Study of Generalized Peritonitis in Children at the Hospital Fousseyni Daou of Kayes: Mali

Abstract

Introduction: Peritonitis is an acute inflammation of the peritoneum; it is a surgical emergency in children, as in adults. It is still common in underdeveloped countries because of the delay in diagnosis. There are primary and secondary peritonitis. The main symptom is violent and sudden abdominal pain in children. The objectives were to determine the hospital frequency of peritonitis, to describe the clinical and therapeutic aspects, to evaluate the mortality of peritonitis. This was a retrospective study that took place in the pediatric surgery department from January 2019 to December 2021; using patient records. All patients operated for peritonitis from 0 to 15 years old were included in this study. Results: During this study, we performed 650 surgeries, including 23 cases of peritonitis, or 3.53% of the surgeries. The ages were between 4 and 15 years old, the male sex was predominant, i.e. 65.21%: 15 cases. The average consultation time was 7 days. The clinical signs were dominated by abdominal pain in 100% of cases, asthenia and deterioration in general condition. All the patients had benefited from a biological assessment, the widal was positive in 12 cases. Abdominal X-ray without preparation and abdominopelvic ultrasound were performed in all patients. Abdominal X-ray without preparation objectified 6 cases of pneumoperitoneum, water levels in 10 patients. Ultrasound showed 16 cases of appendicular peritonitis, i.e. 69.56%. All patients underwent laparotomy and we found 16 cases of appendicular peritonitis 69.56%, 5 ileal perforations i.e. 21.73%, 1 perforation of the gallbladder i.e. 4.34% and tuberculous peritonitis confirmed by pathology 4.34%. The postoperative course was simple in 65.21%, parietal suppuration was observed in 21.73% of patients. We had recorded 3 cases of death or 13.04%.