Non-traumatic intestinal perforation in the regional hospital Borgou of Benin: epidemiological and therapeutic characteristics

Allodé, Alexandre S.; Dossou, Francis M.; Hodonou, Adrien Montcho; Seto, Morel D.; Gbessi, Gaspard D.; Sambo, Bio Tamou; Olory-Togbé, Jean-Léon T.

doi:10.18203/2349-2902.isj20171145

Cited by 6 publications

(2 citation statements)

References 3 publications

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“…In Togo and Madagascar, gastric or duodenal ulcer perforation was the most frequent cause of non-traumatic AGP [12][13] while in Central African Republic, appendicular AGP was the most common [9]. Other causes, such as trauma, tuberculosis, Crohn's disease and tumors are mentionedas well [14,15,16]: probably causes of AGP are function of the context and environment of each country.…”

Section: Discussionmentioning

confidence: 99%

Acute Generalized Peritonitis in a Peripheral Hospital Centre in Benin: Can It Be Managed by a Local General Practitioner?

TOBOME

Hodonou

WAHIDE

et al. 2020

Preprint

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Background: Acute generalized peritonitis is a highly lethal and unfortunately common disease in developing countries. Moreover, lack of specialists and their concentration in main towns, expose the patients to a high but avoidable risk of complications or death. We report the experience of a peripheral hospital in Benin not equipped with specialized surgeons.Methods: This is a descriptive study including patients operated for acute generalized peritonitis from March 1st 2018 to November 30th 2019 at the Atacora Departmental Hospital Centre, Benin. This hospital lacks a CT scan and an intensive care unit. Most of the surgical activity is performed by a General Practitioner with previous surgical training (but no surgical specialization). For the purpose of the study, we evaluated the following patients’ data: age, gender, cause of peritonitis, surgical procedures, postoperative outcome and hospital stay. Results: A total of 63 patients were selected, with a mean age of 23.2 yrs and a sex ratio of 1.5. The mean operative delay was 26 hours (range 6 - 92 hours). An ileal “typhic” perforation was found in 40 patients (63.5%) and 35 of them (87.5%) could benefit of primary repair without bowel resection. 73% of surgical procedures were performed by the general practitioner. Morbidity was 34.9%, mainly represented by surgical site infections. The overall mortality was 14.3%. The average postoperative hospital stay was 12 days (range 11 - 82 days). Patients operated by the General Practitioner were in line with the overall results (morbidity 32.6%, mortality 13.0% and average postoperative hospital stay 11 days, range 1 - 58 days). Conclusion: Acute generalized peritonitis requires urgent management and can be effectively carried out, in a limited resources context, by a general practitioner with surgical skills. The respect of hygiene rules, the availability of qualified human and structural resources as well as the effectiveness of the care costs coverage by the Government are essential to reduce the peritonitis burden in Benin.

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Section: Discussionmentioning

confidence: 99%

Acute Generalized Peritonitis in a Peripheral Hospital Centre in Benin: Can It Be Managed by a Local General Practitioner?

TOBOME

Hodonou

WAHIDE

et al. 2020

Preprint

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“…Its frequency is high in African series [2] [3] however it is a pathology almost unknown in developed countries. Postoperative mortality remains high in sub-Saharan Africa, ranging from 14% to 29.3% [4] [5] mainly due to the late arrival of patients in health facilities. Through this study, we report our experience on the clinical and therapeutic aspects in the management of ileal perforations of typhic origin in the general surgery department of the CHU BSS of Kati.…”

Section: Introductionmentioning

confidence: 99%

TyphicIleal Perforation at Kati Chu-BSS for Diagnostic and Therapeutic Aspects (Mali)

Keita¹,

Diarra²,

Keita³

et al. 2021

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Ileal perforation of typhus origin is a common and serious complication of typhoid fever in tropical environments. It is one of the main causes of morbidity in surgery in Mali. However, it would be preventable if salmonellosis were properly managed upstream, and if our living environments were cleaned up. The purpose of this study is to report on the experience of the Kati UHC General Surgery Department in the management of peritonitis by typhic perforation and to assess its prognosis. Patients and Method: This is a retrospective descriptive study that took place from January 2007 to December 2020 in the General Surgery department of the Hospitalo-University BSS Center of Kati (Mali). We have included patients who have undergone peritonitis with confirmed typhic ileal perforation with laparotomy. The other etiologies of peritonitis by ileal perforation were not retained. Results: In 14 years, we collected 89 cases of peritonitis by typhic ileal perforation. It accounted for 3.14% (89/2829) of surgical procedures, 37.5% (89/1181) of visceral surgical emergencies and 27.6% (89/322) of all acute peritonitis causes combined. There were 70 men against 29 women; the sex ratio was 2.4 with an average age of 25.8 years (extremes 8 years to 65 years). Anastomosis resetions (ileo ileal and ileocolic) predominated in 71.8% of patients. However, the ileo stoma was performed in 5.6%. A significant relationship (p 0.05) was observed between high mortality and MPI score > 26. Morbidity was 39.4% with mortality of 15.7%. The average length of stay in hospital was 12.2 days. Conclusion: Typhoid ileal perforation

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Ileal Perforation and Enteric Fever: Implications for Burden of Disease Estimation

Njarekkattuvalappil

Thomas

Kapil

et al. 2021

The Journal of Infectious Diseases

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Background Ileal perforation occurs in about 1% of enteric fevers as a complication, with a case fatality risk (CFR) of 20%–30% in the early 1990s that decreased to 15.4% in 2011 in South East Asia. We report nontraumatic ileal perforations and its associated CFR from a 2-year prospective enteric fever surveillance across India. Methods The Surveillance for Enteric Fever in India (SEFI) project established a multitiered surveillance system for enteric fever between December 2017 and March 2020. Nontraumatic ileal perforations were surveilled at 8 tertiary care and 6 secondary care hospitals and classified according to etiology. Results Of the 158 nontraumatic ileal perforation cases identified,126 were consented and enrolled. Enteric fever (34.7%), tuberculosis (19.0%), malignancy (5.8%), and perforation of Meckel diverticulum (4.9%) were the common etiology. In those with enteric fever ileal perforation, the CFR was 7.1%. Conclusions Enteric fever remains the most common cause of nontraumatic ileal perforation in India, followed by tuberculosis. Better modalities of establishing etiology are required to classify the illness, and frame management guidelines and preventive measures. CFR data are critical for comprehensive disease burden estimation and policymaking.

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Non-traumatic intestinal perforation in the regional hospital Borgou of Benin: epidemiological and therapeutic characteristics

Cited by 6 publications

References 3 publications

Acute Generalized Peritonitis in a Peripheral Hospital Centre in Benin: Can It Be Managed by a Local General Practitioner?

Acute Generalized Peritonitis in a Peripheral Hospital Centre in Benin: Can It Be Managed by a Local General Practitioner?

TyphicIleal Perforation at Kati Chu-BSS for Diagnostic and Therapeutic Aspects (Mali)

Ileal Perforation and Enteric Fever: Implications for Burden of Disease Estimation

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