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Papers by mamadou ngoné gueye

Open Journal of Gastroenterology

Introduction: As of February 2022, coronavirus disease 2019 (COVID-19) has caused a pandemic affe... more Introduction: As of February 2022, coronavirus disease 2019 (COVID-19) has caused a pandemic affecting all countries, with a total of 399 million patients and 5 million deaths. The lungs are the major organs involved in COVID-19. COVID-19 infection is not limited to the respiratory system but can affect multiple organs including the gastrointestinal tract. The aim of our study was to assess the prevalence of gastrointestinal (GI) symptoms on admission in patients with COVID-19 and their association with adverse outcomes, including mortality. Methods: In a retrospective study, we examined medical record data from patients with SARS-CoV-2 infection admitted to epidemic treatment center of hospital Aristide Le Dantec, Dakar (Senegal) between May 1, 2020, and June 31, 2021. SARS-CoV-2 infection was diagnosed by real-time polymerase chain reaction on nasopharyngeal and throat swabs. We included all patients with SARS-CoV-2 infection and GI symptoms. Result: The study identified 472 hospitalized patients with confirmed SARS-CoV-2 infection during the study period. We recruited 222 patients with gastrointestinal symptoms. The mean age of patients with GI symptoms was 56 years [17-90 years], and 54.9% were male. Patients with GI symptoms had comorbidities in 66.2% of cases. Hypertension, diabetes mellitus and chronic kidney disease were the most common comorbidities at 29.3%, 23.9%, and 6.7%, respectively. Patients with GI had cough in 69.4%, shortness of breath in 61.7%, ageusia in 57.6%, and fever in 53.1%. At presentation among patients with GI symptoms, 32.4% had mild disease, 27.

Open Journal of Gastroenterology

Viral hepatitis C is a major public health problem. The aim of our work was to determine the epid... more Viral hepatitis C is a major public health problem. The aim of our work was to determine the epidemiological, diagnostic and treatment profiles of patients with HCV in Dakar (Senegal). We conducted a retrospective, descriptive, multicentre study between January 1, 2010, and December 31, 2019. We included 26 patients. The mean age of the patients was 53.5 years [28-70 years] and 46.2% were males. Of the 26 patients included, 7 (26.9%) were Senegalese, and the majority were from other African countries. Risk factors for contamination found were surgery in 11 patients (42.3%) and blood transfusion in 1 patient (3.8%). The mean viral load was 6.47 log IU/ml [4.26-7.26 log IU/ml]. Ten patients were infected by genotype 4. No patients were co-infected with HIV or HBV. Six patients (23.1% of patients) had significant fibrosis, of which five (19.2% of patients) were in the stage of cirrhosis. Twelve patients (46.2%) started treatment. Eleven were treatment-naïve and 1 did not respond to ribavirin-pegylated interferon-based therapy after 48 weeks. Ten cases of antiviral therapy were based on DAA and ribavirin-pegylated interferon in 2 patients. For the patients treated with peginterferon and ribavirin, a rapid virologic response was observed at 12 weeks in one patient, and the other patient was lost to follow-up. Among DAA-treated patients, 7 had sustained virologic responses at 12 weeks, 2 persisted, and 1 was lost to follow-up. Moderate thrombocytopenia and weight loss were observed in one patient receiving peginterferon and ribavirin. In our study, no patient died on treatment and no patients developed de novo HCC during or after DAA therapy. Conclusion: Viral hepatitis C is rare in Senegal. Despite the progress made in the therapeutic management of viral hepatitis C, it remains a challenge in Senegal.

Les auteurs rapportent le cas d’un homme de 50 ans ayant consulte pour un ictere de type cholest... more Les auteurs rapportent le cas d’un homme de 50 ans ayant consulte pour un ictere de type cholestatique evoluant depuis plus de 3 semaines. Le bilan biologique revelait un taux de bilirubine totale a 78 mmol/l, de bilirubine conjuguee a 72 mmol/l. La recherche de thrombophilie etait negative. Le scanner retrouvait un foie non dysmorphique, une dilatation des voies biliaires intra hepatiques, des varices perivesiculaires, gastriques gauches et un cavernome en rapport avec une thrombose veineuse portale. Le cavernome realisait une stenose progressive de la voie biliaire principale

