Author(s)

Massamba Miabaou Didace^1*, Mbongo Jean Alfred², Note Madzélé Murielle¹, Motoula Latou Noé¹, Itoua Clautaire², Massamba Alphonse³

¹Digestive Surgery Department, Brazzaville University Hospital, Brazzaville, Congo.
²Gynecology-Obstetrics Department, Brazzaville University Hospital, Brazzaville, Congo.
³Laboratory of Numerical Analysis, Computer Science and Applications (LANIA), Faculty of Sciences and Technology, Marien Ngouabi University, Brazzaville, Congo.

Genital peritonitis is rare in daily surgical practice in Congo-Brazzaville. Clandestine abortions are incriminated. The purpose of the study is to analyze the epidemiological, etiological, diagnostic and therapeutic aspects of genital peritonitis. A retrospective and case series study was realized in departments of Digestive Surgery and Gynecology-Obstetrics of the University Hospital of Brazzaville. The inclusion criteria for the diagnosis of peritonitis were abdominal pain, fever, transit disturbances and signs of peritoneal irritation. The parameters studied were: age, etiological circumstances, anatomical lesions, type of surgical treatment and evolution. During the study period (July 1, 2015-December 31, 2017), 306 patients were admitted to both departments for acute generalized peritonitis. Among them, a genital cause was incriminated in 18 (5.9%) patients. The mean age was 27.6 ± 3.1 years. At the parity and gestational level, 93% of patients had at least two pregnancies, but not more than the second trimester. In addition, 50% of the patients had an induced miscarriage, due to uterine and intestinal lesions. Induced miscarriages accounted for half of etiological circumstances. Physical examination of the abdomen revealed abdominal contracture in 61.1% of cases. Main visceral lesions were uterine perforation (55.5%) followed by rupture of tubo-ovarian abscess (38.9%). The operative follow-up was simple in 83.33% of cases. In conclusion, genital peritonitis remains unfrequented. Median laparotomy has been the main therapeutic approach in our context where emergency laparoscopic surgery is not yet common.

Peritonitis, Abortion, Uterine Perforation

Didace, M. , Alfred, M. , Murielle, N. , Noé, M. , Clautaire, I. and Alphonse, M. (2019) Acute Genital Peritonitis in Brazzaville, Congo. Surgical Science, 10, 368-376. doi: 10.4236/ss.2019.1010041.