Digestive Pathology Research Articles

Diet – an integral part of the treatment of digestive pathology

Gastritis is a general term for a group of conditions with one thing in common: inflammation of the stomach li­ning. The causes of this condition are very varied, the most com­mon being the bacterial infection with Helicobacter pylori. Dietary behaviour plays an important role in both trig­ge­ring and alleviating the condition. In addition to me­di­cal treat­­ment, the nutrition and dietetic specialist is of ma­jor im­por­tance in the management of this pathology, as he or she is able to help both in the acute phase of the disease, with individualised recommendations for each patient, de­­pen­­ding on his or her tolerability, and in the chronic treat­­ment and prevention of exacerbation, by helping to adopt a healthy lifestyle, recognising and eliminating the fac­tors that favour the pathology. Lifestyle im­prove­ments can faci­li­tate the shortening of proton pump inhi­bi­tors ad­mi­nis­tra­tion and reduce the risk of complications that may oc­cur with the long-term administration. In this way, the dys­biosis that may be associated with long-term treatment with pro­ton pump inhibitors and, thus, the imbalances that can lead to intestinal pathology can be prevented.

Everything You Always Wanted to Know About Organoid-Based Models (and Never Dared to Ask).

Homeostatic functions of a living tissue, such as the gastrointestinal tract, rely on highly sophisticated and finely tuned cell-to-cell interactions. These crosstalks evolve and continuously are refined as the tissue develops and give rise to specialized cells performing general and tissue-specific functions. To study these systems, stem cell–based in vitro models, often called organoids, and non–stem cell–based primary cell aggregates (called spheroids) appeared just over a decade ago. These models still are evolving and gaining complexity, making them the state-of-the-art models for studying cellular crosstalk in the gastrointestinal tract, and to investigate digestive pathologies, such as inflammatory bowel disease, colorectal cancer, and liver diseases. However, the use of organoid- or spheroid-based models to recapitulate in vitro the highly complex structure of in vivo tissue remains challenging, and mainly restricted to expert developmental cell biologists. Here, we condense the founding knowledge and key literature information that scientists adopting the organoid technology for the first time need to consider when using these models for novel biological questions. We also include information that current organoid/spheroid users could use to add to increase the complexity to their existing models. We highlight the current and prospective evolution of these models through bridging stem cell biology with biomaterial and scaffold engineering research areas. Linking these complementary fields will increase the in vitro mimicry of in vivo tissue, and potentially lead to more successful translational biomedical applications. Deepening our understanding of the nature and dynamic fine-tuning of intercellular crosstalks will enable identifying novel signaling targets for new or repurposed therapeutics used in many multifactorial diseases.

Eosinophilic Gastroenteritis in Tropical Area: about 6 Cases from Senegal

The aetiologies of hypereosinophilia are dominated by digestive parasitosis and drug intake. In the tropics, because of the frequency of parasitosis, eosinophilic digestive pathologies of primary origin, which are rare, may be overlooked. We report 6 cases of eosinophilic gastroenteritis with polymorphic digestive manifestations testifying to the different locations of eosinophilic infiltration in the digestive parietal layer. Three patients had ascites rich in eosinophils, indicative of serous involvement, while the other two had a muscular form, and the last a mucosal involvement. The evolution was favourable in all cases with corticosteroid therapy, but a recurrence was noted in 4 cases when treatment was stopped.

Benefits of crenotherapy in digestive tract pathology (Review).

Balneotherapy, a branch of physical and rehabilitation medicine using the natural factors of balneal resorts for therapeutical purposes to modulate the symptoms of numerous diseases, represents a non-pharmaceutical therapeutic alternative, easily accepted by patients and used both preventively and curatively. Crenotherapy, a branch of balneotherapy, is the method in which mineral waters are used as a therapeutic internal cure by ingestion. This procedure is performed in spa resorts (where these natural resources exist), and the ingestion of mineral water takes place at the source (spring), in the quantities recommended by the medical rehabilitation physician, according to specific regimens for the condition to be treated. Depending on their physical and chemical composition, the therapeutic mineral waters fall into several categories, having clear indications for certain pathologies. Hypotonic, isotonic, or slightly hypertonic mineral waters are recommended in diseases of the digestive tract and hepatobiliary conditions. Over time, studies have been conducted to determine the effect of these types of treatments, highlighting the complex influence of crenotherapy on the gastrointestinal tract, with favorable results, therefore the use of mineral water intake in various pathologies being recommended. The current review focuses on the existing literature data and refers to the main progress made in understanding the benefit, indications, and crenotherapy procedures in the management of gastrointestinal disorders.