RESUME : Les auteurs rapportent le cas d’un homme de 50 ans ayant consulté pour un ictère de type... more RESUME : Les auteurs rapportent le cas d’un homme de 50 ans ayant consulté pour un ictère de type cholestatique évoluant depuis plus de 3 semaines. Le bilan biologique révélait un taux de bilirubine totale à 78 mol/l, de bilirubine conjuguée à 72 mol/l. La recherche de thrombophilie était négative. Le scanner retrouvait un foie non dysmorphique, une dilatation des voies biliaires intra hépatiques, des varices périvésiculaires, gastriques gauches et un cavernome en rapport avec une thrombose veineuse portale. Le cavernome réalisait une sténose progressive de la voie biliaire principale Mots clés Ictère. Cholangiopathie. Cavernome portal. TDM

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

Pan African Medical Journal, 2018

L'atteinte hépatique est fréquente au cours de l'hyperthyroïdie. Elle est le plus souvent asympto... more L'atteinte hépatique est fréquente au cours de l'hyperthyroïdie. Elle est le plus souvent asymptomatique. Une hyperthyroïdie révélée par un ictère est rarement décrite dans littérature. Nous vous rapportons une observation à Dakar (Sénégal). Il s'agissait d'un patient de 52 ans qui avait consulté notre service pour un ictère associé à un prurit. Les explorations biologiques montraient une augmentation des alanine aminotranférases (1,1 N), des aspartate aminotranférases (1,5 N), des phosphatases alcalines (3 N), des gamma glutamyl transférases (1,3 N) et de la bilirubinémie (22 N). L'échographie abdominale était normale. Une cause toxique ou médicamenteuse, un obstacle sur les voies biliaires, une hépatite virale ou auto immune ainsi qu'une cholangite biliaire primitive ont été exclu. Le dosage des hormones thyroïdiennes montrait une élévation de la T4 libre à 24 ng/dL (9-20 ng/dL) et un taux plasmatique indétectable de TSH inférieure à 0,01µUI/mL (0,35-4,94 UI/mL). Les anticorps anti récepteurs de la TSH étaient positifs à 7,04 UI/L (N < 1,75 UI/L). L'échographie thyroïdienne objectivait un goitre diffus homogène hypervasculaire. Le diagnostic d'une atteinte hépatique secondaire à une maladie de Basedow sans dysfonction cardiaque était retenu. L'évolution clinique et biologique était favorable sous carbimazole. L'ictère peut être révélatrice d'une hyperthyroïdie. La recherche des signes cliniques et biologiques d'une hyperthyroïdie est obligatoire devant un ictère inexpliqué.

Pan African Medical Journal, 2018

Hépatite virale B: aspects cliniques, paracliniques et évolutifs dans le service d'Hépato Gastroe... more Hépatite virale B: aspects cliniques, paracliniques et évolutifs dans le service d'Hépato Gastroentérologie de l'Hôpital Aristide Le Dantec: à propos de 728 cas

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, 2020

Introduction: The aim of this study was to determine the frequency of digestive lesions unrelated... more Introduction: The aim of this study was to determine the frequency of digestive lesions unrelated to portal hypertension during cirrhosis and to look for a possible correlation between these lesions and the severity of chronic liver disease. Material and method: Over a period of 15 months (April 1, 2014 to June 30, 2015), all the records of cirrhotic patients who followed up on an outpatient or inpatient basis in the hepato-gastroenterology department of the Aristide Le Dantec Hospital were collected. The data collected were as follows: age, sex, Child-Pugh severity score, etiology of cirrhosis, indication for endoscopy and endoscopic lesions observed. Results: Data were analyzed from 82 patient records with a mean age of 43 years (range 16 and 79 years) and a sex ratio of 1.4 (54 males). Cirrhosis was classified as Child-Pugh B in 47% of cases and Child-Pugh C in 35% of cases. The etiology was viral B in 75 patients (91.5%), B-D co-infection in 2 cases, and alcoholic in 1 case. The indication for oeso-gastroduodenal endoscopy was a systematic search for signs of portal hypertension in 66 cases (80.4%), upper gastrointestinal haemorrhage in 11 cases (13.4%) and epigastralgia in 6.2% of cases. Endoscopic lesions unrelated to portal hypertension were observed in 61 patients (74.4%). Peptic ulcer was present in 26 patients (31.7%), and congestive gastrobulbitis was observed in 38 patients (46.3%) and erosive gastrobulbitis in 32 patients (39%). Of the 43 upper GI endoscopies with biopsies, Helicobacter pylori was found at histology in 17 cases (39.5%). Eighteen patients (21.9%) had esophageal candidiasis. In multivariate analysis, there was no association be

