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Background: Rectal surgery is technically demanding and associated with significant morbidity. In sub-Saharan Africa, delayed presentation frequently leads to advanced disease and emergency surgery. Objective: To describe indications, operative procedures and postoperative outcomes of rectal surgery in three referral hospitals of Douala, Cameroon. Methods: Retrospective descriptive multicenter study conducted from January 2018 to December 2023, including patients aged ≥15 years who underwent rectal surgery. Sociodemographic data, operative indications, surgical procedures, postoperative morbidity and in-hospital mortality were analyzed. Results: Ninety-one patients were included. Mean age was 54.6 ± 13.4 years with a male predominance (sex ratio 1.2). Rectal cancer was the main indication (68.1%). Abdominoperineal resection was the most frequent procedure (46.2%). Overall morbidity was 9.6% and mortality 6.5%. Conclusion: Rectal surgery in Douala is dominated by advanced malignant disease with a high rate of radical procedures.

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Background: Right colon surgery is a substantial component of digestive surgery in sub-Saharan Africa, where late presentation and emergency conditions remain frequent, and multicenter data are scarce. Objective: To describe the indications, surgical procedures and postoperative outcomes of right colon surgery in four referral hospitals of Douala, Cameroon. Methods: We conducted a retrospective descriptive multicenter study over 10 years (January 2012–December 2021). All patients aged ≥15 years who underwent right colon surgery were eligible. Sociodemographic, operative and postoperative variables were extracted from medical records and analyzed descriptively. Results: A total of 145 patients were included. Mean age was 46.16 ± 18.06 years (16–87), with male predominance (64.1%; sex ratio 1.78). Emergency surgery accounted for 67.58% of cases. Obstructive right colon cancer was the leading indication (25.51%). Right hemicolectomy was the most frequent procedure (57.24%). Overall postoperative morbidity was 65.51%, dominated by surgical site infections (35.06%) and enterocutaneous fistulas (25.97%). In-hospital mortality was 6.89% (n=10). Conclusion: Right colon surgery in Douala is mainly performed in emergency settings for advanced colorectal cancer and is associated with high morbidity. Strengthening early diagnosis and perioperative quality improvement is essential to improve outcomes.

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Background: Sigmoid surgery is a major component of digestive surgery in sub‑Saharan Africa, where emergency abdominal conditions remain frequent. Multicenter local evidence is limited. Objective: To describe indications, operative procedures, and postoperative outcomes of sigmoid surgery in four referral hospitals in Douala, Cameroon. Methods: Retrospective descriptive multicenter study over a 10‑year period. Patients aged ≥15 years undergoing surgery involving the sigmoid colon were included. Sociodemographic variables, indications, procedures, morbidity and mortality were analyzed using IBM SPSS v25. Results: A total of 116 patients were included; 68.1% were male. Mean age was 47.6 ± 15.6 years. Main indications were sigmoid volvulus (19.8%), rectosigmoid junction cancer (19%), sigmoid cancer (12.9%) and rectal cancer (12%). Sigmoid colostomy was the most frequent procedure (56.9%). Laparotomy was the predominant approach. Overall morbidity was 11.2% and mortality 5.1%. Conclusion: Sigmoid surgery in Douala is dominated by emergency indications, particularly volvulus and complicated colorectal cancers. Strengthening early diagnosis and gradual implementation of minimally invasive surgery may improve postoperative outcomes.

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Background: Intrauterine ectopic pregnancies (IUEP) are uncommon. However, invasive management technics are usually required and this could compromise fertility, or obstetric and life prognosis in subsequent pregnancies. Objective: we aimed to assess the occurrence of pregnancy after an IUEP and the outcome of these pregnancies in 2 hospitals in Yaoundé, Cameroon. Methods: this was a descriptive cross-sectional study carried out on a 5-years period (2018-2022) with an exhaustive sampling. The study was done at two reference hospitals in Yaoundé and lasted 09 months (December 2023 to August 2024). We reviewed theatre registers for cases and searched for their files from which case details were extracted. We completed data through phone calls and used descriptive statistics as appropriate. Results: we found a total of 78 intrauterine (cornual or interstitial), excluded 37 cases and 41 cases were considered. Out of the 41 patients considered in the study, 17 conceived, 10 had reached at least 30 weeks of gestation with 3 still pregnant and 7 had a term delivery; of which 3 were vaginal and 4 by caesarean section. We recorded no uterine rupture. Conclusion: The fertility after IUEP was good and the outcome of subsequent pregnancies was favourable, with a slight preference for caesarean section as route of delivery.

