Kassegne I, Kanassoua K, Sewa E V, Tchangaï B, Sambiani J, Ayité A E, Dosseh E D
Service de chirurgie générale, CHU Kara, 18, rue de la Victoire, BP 18 Kara, Togo.
Service de chirurgie générale, CHU Sylvanus Olympio, Lomé, Togo.
Med Sante Trop. 2015 Jan-Mar;25(1):39-43. doi: 10.1684/mst.2014.0386.
The aim of this study was to describe the epidemiologic, diagnostic, and therapeutic aspects of surgical abdominal emergencies in a teaching hospital in a developing country (Togo).
This retrospective study included the medical files of all patients managed for surgical abdominal emergencies from March 1, 2002, to March 1, 2012.
The study included 594 patients, with a mean age of 30.3 years (range: 1 month to 80 years) and a 2.1 male:female sex ratio. The emergencies were acute generalized peritonitis (54.5%), intestinal obstruction (26.6%), acute appendicitis (14.5%), and abdominal trauma (4.4%). Plain abdominal radiographs were taken for 414 patients with acute generalized peritonitis (324 cases) and intestinal obstructions without a strangulated hernia (90 cases). Nine patients had abdominal ultrasounds for abdominal trauma (5 cases) and appendicular abscess (4 cases). No abdominal CT scan was performed. All patients underwent surgery, 316 (53.2%) by physician assistants and 278 (46.8%) by surgeons. Resuscitation and anesthesia were performed by nurse-anesthetists. The postoperative course was complicated in 182 cases (30.7%). These complications included parietal suppurations (18.2%), eviscerations (5.1%), ileal fistulas (4.4%), and postoperative peritonitis (3%). The death rate was 11.4%.
Surgical abdominal emergencies at the Kara teaching hospital were both common and serious. Their particularly high morbidity and mortality might be reduced through the adoption of reasonably practicable measures: paramedical personnel training, public awareness, establishment of management protocols, and improvement of technical equipment (laboratory).
本研究旨在描述一个发展中国家（多哥）一家教学医院中腹部外科急症的流行病学、诊断及治疗方面的情况。
这项回顾性研究纳入了2002年3月1日至2012年3月1日期间所有因腹部外科急症接受治疗的患者的病历。
该研究纳入了594例患者，平均年龄为30.3岁（范围：1个月至80岁），男女比例为2.1:1。急症类型包括急性弥漫性腹膜炎（54.5%）、肠梗阻（26.6%）、急性阑尾炎（14.5%）及腹部创伤（4.4%）。414例急性弥漫性腹膜炎患者（324例）及无绞窄性疝的肠梗阻患者（90例）进行了腹部平片检查。9例腹部创伤患者（5例）及阑尾脓肿患者（4例）进行了腹部超声检查。未进行腹部CT扫描。所有患者均接受了手术，316例（53.2%）由医师助理实施，278例（46.8%）由外科医生实施。复苏及麻醉由护士麻醉师进行。术后病程中有182例（30.7%）出现并发症。这些并发症包括腹壁化脓（18.
