Post-Operative Peritonitis: Diagnostic Problems, Morbidity and Mortality in Developing Countries

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=48786#.VDdQhFfHRK0

Author(s)  

Alhassane Traoré, Bakary Tientigui Dembélé, Adégné Togo, Lassana Kanté, Madiassa Konaté, Ibrahima Diakité, Simo Notue Fabienne Laurence, Boubacar Karembé, Abdoulaye Diarra, Amadou Traoré, Mahamane Djibo Diango, Gangaly Diallo

Affiliation(s)

Faculty of Medicine and Odonto-Stomatology, Bamako, Mali.
Faculty of Medicine and Odonto-Stomatology, Bamako, Mali.
Faculty of Medicine and Odonto-Stomatology, Bamako, Mali.
Faculty of Medicine and Odonto-Stomatology, Bamako, Mali.
Faculty of Medicine and Odonto-Stomatology, Bamako, Mali.
Department of General Surgery, CHU Gabriel Touré, Bamako, Mali.
Department of General Surgery, CHU Gabriel Touré, Bamako, Mali.
Department of General Surgery, CHU Gabriel Touré, Bamako, Mali.
Department of General Surgery, CHU Gabriel Touré, Bamako, Mali.
Department of General Surgery, CHU Gabriel Touré, Bamako, Mali.
Faculty of Medicine and Odonto-Stomatology, Bamako, Mali.
Faculty of Medicine and Odonto-Stomatology, Bamako, Mali.

ABSTRACT

Goal: To study the diagnostic difficulties and post-operative morbidity and mortality of peritonitis. Patients and Methods: Retrospective study about the records of adult patients operated on between 1999 and 2013 whose diagnosis of post-operative peritonitis was made. Results: We achieved 23,573 lanterns and recorded 148 cases of postoperative peritonitis or 0.62%. The medium age was 37.1 ± 17.7 years and the sex ratio was 1.2. The delay between the initial intervention and reoperation was less than 5 days. Factors occurrence of postoperative peritonitis were those related to the initial surgery: septic context 70.8%, emergency surgery 81.1% under the seat mesocolic 25% and 20.3% initial surgical technique. The diagnosis was made preoperatively in 62.2% (n = 92). Ultrasound has found an effusion in 29.7% (n = 44). Cytobactériologic review identified germs in 85.1% (n = 126) and sterile in 12.9% of patients (n = 22). The most frequent etiologies were: 22.9% anastigmatic leak (n = 34), the phoenix abscess in 17.6% (n = 26), iatrogenic perforation 13.5% (n = 20) and digestive fistula 25% (n = 37). Other causes were the stoical necrosis 12.2% (n = 18) and evisceration 8.8% (n = 13). We performed a digestive stoma in 61% (n = 89), a closure of the abdomen bolsters in 8.8% (n = 13), a suture in iatrogenic perforation in 13.5% (n = 20) and washing with drainage in patients with phoenix abscess in 17.6% (n = 26). Morbidity was 22.3% and 53.4% mortality. Conclusion: The diagnosis of post-operative peritonitis is difficult in a developing country. Morbidity and mortality is high. Improved diagnostic tools are needed.

KEYWORDS

Peritonitis, Postoperative Morbidity and Mortality, Surgery

Cite this paper

Traoré, A. , Dembélé, B. , Togo, A. , Kanté, L. , Konaté, M. , Diakité, I. , Laurence, S. , Karembé, B. , Diarra, A. , Traoré, A. , Diango, M. and Diallo, G. (2014) Post-Operative Peritonitis: Diagnostic Problems, Morbidity and Mortality in Developing Countries. Surgical Science, 5, 363-367. doi: 10.4236/ss.2014.58059. 

 

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