ASPECTS DIAGNOSTIQUES ET THERAPEUTIQUES DES PERFORATIONS DIGESTIVES NON TRAUMATIQUES AU CENTRE HOSPITALIER UNIVERSITAIRE DE LIBREVILLE

Abstract

Introduction: Non-traumatic digestive perforations are digestive surgical emergencies. They are usually considered perforations in free peritoneum. The objective of this work is to study the epidemiological, diagnostic and therapeutic aspects of non-traumatic digestive perforations at the Visceral Surgery Department of the Libreville University Hospital. Patients and method: Retrospective study of patients hospitalized and operated on at the Visceral Surgery Department of the Libreville University Hospital from January 2016 to December 2020 for non-traumatic digestive perforations. Epidemiological, etiological and therapeutic data were studied Results: They represented 14.1% of digestive surgical emergencies. The average age of the patients was 34±13.7 years [16-70 years]. the sex ratio was equal to 2.3. Intraoperatively, duodenal perforations were found in 48.1% of patients (n=37). Among the perforations of the small intestine, 4 were probably of typhoid origin (5.1%). The only colonic perforation was of tumor origin. In case of perforation of duodenal ulcer, suture associated with omental plasty was performed. An appendectomy was performed in all patients with appendiceal perforation. Overall operative morbidity was 3.9%. Mortality was 1.3% (n=1). The average length of hospitalization was 8.3 days. Conclusion: Non-traumatic digestive perforations are frequent digestive surgical emergencies, occurring at all ages, especially in men. The etiologies are numerous. The surgical procedure depends on the etiology.