Clinical and laboratory algorithm for diagnosis of metabolic syndrome with use of new medical technologies in liquidators of Chernobyl accident

Based on a long-term dynamic study of the state of health of liquidators of the consequences of the Chernobyl accident, it was found that 75 % of patients have a metabolic syndrome, burdened with concomitant somatic pathology. The article presents literature data on the key role of adipokine levels in the development of the metabolic syndrome of adipose tissue, hormonal indicators, vitamins and other nutrients, which require modern methods of laboratory diagnostics to determine.The aim. To develop a clinical and laboratory algorithm for diagnosing metabolic syndrome in liquidators of the consequences of the Chernobyl accident using new medical technologies.Methods. 122 liquidators of the consequences of the Chernobyl accident with cerebrovascular diseases, diseases of the digestive system and endocrine system pathology were examined. Based on the International recommendations of 2009, two groups were formed: those with the absence (n = 32) and the presence (n = 90) of metabolic syndrome (MS). The control group consisted of 30 people with MS who were examined and treated at the clinic, but did not have contact with radiation. All patients were male, with an average age of 64–66 years. The main biochemical parameters in blood serum were determined. Immunochemiluminescent method was used to determine hormonal parameters. Mass spectrometry was used to determine the indicators of oxidative stress (MDA, fat-soluble vitamins A, E, D, polyunsaturated fatty acids), and trace elements.Results and analysis. A characteristic feature of MS in LPA is a signifcantly (p < 0.05) low level of total testosterone in the blood serum and the calculated ratio of testosterone/estradiol. With increasing number of MS components signifcantly (p < 0.05) increases in serum level of basal insulin and HOMA IR, leptin levels, decreases the concentration of adiponectin. The analysis of the obtained results did not reveal signifcant differences in the content of the main markers of MS in LP and patients of the control group with MS. In 25% of LPA with MS, adiponectin values are determined below the lower limit of the reference range (less than 5.6 μg/ml), and the leptin content is higher than 21.0 ng/ml at the upper limit of the reference range of 5.6 ng/ml. there Is a stable tendency to reduce HDL cholesterol. When comparing the studied indicators for MS in patients with MS at the Chernobyl NPP and the control group, a statistically signifcant increase in the concentration of vitamin E (9.7 [6.8–12.7] and 6.3 [5.3–7.7]; p = 0.001) was found by 54 % and a decrease in the level of linoleic acid (230.9 [184.6–293.0] and 262.3 [214.1–426.3]; p = 0.014) by 12 %. A decrease in selenium, zinc, copper and iodine was detected.Conclusion. The results of the study demonstrated that liquidators of the consequences of the Chernobyl accident with metabolic syndrome may develop various pathogenetic variants of MS, which can be clarifed by the proposed additional criteria of the diagnostic algorithm. Identifying the pathogenetic variant of MS opens up the possibility of a personalized approach to MS therapy and prevention of the development of circulatory diseases and diabetes.

Trace Element Imbalance in Patients with Combined Digestive and Renal Pathology Complicated with COVID-19

Diagnosis and treatment of digestive lesions remain the hold the limelight of both practitioners and scientists. Their combination worsens the prognosis in patients with chronic kidney disease in chronic glomerulonephritis, there is an imbalance of trace elements, which negatively affects the course of the disease and increases the risk of such complications. The paper aims to study the effect of Minerol on the clinical manifestations of the disease in patients with combined damage to the gastroenterological zone (chronic gastroduodenitis, peptic ulcer disease) and kidneys (chronic glomerulonephritis and pyelonephritis) according to clinical, laboratory and instrumental research methods. The diagnosis was verified by esophagogastroduodenoscopy with targeted biopsy, X-ray method, ph-metry, ultrasound; association with Helicobacter pylori – according to biopsy urease and respiratory tests, the presence of urinary syndrome − generally accepted laboratory methods, and radionuclide methods, if necessary. Patients were divided into two groups aged 18-60 years. When included in the complex treatment of gastroduodenal zone and kidney lesions, the biologically active drug Minerol contributes to a faster recovery of patients and plays an indispensable role in the prevention of complications such as uremic anaemia, cardiomyopathy, etc., providing anti-inflammatory and sanogenetic effects, can be useful in the treatment of post COVID syndrome.

