INVAGINATION INTESTINALE AIGUË DE L’ADULTE : ASPECTS DIAGNOSTIQUES, THERAPEUTIQUES A PROPOS DE SEPT CAS DIAGNOSTIQUES AU CHU DE L’AMITIE SINO-CENTRAFRICAINE DE BANGUI, RCA

Abstract

Objective: To report the diagnostic and therapeutic difficulties of acute intussusception in adults in Bangui, Central African Republic. Patients and method: It was a retrospective descriptive study carried out in the general surgery department of Friendship Sino Centrafricaine University Hospital in Bangui. The reported data run from January 2019 to June 2023. It focuses on the records of adult patients of both sexes who underwent exploratory laparotomy for a bowel obstruction in which intussusception was diagnosed. Results: Intussusception accounted for 1.03% (N:7) of the 674 cases of acute bowel obstruction operated during the period. The mean age of patients was 32.8 years ± 9.7. Male subjects accounted for 57.14% (sex ratio = 1.33). At admission, five patients had occlusive syndrome and the other two had prolapse of a mass through the anus. Laparotomy was used to diagnose intussusception in all cases. These were ileo ileal intussusception (57.1%), ileocecal (14.3%), colo-colic profunated by the anus (14.3%) and ileo-caeco-colic profunted by the anus (14.3%). Surgical procedures consisted of hail resection followed by termino-terminal anastomosis (42.8%), hail resection followed by ileocolic anastomosis (28.6%) and colonic resection, colostomy and restoration of delayed digestive continuity (28.6%).The histopathological study of the operating rooms had found chronic inflammation of the colonic mucosa (28.6%), colonic adenocarcinoma (14.3%), and adenomatous polyp (14.3%). In 3 patients aged 18, 22, and 29 years respectively no cause was found (42.8%). The postoperative follow-up was simple in all operated patients. Conclusion: Intussusception is a rare condition in adults. The diagnosis is often difficult and made on laparotomy. Practitioners' attention should be drawn to prolapsed masses in the anus in adults.