TITLE:
Gastric Perforation in a 28-Month-Old Child: Complicated by Peritonitis Admitted to the Surgical Emergency Room after a Case
AUTHORS:
Abdoulaye Touré, Fofana Naby, Amadou Yalla Camara, Joseph Donamou, Boubacar Atigou Dramé, Oularé Ibrahima, Camara M’mah Lamine, Bangoura Almamy, Camara Mariama Mohamed, Emile Camara, Godwe Justin Naibe
KEYWORDS:
Resuscitation, Gastric Perforation, Child, Peritonitis, Ignace Deen
JOURNAL NAME:
Open Journal of Emergency Medicine,
Vol.8 No.4,
December
28,
2020
ABSTRACT: We report the case of a 28-month-old male child with no particular history who was admitted to the emergency room for severe abdominal pain associated with vomiting, asthenia and fever at 39.1˚C that had progressed for 4 days. He was conscious, polypneic at 32 cycles/min on admission. On palpation the abdomen was distended, painful as a whole, more pronounced in the epigastrium. There was abdominal contracture, generalized defense, a cry with sudden decompression of the umbilicus. On abdominal auscultation, there was a disappearance of prehepatic dullness, a decrease in the dullness of the flanks and absence of hydro-aeric noises. On the digital rectal examination, Douglas’s cul de sac was bulging and sensitive. An unprepared X-ray of the abdomen revealed diffuse grayness, lateral gas crescent pneumoperitoneum under diaphragm. The preoperative resuscitation consisted of the placement of a nasogastric tube, a urinary catheter, a peripheral venous route and the fluid electrolyte rebalancing adapted according to the blood ionogram, early antibiotic therapy with broad aero and anaerobic spectrum. Surgical management under general anesthesia found at laparotomy a perforation of the anterior surface of the duodenal bulb which we estimate to be 1 cm in diameter with fibrin deposits. The gesture was the toilet of the peritoneal cavity; suture of the bank and the operative consequences were simple.