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Background: Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity and mortality, mainly due to complication, especially in resource-limited settings. This study aimed to identify maternal factors associated with PE complications, to help identify ways to orient limited resources. Methods: We conducted a case-control study at three tertiary hospitals in Yaoundé: the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, University Teaching Hospital, and Central Hospital. Records of women admitted for preeclampsia between January 2022 and December 2023 were reviewed. Cases were women with maternal complications of preeclampsia, while controls were those with preeclampsia and no complications, matched by maternal age. Data were analysed using R version 4.3.3. Pearson’s chi-squared test and Student’s t-test were used for comparisons, and adjusted odds ratios (aORs) determined using multiple logistic regression. Results: We recruited 291 participants (97 cases and 194 controls). The most frequent complications were eclampsia (59.2%) and HELLP syndrome (18.5%). Risk factors were alcohol consumption during pregnancy (aOR = 2.53; 95% CI: 1.19–5.40; p=0.016) and having a new partner (aOR = 3.63; 95% CI: 1.14–11.57; p=0.029). Age >20 years (aOR = 0.87; 95% CI: 0.80–0.94; p<0.001), and having ≥ 5 ANCs (aOR = 0.71; 95% CI: 0.58–0.88; p=0.001), were protective. Conclusion: Eclampsia was the most common complication of PE at these hospitals. Factors associated with complications were alcohol consumption, a new partner, and suboptimal ANC. We emphasize the importance of optimum antenatal care, and avoidance of alcohol, to promote prevention and early case detection and management.

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Introduction: Post–spinal anesthesia bacterial meningitis is an exceptional complication, most often caused by Gram-positive cocci originating from the oropharyngeal flora. Infections due to Escherichia coli are extremely rare and are generally reported as isolated cases. Case Report: We report the case of a 37-year-old woman with no previous medical history who developed altered consciousness twelve hours after a cesarean section performed under spinal anesthesia. Clinical examination revealed obnubilation, neck stiffness, and cloudy cerebrospinal fluid. Cerebrospinal fluid culture isolated Escherichia coli sensitive to ceftriaxone. A breach in aseptic technique was identified, involving the use of the paper inner packaging of a pair of surgical gloves as an operative drape. Early antibiotic therapy with ceftriaxone combined with corticosteroid therapy resulted in a favorable outcome without sequelae after 21 days of treatment. Conclusion: This case illustrates the rare but serious occurrence of Escherichia coli meningitis following spinal anesthesia and highlights the importance of strict aseptic technique, rapid diagnosis, and early antibiotic treatment. Exclusive use of certified sterile surgical drapes remains an essential preventive measure.

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Introduction: Despite improvements in health, maternal mortality remains a global public health problem. The haemorrhages of the third trimester are still responsible for a heavy mortality. Objectives: Contribute to the study of immediate postpartum hemorrhages (PPH) at the maternity department of Nabil Choucair Health Center (NBHC). Methodology: It was a retrospective descriptive and analytical study on cases of PPH treated between of January 1st, 2011 and December 31th, 2015 at the maternity department of NBHC. We included any patient who was being cared for in the maternity waedfor a PPH. We studied the sociodemographic characteristics of the patients, identified etiological factors and evaluated treatment and prognosis. Results: The frequency of PPH was 1.1%. The mean age of the patients was 27.5 years. Primiparas (34.3%) and pauciparas (33.3%) were the most affected. The main etiologies of PPH were traumatic lesions (39.6%), uterine atony (31%) and retained placenta (25.2%). Medical management was based on resuscitation using filling fluids, transfusion (22.4%) and administration of oxytocin (51.4%) and prostaglandin analogs associated with oxytocin (48.6%). Obstetrical care consisted of uterine revision and uterine massage (59.8%), uterine revision alone (20.4%) and uterine revision, uterine massage and sandbag placement (19.1%). The mechanical means were mainly represented by intra-vaginal tamponade (69.2%) and intrauterine tamponade (24.4%), including 2 with the balloon. The surgical treatment included 18 hemostasis hysterectomies (13.1%) and 118 (85.5%) restorative sutures. The main maternal complication of PPH was anemia (71%). The lethality related to PPH was 6.8% with 14 deaths including 7 from blood clotting disorders. Conclusion: The diagnosis and precise estimation of postpartum hemorrhage are the basic elements of the course to be taken.