. Such clinical cases are rare. Anatomopathology after fine needle aspiration biopsy confirms the diagnosis. The prognosis is generally poor, despite increasingly significant means and progress in treatment options.
PLoS ONE, 2014
Helicobacter pylori has probably infected the human stomach since our origins and subsequently di... more Helicobacter pylori has probably infected the human stomach since our origins and subsequently diversified in parallel with their human hosts. The genetic population history of H. pylori can therefore be used as a marker for human migration. We analysed seven housekeeping gene sequences of H. pylori strains isolated from 78 Senegalese and 24 Malagasy patients and compared them with the sequences of strains from other geographical locations. H. pylori from Senegal and Madagascar can be placed in the previously described HpAfrica1 genetic population, subpopulations hspWAfrica and hspSAfrica, respectively. These 2 subpopulations correspond to the distribution of Niger-Congo speakers in West and most of subequatorial Africa (due to Bantu migrations), respectively. H. pylori appears as a single population in Senegal, indicating a long common history between ethnicities as well as frequent local admixtures. The lack of differentiation between these isolates and an increasing genetic differentiation with geographical distance between sampling locations in Africa was evidence for genetic isolation by distance. The Austronesian expansion that started from Taiwan 5000 years ago dispersed one of the 10 subgroups of the Austronesian language family via insular Southeast Asia into the Pacific and Madagascar, and hspMaori is a marker for the entire Austronesian expansion. Strain competition and replacement of hspMaori by hpAfrica1 strains from Bantu migrants are the probable reasons for the presence of hspSAfrica strains in Malagasy of Southeast Asian descent. hpAfrica1 strains appear to be generalist strains that have the necessary genetic diversity to efficiently colonise a wide host spectrum.