ABSTRACT
Introduction: Surgical jaundice, or obstructive jaundice, results from the blockage of bile flow due to benign or malignant conditions, leading to elevated bilirubin levels and associated symptoms. Early identification of the underlying cause is crucial for timely intervention and improved patient outcomes. This study aimed to evaluate the clinical aspects of surgical jaundice in patients admitted to DMCH. Methods: This prospective observational study was conducted at the Department of Surgery, Dhaka Medical College Hospital, over 12 months. A total of 100 patients were selected as study subjects by purposive convenient sampling technique. The diagnosis was established based on investigations. After data collection, all entries were checked for consistency and analyzed using SPSS version 26. Result: Among 100 patients with surgical jaundice (mean age 53.7±10.9 years), 57% had malignant causes, primarily carcinoma of the pancreatic head (32%), while 43% had benign causes, with choledocholithiasis (28%) being the most common. Jaundice was universal, and abdominal pain was the most frequent symptom, though malignancy was significantly associated with loss of appetite, weight loss, dark urine, and abdominal lump (p<0.05). Liver function tests showed significantly higher serum bilirubin and alkaline phosphatase levels in malignant cases (p<0.001). Conclusion: This study found that carcinoma head of the pancreas and choledocholithiasis are the most common causes of surgical jaundice. Overall, malignancy is the most frequent etiology of surgical jaundice. Abdominal pain was the most common clinical presentation in both malignant and benign cases. Loss of appetite and weight, dark urine, and a lump in the abdomen were found significantly higher among the malignant jaundice patients than in benign cases.

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Introduction: The objective was to present the results of the management of traumatic pelvic fractures in children in the department. Materials and Methods: This is a prospective 16-month study from January 2024 to July 2025 on patients admitted, hospitalised and treated for traumatic pelvic fractures. The parameters studied were epidemiological, clinical, radiological, therapeutic and evolutionary. Results: Thirty patients were registered, corresponding to 35 cases of lower limb fractures. The average age was 11.7 years (7 to 15 years). There were 13 (43.33%) boys and 17 (56.67%) girls, with a sex ratio of 0.76. The majority of patients were schoolchildren (28, or 93.33%). Only five (16.66%) patients were transported by ambulance. Road traffic accidents accounted for 25 cases (83.33%). Pain associated with functional impairment was found in all cases. The fracture was closed in 21 cases (70%). Overlap was the most commonly observed displacement in 14 cases (40%). ECMES was performed in 16 cases (45; 71%). The average length of hospitalisation was 17.46 days (1 to 140 days). The outcome was favourable in 25 patients (80.33%). The minimum follow-up period was 6 months. Conclusion: Traumatic fractures of the lower limb are common in our setting, with schoolchildren being the most affected. Only prevention can help reduce the frequency of these accidents.

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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: 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: 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.