Pan African Medical Journal, 2018

Anomalies électrocardiographiques et échocardiographiques au cours de la cirrhose virale b: à pro... more Anomalies électrocardiographiques et échocardiographiques au cours de la cirrhose virale b: à propos de 60 cas au service d'hepato-gastroenterologie de l'Hopital Aristide Le Dantec de Dakar (HALD) Electrocardiographic and echocardiographic abnormalities in patients with cirrhosis due to viral hepatitis B: about 60 cases reported in the Hepatogastroenterologic Department at the Aristide Le Dantec Hospital in Dakar (HALD)

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.

Journal Africain d'Hépato-Gastroentérologie, 2015

Advanced Research in Gastroenterology & Hepatology, 2020

Introduction: Ingestion of caustic products is a diagnostic and therapeutic emergency. Its severi... more Introduction: Ingestion of caustic products is a diagnostic and therapeutic emergency. Its severity is related to the risk of death and digestive functional sequelae. Common in children, following accidental ingestion, many studies have been devoted to it in the pediatric environment. However, data on adult populations are rare in our context. The aim of this work was to describe the profile of patients hospitalized for caustic ingestion, the context of occurrence, the endoscopic lesions observed, their evolution and their therapeutic modalities. Patients and methods: This was a descriptive retrospective study in the Hepato-Gastroenterology Department of the Idrissa Pouye General Hospital (HOGIP) over a period of 8 years (March 2008-March 2016). The records of patients over 15 years old, hospitalized for caustic ingestion were collected. The age, sex, circumstances of occurrence, nature of the caustic, consultation and endoscopy time, endoscopic lesions and their therapeutic modalities were studied. Results: Of the 2750 patients hospitalized during the study period, 25 were admitted for ingestion of digestive caustic products, corresponding to a prevalence of 0.9%. Three records were not searched. The following data were obtained from the analysis of 22 records. The mean age was 36.5 years (range: 16-82 years) with a sex ratio of 0.7 (13 females). Ingestion of the caustic was voluntary in 16 cases (11 women). The main motivations for the women were family conflicts. A regular intake of hallucinogenic substances (Indian hemp) was noted in 80% of men who voluntarily ingested a caustic product. Caustic soda was the product most often incriminated. The average quantities of caustic ingested were respectively 100cc and 300cc depending on whether the ingestion was accidental or voluntary. The median consultation time was 5 hours (30min-28d) and the median endoscopy time was 48 hours (16h-70d). The main acute esophageal lesions objectified were grade IIB (46.8%) and IIIA (37.3%) according to Di Costanzo's classification. At the gastric level, grade I and IIa lesions were present in 36.4% and 43% of cases respectively. Control endoscopy revealed esophageal or gastric stenosis in 8 cases (36.4%) and 2 cases (9%) respectively. Therapeutically, a total diet was instituted in all patients. The average duration of the diet was 15 days (2 days-21 days). Parenteral nutrition was introduced in 5 patients (22.7%). PPI therapy and rehydration were the standard treatment in all patients. Eight patients received endoscopic esophageal dilations. The mean number of dilation sessions was 4 (range: 2-11). Gastroentero anastomosis was performed in 2 patients. One case of death was recorded at D7 of hospitalization following septic shock in a patient with grade IIIB esogastric lesions of Di Costenzo. Conclusion: The ingestion of caustic products in the hospitalization unit of the Hepato-Gastroenterology Department of Idrissa Pouye General Hospital is more frequent in women, most often related to an attempt at autolysis in the context of family conflicts. In men, caustic ingestion generally occurs in the context of taking hallucinogenic products. Caustic soda is the product most often incriminated. Esophageal stenosis is the main sequelae.