RCP Pacifique : bilan après un an et 323 cancers rares et/ou complexes discutés

Overseas France represents 18% of French territory and is home to 4% of its population for whom there is unequal treatment in the field of rare/complex cancer. To report our experience of intercontinental multidisciplinary videoconferencing between the French mainland and Pacific territories. Every other friday, three centers located in Papeete, Nouméa and Paris-Villejuif connected between 6:30 AM and 8:00 AM GMT to discuss cases of rare/complex cancers. Between November 2019 and December 2020, 323 presentations implicating 233 patients involved sarcoma (n=93), digestive pathology (n=60), neuroendocrine tumors (n=35), urology (n=24), gynecology (n=24), neurology (n=16), thyroid pathology (n=14), dermatology (n=14), senology (n=11), hematology (n=11), ENT pathology (n=10), pathology thoracic (n=10) and pediatrics (n=1). Of the 233 patients, 134 (57.5%) living in New Caledonia and 99 (42.5%) in French Polynesia, 117 (50.5%) had metastatic disease. 39 patients (16.7%) were transferred to French mainland (EVASAN), for surgery (n=25), vectorized radiotherapy (n=7), biopsy (n=5), chemotherapy (n=1) or inclusion in a clinical trial (n=1). 195 patients (83.7%) were treated at home, 15 (6.4%) are still awaiting a decision and 4 (1.7%) lost to follow-up. The use of videoconferencing to discuss rare/complex cancer cases was effective in guaranteeing French overseas population access to innovative therapies and clinical trials, limiting the need for intercontinental transfer to 16.7%.

Intestinal anti-tissue transglutaminase IgA deposits as a complementary method for the diagnostic evaluation of celiac disease in patients with low-grade histological lesions.

Evaluating the usefulness of intestinal anti-transglutaminase IgA (anti-TG2 IgA) deposits detection as a complementary or decision-supporting tool in the diagnosis of celiac disease (CD) in patients with low degree of enteropathy. Small intestinal biopsies (SIB) were performed from 2008 to 2017 in patients on suspicion of CD (positive CD serology and/or symptoms) referred to our Pediatric Gastroenterology Unit. We determined anti-TG2 IgA deposits by using double immunofluorescence in all the patients in whom Marsh 0 or Marsh 1 was detected in the conventional histological study and in a random selection of patients with clearly positive serology and histological Marsh 2-3 lesion. Seventy-five pediatric patients were split into three groups according to the final diagnosis: (i) 13 children with a Marsh 0 or 1, negative CD serology and final non-CD diagnosis; none presented intestinal anti-TG2 IgA deposits; (ii) 15 potential CD cases (Marsh 0 or 1 and CD-associated antibodies), detecting anti-TG2 IgA deposits in 12; on follow-up, another biopsy performed in 11/15 showed villi atrophy in seven and a Marsh 2 lesion in two of them, patients being finally diagnosed as CD cases; and (iii) 47 children with Marsh 2-3 histological lesion and final CD diagnosis; all of them had intestinal anti-TG2 IgA deposits. Anti-TG2 deposits are a useful complementary tool for CD diagnosis in pediatric population with digestive pathologies suggestive of CD. It is especially helpful in those with low-grade lesion, in which anti-TG2 deposits are predictive of the development of more severe lesions on follow-up.

Role of Endoscopic Ultrasound in Liver Disease: Where Do We Stand?

As the burden of liver disease in the general populace steadily increases, so does the need for both advanced diagnostic and treatment options. Endoscopic ultrasound is a reliable diagnostic and therapeutic method that has an established role, foremost in pancreatobiliary pathology. This paper aims to summarize the growing role of endoscopic ultrasound in hepatology based on the search of the current literature. A number of applications of endoscopic ultrasound are reviewed, including both noninvasive methods and tissue acquisition in focal and diffuse liver disease, portal hypertension measurement, detection and management of gastric and esophageal varices, treatment of focal liver lesions and staging of pancreatobiliary malignancies, treatment of cystic and solid liver lesions, as well as liver abscess drainage. Both hepatologists and endoscopists should be aware of the evolving role of endoscopic ultrasound in liver disease. The inherent invasive nature of endoscopic examination limits its use to a targeted population identified using noninvasive methods. Endoscopic ultrasound is one the most versatile methods in gastroenterology, allowing immediate access with detection, sampling, and treatment of digestive tract pathology. Further expansion of its use in hepatology is immanent.

