Peritonitises Gastroduodenal by Perforation Him of the Hospital of Sikasso: Aspects Epidemio-Clinical and Sanative

Abstract

The aim of the work was to describe the epidemiological, clinical and therapeutic aspects of peritonitis by gastroduodenal perforation. Patients and methods: the study was retrospective, and descriptive from January 2010 to December 2013.It was carried out in the general surgery department of the hospital of Sikasso (Mali). Patients operated for gastric and/or duodenal perforation were included. The parameters studied were frequency, age, sex, clinical aspects, and treatment, postoperative. Results: The clinical records of 54 patients were collected. Gastroduodenal perforations accounted for 9.2% of digestive perforations. The mean age of the patients was 34.8 years, with a sex ratio =9.8 at the risk of men. The notion of taking non-steroidal anti-inflammatory drugs was found in 72.2%, an ingestion of plant decoction in 18.5%, a history of gastritis in 7.4%, a history of peptic ulcer in 8%. Abdominal pain was present in all patients; vomiting in 19 patients. The average duration of evolution of the symptomatology was 36 hours. On physical examination the most frequent signs were abdominal contracture in 96.2% of patients; a disappearance of prehepatic dullness in all patients. On digital rectal examination Douglas-fir was bulging and painful in 24 patients. X-ray of the abdomen without preparation found pneumoperitonea in 77.7% of patients. An excision, suture plus omentoplasty were performed in 52 patients. Surgical follow-ups were simple in 77.9% patients, with a morbidity of 12.9% and a mortality of 9.3%. Conclusion: Peritonitis by gastroduodenal perforation is a frequent pathology in our context. It can cause a high mortality. Early diagnosis and treatment could improve outcomes.