Abstract
Introduction: Post-operative acute evisceration is defined as a total dehiscence of the abdominal wall of all the constituents of the abdominal wall. The objective is to determine hospital frequency, identify favorable factors and key etiologies, and assess the rate of morbi-mortality. Patients and Method: This is a retrospective and descriptive study carried out in the general surgery departments of the Teaching Hospitals of Point “G”, Gabriel TOURE and the pediatric surgery department of the Gabriel TOURE University Hospital in Bamako, involving 53 patients. The study ran from January 1, 2005 to December 31, 2007. Inclusion Criteria: All cases of postoperative acute evisceration operated. Non-Inclusion Criteria: All cases of evisceration of other etiologies. Results: The average age was 34.2 years with extremes of 6 and 75 years, the sex ratio was 1.12 in favor of women. The initial clinical picture was peritonitis in 26 cases or 49.1%, occlusion in 16 cases or 30.2% and tumors in 6 cases or 11.3%. The post-operative complications responsible for evisceration were: parietal suppuration 28 cases or 52.8%; digestive fistulas 15 cases or 28.3%; post-operative ascites 4 cases or 7.5%. Conclusion: Post-operative acute evisceration is a rare but serious condition due to morbidity and mortality.
Highlights
Post-operative acute evisceration is defined as a total dehiscence of the abdominal wall of all the constituents of the abdominal wall
Post-operative acute eviscerations accounted for 0.3%, 0.41% of hospitalizations, 0.6% of surgical patients and 1.2% of laparotomies
Factors such as digestive fistula, post-operative ascites formation, parietal suppurations, coughing and vomiting have been found by many authors as the causes of evisceration and these factors would cause delayed healing of the surgical wound [4] [6] [10]
Summary
Postoperative acute evisceration is an externalization of the abdominal viscera through a sutured surgical wound, disunited by a lack of healing of all parietal plans including the skin [1]. It is a rare but dreadful post-operative complication of abdominal surgery and can lead to an unsightly gap in the abdomen perceived. In France it occurs in 0.3% of laparotomies and accounts for 17% of post-operative complications. In the USA [5], 12 cases of abdominal wall dehiscence out of 2785 laparotomies over a 5-year period were found. In Mali few studies have been conducted on post-operative acute eviscerations, which is why we initiated this study with the following objectives
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