Diagnosis of Functional Gastrointestinal Disorders and Choice of Treatment Regimen in Constipation Patients

Aim. A practical review of functional gastrointestinal disorder diagnosis in constipation patients and the rationale for opting treatment.Key points. Functional constipation commonly afflicts different ages and negatively impacts the quality of life. The current diagnostic algorithm in chronic constipation includes the disease identification according to Rome Criteria IV, red-flag symptom detection and instrumental laboratory examination. Functional constipation is notably often associated with anorectal abnormalities that bear a diagnostic value to elaborate an apt treatment strategy. Anorectal manometry, rectal sensation and balloon expulsion tests are the well-studied and significant probing techniques for objective anorectal zone sensorimotor function assessment in patients with functional constipation. The article reviews modern diagnostic methods in functional defecation disorders.Conclusion. The examination and treatment algorithms presented will help improve diagnosis and apply the most suitable management in a constipation-associated functional digestive pathology.

Intraoperative Endoscopy as an Adjuvant to Minimally Invasive Surgery in Pediatrics.

Background: Minimally invasive surgery has a different visual and tactile perception compared with conventional surgery, which could lead to complications, especially in complex procedures. In these cases, flexible endoscopy can facilitate and prevent complications in minimally invasive procedures in children. The study aimed to clarify the utility of intraoperative endoscopy as an adjuvant to minimally invasive surgery in children. Materials and Methods: This retrospective study reviewed the medical records of pediatric patients who had undergone endoscopy during a minimally invasive surgery to treat an upper digestive pathology between January 2000 and December 2020. Results: The study included 83 patients who underwent a laparoscopic procedure with simultaneous endoscopy. The diagnosis was peptic stenosis in 9 patients, achalasia in 23, congenital embryonic tracheobronchial remnants in 4, re-fundoplication in 42, esophageal duplication in 2, superior mesenteric artery syndrome in 2, and giant gastric hemangioma in 1 patient. With adjuvant endoscopy, 7 digestive perforations were noted, 11 cases of short esophagus were diagnosed, and the permeability of the anastomosis was confirmed in 6 cases. No complications were related with the endoscopy procedures. Discussion: Minimally invasive surgery has a few special and tactile limitations that can lead to complications in certain procedures. Simultaneous digestive endoscopy in the upper gastrointestinal tract facilitates organ identification and dissection. Conclusion: Digestive endoscopy is an excellent adjunct to minimally invasive surgery in children because it facilitates and identifies complications and ensures safer minimally invasive surgeries. Future prospective studies are required to assess this conclusion.

Association of ulcerative colitis and IgA nephropathy: A case report

The extradigestive manifestations of chronic inflammatory bowel disease most often affect the articulations, skin, eyes, liver and bile ducts. Renal involvement is rare, and manifests as kidney stones, glomerulonephritis, tubulointerstitial nephritis, and secondary amyloidosis. In this context of chronic inflammatory bowel disease, in particular ulcerative colitis, renal involvement is very often secondary to nephrotoxicity of the basic treatment of digestive pathology, and very rarely an authentic extradigestive manifestation of intestinal disease. We report a case of IgA nephropathy as an extra-digestive manifestation of ulcerative colitis. The objective of this study is not to neglect the IgA nephtopathy as an extradigestive manifestation of IBD which, even though rare, remains a condition to be looked for by clinicians during the follow-up of IBD.

The state of the resident intestinal microbial association and its relationship with concentrations of dioxins in blood lipids of firefighters

Relevance. Career firefighters are involved in extreme activities, and their functional reserves are probabilistically disturbed. Toxic products of combustion can significantly affect their health state.Intention – To analyze and evaluate effects of blood lipid dioxins on the microbiome of the parietal intestinal flora in firefighters of the Federal Fire Service of the Emercom of Russia.Methodology. Relationships between the microbiota composition and concentrations of blood lipid dioxins were analyzed in firefighters vs Emercom employees not involved in firefighting (control group).Results and Discussion. Microbiota concentrations in firefighters were associated with levels of blood lipid dioxins. In firefighters with dioxins > 350 pg/g lipids in the blood, normal microflora concentrations significantly decreased and conditionally pathogenic microflora concentrations significantly increased compared to firefighters with lower concentrations of dioxins and the control group.Conclusion. Disturbances in the microbiome of the parietal intestinal flora in the examined firefighters are related to exposure to toxic products of combustion, including dioxins, during firefighting. The microbiome disorders detected in firefighters can predict development of the digestive tract pathology, thus necessitating control and targeted correction of the somatic state and microecological status of this contingent.

