Diagnosis and Treatment of Digestive Emergencies in Two Hospitals in Douala (Cameroon)

Abstract

Background: Gastrointestinal tract (GIT) surgical emergencies represent a significant amount within surgical pathologies, in Africa and throughout the world. Our study was aimed to assess the etiological, therapeutic and prognostic aspects of GIT surgical emergencies in patients from two hospitals in Douala, Cameroon. Patients and Method: A longitudinal prospective study was conducted from December 2018 to May 2019, including 203 patients of all ages and both sexes who presented with a GIT surgical emergency in any clinical form, and who underwent surgery within one of our hospitals. We collected patients' parameters through a survey, from complete history to clinical examination, then followed them up from surgery to post-operative time. Gathered information was analyzed by IBM Statistical Package for Social Science (SPSS) 23.0 software version. Results: GIT surgical emergencies accounted for 27.5% of all surgical emergencies. Our target population included 55.2% (n = 112) of men, and 44.8% (n = 91) of women, observing a sex-ratio of 1.23. The mean age of the patients was 36.3 ± 17.1 years, with extreme values of 6 months and 86 years. Abdominal pain was the most common symptom, vomiting and lack of bowel movement or gas pass, were the main associated symptoms in 27.6% and 16.7% of cases, respectively. Etiologically, leading pathologies were intestinal obstruction (32.0%, 64 cases), acute appendicitis (24.6%, 50 cases), then came peritononitis and abdominal trauma with respectively 22.7% (46 cases) and 21.7% (43 cases). Most patients underwent surgery within 24 hour.

Spectrum, Management, and Outcomes of Abdominal Surgical Emergencies at a Referral Hospital in North West Cameroon

“…Abdominal surgical emergencies affect a heterogeneous group of people including all age groups and genders. Male predominance (male to female ratio = 1.4:1) was observed in this study which is in agreement with other studies in Africa, and even in the developed world [12,13,18,19]. The mean age was 47.4 years which is comparable with findings in South Africa reported by Rickard et al [8], in the USA reported by Purcell et al in Malawi [16].…”

“…The in-hospital delay from presentation to surgery was 8 hours (median). This compares favorably with other studies from Africa [12,22]. However, this is still very high when compared with findings from developed countries.…”

“…A similar pattern was reported in a study from Ghana [11]. In Cameroon in 2019, the most common abdominal surgical emergencies were intestinal obstruction, acute appendicitis, peritonitis, and trauma [12]. Management of surgical emergencies remains a challenge in resource limited settings because delayed presentation of patients requiring surgery is common, which is mainly due to the transfer of patients between facilities among other factors [13,14].…”

“…Intestinal obstruction, perforated peptic ulcers, acute appendicitis, ruptured ectopic pregnancies, and acute cholecystitis were the most frequent abdominal surgical emergencies in this study. Engbang et al [12] reported similar findings in Douala, Cameroon. These findings are also similar to studies from other African countries that reported intestinal obstruction as the most common abdominal surgical emergencies [10,11,16,22,23].…”