The anesthesiological management of acute surgical abdomens remains a delicate exercise for anesthesiologists and resuscitators, given the major volume disturbances, the delay in diagnosis with its corollary of septic shock, and the dysfunction of the emergency departments with which they are confronted. The objectives of this work were to study clinical and anesthesiological aspects, as well as intraoperative morbidity and mortality related to acute surgical abdomens. We conducted a prospective 12-month study. In this study was included Any patient received in the emergency room of the C.H.U Gabriel Touré in whom the diagnosis of acute surgical abdomen had been retained on the basis of clinical and paraclinical signs who agreed to participate. Results: During our study period, acute surgical abdomens represented 631/1335 cases of all emergency surgeries. Fifty-six of them were referred to intensive care immediately after surgery. Peritonitis represented 376 cases (61%) followed by intestinal obstruction (135/631), appendicitis (76/631) and hemoperitoins (33/631). The clinical presentation on admission was dominated by signs of hypovolemic and infectious delay. The average hemoglobin level was 12.03g / dl. Renal impairment (clearance <50 ml / ml) was detected in 50 patients. The mean operating time was 134.32 min regardless of the diagnosis. In the intensive care group, the reason for admission was dominated by states of shock 24 out of 56 cases (i.e. 42.9%), delayed awakening 5/56 cases, bronchial inhalation 4/56, cardio circulatory arrest 2/56 . In this group 14 patients received artificial ventilation ≥12h. Vasoactive support coupled with macromolecular filling was required in 17/56 cases. Eleven patients were reoperated x 25 during their stay in intensive care. The major postoperative complications were septic shock in 11 cases, hemorrhagic shock in 6 cases and 1 cardiogenic shock. The overall mortality from acute surgical abdomens was 2.24% patients (30 patients). Conclusion: The management of abdominal surgical emergencies must be multidisciplinary in order to further reduce the morbidity and mortality rate which remains significant today. Keywords: Anesthesia, perioperative, abdominal surgical emergency, Gabriel Touré University Hospital
Introduction confronté à un challenge quotidien d´engorgement des urgences, nous avons mené cette étude afin de déterminer les causes de la surpopulation du service des urgences et évaluer le processus d´orientation d´aval post soins. Méthodes il s´agit d´une étude prospective sur un an au service d´accueil des urgences du CHU Gabriel Touré. Ce travail incluait tous les patients admis dans ledit service appartenant aux classes 3, 4, 5 de la classification clinique des malades aux urgences (CCMU) et dont la durée de séjour au service est supérieure ou égale à 24h. N´ont pas été inclus les patients consultants aux urgences et appartenant aux classes 1, 2, de la classification CCMU; les patients n´ayant pas de dossier médical bien établi, les patients décédés avant soins. Résultats nous avons enregistré 19 571 recours au service d´accueil des urgences dont 44 cas d´afflux massif drainant 570 patients. Taux d´occupation des lits était de 108,03% dans notre service au même moment la moyenne générale à l´échelle de l´hôpital affichait 56%. Selon la classification CCMU, 83,75% des patients étaient CCMU3. Les patients neurolésés avaient représenté 557 cas. Les pathologies traumatiques avaient représenté 56,7% des patients contre 49,2% de pathologies médicales rencontrées. Conclusion la durée moyenne de séjour était 63,59 heures et une durée max de 45 jours. Plus d´un quart des motifs de retard de mutation intra hospitalière était dû à la nécessite une surveillance spécifique ou des soins particuliers non faisable en hospitalisation conventionnelle.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.