Open Journal of Gastroenterology

Introduction: As of February 2022, coronavirus disease 2019 (COVID-19) has caused a pandemic affe... more Introduction: As of February 2022, coronavirus disease 2019 (COVID-19) has caused a pandemic affecting all countries, with a total of 399 million patients and 5 million deaths. The lungs are the major organs involved in COVID-19. COVID-19 infection is not limited to the respiratory system but can affect multiple organs including the gastrointestinal tract. The aim of our study was to assess the prevalence of gastrointestinal (GI) symptoms on admission in patients with COVID-19 and their association with adverse outcomes, including mortality. Methods: In a retrospective study, we examined medical record data from patients with SARS-CoV-2 infection admitted to epidemic treatment center of hospital Aristide Le Dantec, Dakar (Senegal) between May 1, 2020, and June 31, 2021. SARS-CoV-2 infection was diagnosed by real-time polymerase chain reaction on nasopharyngeal and throat swabs. We included all patients with SARS-CoV-2 infection and GI symptoms. Result: The study identified 472 hospitalized patients with confirmed SARS-CoV-2 infection during the study period. We recruited 222 patients with gastrointestinal symptoms. The mean age of patients with GI symptoms was 56 years [17-90 years], and 54.9% were male. Patients with GI symptoms had comorbidities in 66.2% of cases. Hypertension, diabetes mellitus and chronic kidney disease were the most common comorbidities at 29.3%, 23.9%, and 6.7%, respectively. Patients with GI had cough in 69.4%, shortness of breath in 61.7%, ageusia in 57.6%, and fever in 53.1%. At presentation among patients with GI symptoms, 32.4% had mild disease, 27.

Open Journal of Gastroenterology

Viral hepatitis C is a major public health problem. The aim of our work was to determine the epid... more Viral hepatitis C is a major public health problem. The aim of our work was to determine the epidemiological, diagnostic and treatment profiles of patients with HCV in Dakar (Senegal). We conducted a retrospective, descriptive, multicentre study between January 1, 2010, and December 31, 2019. We included 26 patients. The mean age of the patients was 53.5 years [28-70 years] and 46.2% were males. Of the 26 patients included, 7 (26.9%) were Senegalese, and the majority were from other African countries. Risk factors for contamination found were surgery in 11 patients (42.3%) and blood transfusion in 1 patient (3.8%). The mean viral load was 6.47 log IU/ml [4.26-7.26 log IU/ml]. Ten patients were infected by genotype 4. No patients were co-infected with HIV or HBV. Six patients (23.1% of patients) had significant fibrosis, of which five (19.2% of patients) were in the stage of cirrhosis. Twelve patients (46.2%) started treatment. Eleven were treatment-naïve and 1 did not respond to ribavirin-pegylated interferon-based therapy after 48 weeks. Ten cases of antiviral therapy were based on DAA and ribavirin-pegylated interferon in 2 patients. For the patients treated with peginterferon and ribavirin, a rapid virologic response was observed at 12 weeks in one patient, and the other patient was lost to follow-up. Among DAA-treated patients, 7 had sustained virologic responses at 12 weeks, 2 persisted, and 1 was lost to follow-up. Moderate thrombocytopenia and weight loss were observed in one patient receiving peginterferon and ribavirin. In our study, no patient died on treatment and no patients developed de novo HCC during or after DAA therapy. Conclusion: Viral hepatitis C is rare in Senegal. Despite the progress made in the therapeutic management of viral hepatitis C, it remains a challenge in Senegal.

Les auteurs rapportent le cas d’un homme de 50 ans ayant consulte pour un ictere de type cholest... more Les auteurs rapportent le cas d’un homme de 50 ans ayant consulte pour un ictere de type cholestatique evoluant depuis plus de 3 semaines. Le bilan biologique revelait un taux de bilirubine totale a 78 mmol/l, de bilirubine conjuguee a 72 mmol/l. La recherche de thrombophilie etait negative. Le scanner retrouvait un foie non dysmorphique, une dilatation des voies biliaires intra hepatiques, des varices perivesiculaires, gastriques gauches et un cavernome en rapport avec une thrombose veineuse portale. Le cavernome realisait une stenose progressive de la voie biliaire principale

