Abstract: Background: borderline ovarian tumors are rare epithelial tumors, more common before the age of 40, with challenging preoperative diagnosis. Our aim is to describe the management of a case in a resource-limited context in Burkina Faso. Case report: a 26-year-old primigravida with a 4-year-old child presented with an abdominal mass evolving over one year in the context of secondary amenorrhea. Clinical examination revealed weight loss, cutaneous-mucosal pallor, increased abdominal volume with tender deep palpation, and an irregular, mildly firm mass around the umbilicus extending to the iliac fossae, with a depressed area along the midline. Speculum examination was normal. On vaginal examination, the cervix was unremarkable, the uterus was of normal size, but the lateral fornices and Douglas pouch were filled. Further investigations revealed microcytic hypochromic anemia and a borderline normal CA 125 level. The rest of the laboratory tests were normal. Abdominal and pelvic ultrasound and CT revealed a strong suspicion of a bilateral ovarian tumour, with no signs of secondary localisation. MRI was not available. The diagnosis of probably malignant bilateral ovarian tumour was retained, and laparotomy was indicated. When the parietal peritoneum was opened, two ovarian tumours with a budding appearance occupied the entire lower half of the abdomen. A part of the omentum was in contact with both masses. Bilateral adnexectomy, total hysterectomy and partial omentectomy were performed in the absence of an extemporaneous histological study. Histological study of the surgical specimens concluded that the tumour was borderline ovarian. Follow-up at 3 years showed no signs of recurrence or tumour extension. Conclusion: borderline ovarian tumours are managed surgically, and the choice of conservative or radical surgery is not easy when there is a desire to have children, and when the ovaries are bilaterally involved. Fortunately, the vital prognosis is favourable.
Abstract: Background: borderline ovarian tumors are rare epithelial tumors, more common before the age of 40, with challenging preoperative diagnosis. Our aim is to describe the management of a case in a resource-limited context in Burkina Faso. Case report: a 26-year-old primigravida with a 4-year-old child presented with an abdominal mass evolving over one...Show More
Abstract: Sickle cell disease in pregnant women can lead to potentially serious complications for both the mother and fetus. Its management remains a major public health challenge, particularly in resource-limited regions. Here, we report the management of a case at the Regional University Hospital (RUH) of Ouahigouya. A 30-year-old patient with 2 pregnancies, 1 miscarriage following a vaso-occlusive crisis. The current pregnancy was monitored at a peripheral health center until 25 weeks of gestation when the patient experienced a vaso-occlusive crisis, prompting her evacuation to the CHUR-OHG. Electrophoresis of hemoglobin revealed 53% hemoglobin S fraction and 47% hemoglobin C fraction, with mild anemia at 9.6g/dl. After symptomatic treatment and hydration, the first crisis improved; however, due to the succession of crises, manual exchange transfusion was discussed and indicated by the care team. Initially, this exchange was not performed due to a lack of blood products. Thanks to the opening of the new transfusion center in the region, the required blood bags were available for the procedure. Manual exchange transfusion was performed, using AA red blood cell concentrate. The immediate aftermath of the exchange transfusion was straightforward, and the patient was able to carry her pregnancy to term without further complications. Delivery was by caesarean section, at 38 weeks of gestation. The newborn, a female, had Apgar scores of 9/10 and 10/10, with a weight of 2600 grams. Postoperative recovery was uneventful with no vaso-occlusive crises.
Abstract: Sickle cell disease in pregnant women can lead to potentially serious complications for both the mother and fetus. Its management remains a major public health challenge, particularly in resource-limited regions. Here, we report the management of a case at the Regional University Hospital (RUH) of Ouahigouya. A 30-year-old patient with 2 pregnancie...Show More