Non-Malformative Emergency Abdominal Surgery in Children Aged 0 - 5 Years

Abstract

Childhood abdominal surgery emergencies are a major challenge and problematic for the surgeon. The objective is to assess the pattern of non-malformative emergency abdominal surgery in children under 5 years old and to evaluate their management. Patients and Methods: A retrospective study of children under five years of age operated between January 2015 and December 2019 who presented with non-malformative abdominal surgical emergency at the Niamey National Hospital. Results: We collected 327 patients aged 0 to 5 years who underwent surgery for abdominal emergency. The average age was 2.8 ± 0.7 years. Boys accounted for 70.64% (n = 231) of the cases. Non-traumatic emergencies accounted for 97% (n = 317) of the cases. They were dominated by peritonitis in 44.6% (n = 146) and strangulated hernia in 43.7% (n = 143). Peritonitis was attributed to ileal typhoid perforation in 85.61% (n = 125) cases. The strangulated hernias were umbilical at 87.41% (n = 125) and inguinal at 12.59% (n = 18). Abdominal trauma accounted for 3% (n = 10); including 6 cases of abdominal contusion and 4 cases of penetrating wound. Intestinal resection with or without stoma was performed in 28.44% (n = 93). Postoperative complications were observed in 8.5% (n = 28) of the cases and mortality was 5.5% (n = 18). Conclusion: Non-malformative emergency abdominal surgery for children under 5 years was dominated by peritonitis. The morbidity and mortality are high. Fight against disease due to dirty hands and fecal peril like such as typhoid fever will reduce their frequency, but also improve the prognosis.