Purpose: Digestive or gastrointestinal fistula is one of the most feared postoperative complication along with dehiscence and infection. The aim of this study was to determine the etiological, clinical and therapeutic aspects of enterocutaneous fistulas in a disadvantaged surgical setting. Methods: This was a retrospective study covering a period of three years (January 2018 to December 2020) including records of patients managed for postoperative enterocutaneous fistula in the general surgery department of the Ignace DEEN national hospital in Conakry (Guinea). Results: During the three years of study, we compiled 69 records of patients with postoperative enterocutaneous fistulas, representing 14.68% of all postoperative abdominal complications registered in the department (n=468). The mean age of the patients was 29.61±17.32 years. In this series, 53 patients (76.81%) were initially operated in private health facilities and then referred to our department after the occurrence of the fistula. The most frequent indications for initial surgery were typhoid ileal perforation (37.68%) followed by appendicitis (26.09%) and sigmoid colon volvulus (15.94%). Spontaneous closure of the fistula was obtained in 41 patients (59.42%) with a mean time of 23 days. We noted 18 deaths (26.09%). Conclusion: Postoperative enterocutaneous fistula is a severe complication whose management in our environment is difficult and desperate for both patient and surgeon.
Introduction: Acute generalized peritonitis is a life-threatening emergency. It is most often secondary to a perforation of the digestive organ and or to the spread of an intra-abdominal septic area. Methodology: We carried out a descriptive retrospective study lasting from January 1, 2018 to December 31, 2018 on the contribution of imaging in the management of acute generalized peritonitis general surgery department of the hospital Chinese-Guinean. Were included in our study, all records of patients with acute generalized peritonitis will be confirmed by imaging. We carried out an exhaustive recruitment of all complete files. Our variables were analyzed using the Epi-info 7.2 software. Result: Out of 578 hospitalized patients, peritonitis represented 8.8% of cases. We noted a male predominance with 60.8% and a Sex-ratio: M / F = 1.6 whose mean age was 41.9 ± 13.5 years; extremes ranging from 17 and 67 years with a modal class ≥ 30 years or 88.3%. Housewives were the most collected with 25.5% Abdominal pain was the main reason for consultation, i.e., 90.2%, the physical sign was dominated by a convex and sensitive Douglas-fir, i.e., 27.5%. The clinical diagnosis was supported by abdomen without preparation and abdominal ultrasound; performed in 84.3% and 15.7% of patients, respectively. We noted a morbidity rate of 15.7% dominated by septic shock (15.7%). Conclusion: Our study made it possible to determine the contribution of imaging in the management. In addition, in our study, the abdomen without preparation and the abdomino-pelvic ultrasound were revealed as a key link in the management of acute generalized peritonitis.
Introduction: We report the clinical observation of 2 cases of volvulus with sigmoid necrosis in children. Observation: Two male patients, aged 12 and 15, were hospitalized with acute mechanical bowel obstruction. There was an asymmetric, motionless meteorism and rectal emptiness. X-rays of the abdomen revealed an arch. Laparotomy found volvulus with necrosis of the sigmoid colon. The Hartmann-type colostomy and the ideal colectomy were the surgical procedures. Conclusion: Sigmoid volvulus is a rare abdominal emergency in children and severe in the necrosis stage.
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