TITLE:
Traumatic Digestive Perforation in the Hospital of Sikasso: Epidemio-Clinical and Therapeutic Aspects
AUTHORS:
Moussa Diassana, Bathio Traoré, Aly Boubacar Diallo, Mamadou Bernad Coulibaly, Doh Sylla, Amadou Maiga, Aboubacar Karambé, Amadou Bah, Aboubacar Yoro Sidibé, Layes Touré, Ternan Traoré, Ousmane Dembelé, Salif Traoré, Moussa Kanté, Mamadou Sangaré, Kokoroba Sidibé, Youssouf Diakité, Mahamadou Coulibaly, Moro Sidibé, Soumaila Alama Traoré, Moussa Samaké, Nana Kadidia Fofana, Bakary Tientigui Dembélé
KEYWORDS:
Perforation, Digestive, Traumatic, Sikasso (Mali)
JOURNAL NAME:
Surgical Science,
Vol.14 No.6,
June
14,
2023
ABSTRACT: Traumatic digestive perforation is the pathological
opening of the wall of a hollow organ of the digestive tract (esophagus,
stomach, small intestine, large intestine, rectum, and extrahepatic bile ducts)
following trauma. Injuries to the digestive viscera, especially from trauma,
have been known since antiquity. Aristotle recognized that a slight blow can
cause an intestinal injury. Perforation of a hollow organ of the digestive
sphere results in peritonitis, which in this case is the consequence of an
infection of the peritoneal cavity by spreading of the digestive contents. The
aim of the work was to describe the epidemiological, clinical and therapeutic
aspects of traumatic digestive perforation. Patients and method: The study was retrospective and descriptive from January 1, 2016 to December
31, 2020, in the general surgery department of the hospital of Sikasso (Mali).
Patients operated for traumatic digestive perforation were included. Results: The clinical records of 42 patients were collected. Traumatic digestive
perforations represented 12.3% of patients hospitalized for abdominal trauma.
The average age of the patients was 26.6 years, with a sex ratio of 6:1. The
most frequent etiology was road traffic accidents with 38% of patients. The
average delay of consultation was 5 days. Abdominal
pain was present in 38 patients, vomiting in 17 patients. On physical
examination, the most frequent signs were abdominal contracture in 61.9% of patients, and disappearance of pre-hepatic dullness in 54.7% of patients. On
rectal examination, the
douglas was bulging and painful in 21 patients. X-ray of the abdomen without
preparation showed pneumoperitoneum in 54.1% of patients. Excision, suture and
peritoneal lavage were performed in 31 patients. The postoperative course was
marked by parietal suppurations in 5 patients, a digestive fistula in 2
patients and 4 cases of death (9.5%). Conclusion: Traumatic digestive
perforation is a frequent pathology in surgery. Road accident was the main
cause. The treatment is essentially surgical.