RESUME : Les auteurs rapportent le cas d’un homme de 50 ans ayant consulté pour un ictère de type... more RESUME : Les auteurs rapportent le cas d’un homme de 50 ans ayant consulté pour un ictère de type cholestatique évoluant depuis plus de 3 semaines. Le bilan biologique révélait un taux de bilirubine totale à 78 mol/l, de bilirubine conjuguée à 72 mol/l. La recherche de thrombophilie était négative. Le scanner retrouvait un foie non dysmorphique, une dilatation des voies biliaires intra hépatiques, des varices périvésiculaires, gastriques gauches et un cavernome en rapport avec une thrombose veineuse portale. Le cavernome réalisait une sténose progressive de la voie biliaire principale Mots clés Ictère. Cholangiopathie. Cavernome portal. TDM

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

Pan African Medical Journal, 2018

L'atteinte hépatique est fréquente au cours de l'hyperthyroïdie. Elle est le plus souvent asympto... more L'atteinte hépatique est fréquente au cours de l'hyperthyroïdie. Elle est le plus souvent asymptomatique. Une hyperthyroïdie révélée par un ictère est rarement décrite dans littérature. Nous vous rapportons une observation à Dakar (Sénégal). Il s'agissait d'un patient de 52 ans qui avait consulté notre service pour un ictère associé à un prurit. Les explorations biologiques montraient une augmentation des alanine aminotranférases (1,1 N), des aspartate aminotranférases (1,5 N), des phosphatases alcalines (3 N), des gamma glutamyl transférases (1,3 N) et de la bilirubinémie (22 N). L'échographie abdominale était normale. Une cause toxique ou médicamenteuse, un obstacle sur les voies biliaires, une hépatite virale ou auto immune ainsi qu'une cholangite biliaire primitive ont été exclu. Le dosage des hormones thyroïdiennes montrait une élévation de la T4 libre à 24 ng/dL (9-20 ng/dL) et un taux plasmatique indétectable de TSH inférieure à 0,01µUI/mL (0,35-4,94 UI/mL). Les anticorps anti récepteurs de la TSH étaient positifs à 7,04 UI/L (N < 1,75 UI/L). L'échographie thyroïdienne objectivait un goitre diffus homogène hypervasculaire. Le diagnostic d'une atteinte hépatique secondaire à une maladie de Basedow sans dysfonction cardiaque était retenu. L'évolution clinique et biologique était favorable sous carbimazole. L'ictère peut être révélatrice d'une hyperthyroïdie. La recherche des signes cliniques et biologiques d'une hyperthyroïdie est obligatoire devant un ictère inexpliqué.

Pan African Medical Journal, 2018

Hépatite virale B: aspects cliniques, paracliniques et évolutifs dans le service d'Hépato Gastroe... more Hépatite virale B: aspects cliniques, paracliniques et évolutifs dans le service d'Hépato Gastroentérologie de l'Hôpital Aristide Le Dantec: à propos de 728 cas

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, 2020

Introduction: The aim of this study was to determine the frequency of digestive lesions unrelated... more Introduction: The aim of this study was to determine the frequency of digestive lesions unrelated to portal hypertension during cirrhosis and to look for a possible correlation between these lesions and the severity of chronic liver disease. Material and method: Over a period of 15 months (April 1, 2014 to June 30, 2015), all the records of cirrhotic patients who followed up on an outpatient or inpatient basis in the hepato-gastroenterology department of the Aristide Le Dantec Hospital were collected. The data collected were as follows: age, sex, Child-Pugh severity score, etiology of cirrhosis, indication for endoscopy and endoscopic lesions observed. Results: Data were analyzed from 82 patient records with a mean age of 43 years (range 16 and 79 years) and a sex ratio of 1.4 (54 males). Cirrhosis was classified as Child-Pugh B in 47% of cases and Child-Pugh C in 35% of cases. The etiology was viral B in 75 patients (91.5%), B-D co-infection in 2 cases, and alcoholic in 1 case. The indication for oeso-gastroduodenal endoscopy was a systematic search for signs of portal hypertension in 66 cases (80.4%), upper gastrointestinal haemorrhage in 11 cases (13.4%) and epigastralgia in 6.2% of cases. Endoscopic lesions unrelated to portal hypertension were observed in 61 patients (74.4%). Peptic ulcer was present in 26 patients (31.7%), and congestive gastrobulbitis was observed in 38 patients (46.3%) and erosive gastrobulbitis in 32 patients (39%). Of the 43 upper GI endoscopies with biopsies, Helicobacter pylori was found at histology in 17 cases (39.5%). Eighteen patients (21.9%) had esophageal candidiasis. In multivariate analysis, there was no association be

Pan African Medical Journal, 2018

Anomalies électrocardiographiques et échocardiographiques au cours de la cirrhose virale b: à pro... more Anomalies électrocardiographiques et échocardiographiques au cours de la cirrhose virale b: à propos de 60 cas au service d'hepato-gastroenterologie de l'Hopital Aristide Le Dantec de Dakar (HALD) Electrocardiographic and echocardiographic abnormalities in patients with cirrhosis due to viral hepatitis B: about 60 cases reported in the Hepatogastroenterologic Department at the Aristide Le Dantec Hospital in Dakar (HALD)

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.

Journal Africain d'Hépato-Gastroentérologie, 2015

Advanced Research in Gastroenterology & Hepatology, 2020

Introduction: Ingestion of caustic products is a diagnostic and therapeutic emergency. Its severi... more Introduction: Ingestion of caustic products is a diagnostic and therapeutic emergency. Its severity is related to the risk of death and digestive functional sequelae. Common in children, following accidental ingestion, many studies have been devoted to it in the pediatric environment. However, data on adult populations are rare in our context. The aim of this work was to describe the profile of patients hospitalized for caustic ingestion, the context of occurrence, the endoscopic lesions observed, their evolution and their therapeutic modalities. Patients and methods: This was a descriptive retrospective study in the Hepato-Gastroenterology Department of the Idrissa Pouye General Hospital (HOGIP) over a period of 8 years (March 2008-March 2016). The records of patients over 15 years old, hospitalized for caustic ingestion were collected. The age, sex, circumstances of occurrence, nature of the caustic, consultation and endoscopy time, endoscopic lesions and their therapeutic modalities were studied. Results: Of the 2750 patients hospitalized during the study period, 25 were admitted for ingestion of digestive caustic products, corresponding to a prevalence of 0.9%. Three records were not searched. The following data were obtained from the analysis of 22 records. The mean age was 36.5 years (range: 16-82 years) with a sex ratio of 0.7 (13 females). Ingestion of the caustic was voluntary in 16 cases (11 women). The main motivations for the women were family conflicts. A regular intake of hallucinogenic substances (Indian hemp) was noted in 80% of men who voluntarily ingested a caustic product. Caustic soda was the product most often incriminated. The average quantities of caustic ingested were respectively 100cc and 300cc depending on whether the ingestion was accidental or voluntary. The median consultation time was 5 hours (30min-28d) and the median endoscopy time was 48 hours (16h-70d). The main acute esophageal lesions objectified were grade IIB (46.8%) and IIIA (37.3%) according to Di Costanzo's classification. At the gastric level, grade I and IIa lesions were present in 36.4% and 43% of cases respectively. Control endoscopy revealed esophageal or gastric stenosis in 8 cases (36.4%) and 2 cases (9%) respectively. Therapeutically, a total diet was instituted in all patients. The average duration of the diet was 15 days (2 days-21 days). Parenteral nutrition was introduced in 5 patients (22.7%). PPI therapy and rehydration were the standard treatment in all patients. Eight patients received endoscopic esophageal dilations. The mean number of dilation sessions was 4 (range: 2-11). Gastroentero anastomosis was performed in 2 patients. One case of death was recorded at D7 of hospitalization following septic shock in a patient with grade IIIB esogastric lesions of Di Costenzo. Conclusion: The ingestion of caustic products in the hospitalization unit of the Hepato-Gastroenterology Department of Idrissa Pouye General Hospital is more frequent in women, most often related to an attempt at autolysis in the context of family conflicts. In men, caustic ingestion generally occurs in the context of taking hallucinogenic products. Caustic soda is the product most often incriminated. Esophageal stenosis is the main sequelae.