A Preventable Cause of Hypotonia in Infants: Case Report of Two Infants with Vitamin B12 Deficiency

Introduction: Innate deficits in the metabolism or transport of vitamin B12 are exceptional. The main cause of vitamin B12 deficiency in infants is secondary to maternal deficiency. Maternal deficiency can have a vegan diet, low socio-economic level (developing countries) and a high level of development with a poor diet) or digestive pathologies responsible for a lack of absorption. The clinical signs are not very specific (developmental delay, pallor, hypotonia, vomiting and diarrhoea), which explains the frequent delay in diagnosis. The pathophysiology of the neurological damage, which is still uncertain, is thought to be secondary to a defect in myelination with altered nerve conduction and cortical atrophy. The aim of this work is to underline the importance of raising awareness of vitamin B12 deficiency in order to avoid its profound neurological repercussions, especially as substitution treatment allows an improvement or a reversibility of the neurological damage and raises the question of the possibility of screening new-borns. Materials and Methods: We report the case of two infants aged 6 months and 10 months with hypotonia and psychomotor regression from an early age, whose biological examination revealed pancytopenia with a collapsed vitamin B12 level in both infants and both mothers.

Could Helicobacter Pylori Infection Be A Risk Factor for Hyperemesis Gravidarum

Nausea and vomiting during pregnancy are the most common conditions affecting pregnancy, occurring in about 80% of all pregnancies and commonly disappears by 16 to 18 weeks of gestation. Hyperemesis gravidarum is the most severe form of nausea and vomiting in pregnancy, it is accompanied by starvation, dehydration, acidosis, alkalosis from hydrochloric acid loss in the vomits, hypokalemia, weight loss and transient hepatic dysfunction [1]. Many hypotheses have been published to explain the etiology and pathophysiology of hyperemesis gravidarum including infections, gastrointestinal tract dysfunctions, endocrinal changes, anatomical, metabolic and immunological factors. However, no single theory is enough to give an adequate explanation for all the properties of hyperemesis gravidarum. Some studies done on patients with hyperemesis gravidarum indicated a relationship between Helicobacter pylori and hyperemesis gravidarum, in addition multiple gastrointestinal and extra digestive pathologies may be associated with Helicobacter pylori infection.

Cocaine and Amphetamine Regulated Transcript (CART) Expression Changes in the Stomach Wall Affected by Experimentally Induced Gastric Ulcerations.

Cocaine- and amphetamine-regulated transcript (CART) is a peptide suggested to play a role in gastrointestinal tract tissue reaction to pathology. Gastric ulceration is a common disorder affecting huge number of people, and additionally, it contributes to the loss of pig livestock production. Importantly, ulceration as a focal disruption affecting deeper layers of the stomach wall differs from other gastrointestinal pathologies and should be studied individually. The pig’s gastrointestinal tract, due to its many similarities to the human counterpart, provides a valuable experimental model for studying digestive system pathologies. To date, the role of CART in gastric ulceration and the expression of the gene encoding CART in porcine gastrointestinal tube are completely unknown. Therefore, we aimed to verify the changes in the CART expression by Q-PCR (gene encoding CART in the tissue) and double immunofluorescence staining combined with confocal microscopy (CART immunofluorescence in enteric nervous system) in the porcine stomach tissues adjacent to gastric ulcerations. Surprisingly, we found that gastric ulcer caused a significant decrease in the expression of CART-encoding gene and huge reduction in the percentage of CART-immunofluorescent myenteric perikarya and neuronal fibers located within the circular muscle layer. Our results indicate a unique CART-dependent gastric response to ulcer disease.

Association of Ulcerative Colitis and IgA Nephropathy: A Case Report

The extra-digestive manifestations of chronic inflammatory bowel disease most often affect the joints, skin, eyes, liver and bile ducts. Renal involvement is rare, and manifests as kidney stones, glomerulonephritis, tubulointerstitial nephritis, and AA-type secondary amyloidosis. In this context of chronic inflammatory bowel disease, in particular ulcerative colitis, renal involvement is very often secondary to nephrotoxicity of the basic treatment of digestive pathology, and very rarely an authentic extra-digestive manifestation of intestinal disease. We report a case of IgA nephropathy as an extra-digestive manifestation of ulcerative colitis.

State of iodine supply in children with chronic gastroduodenitis

Objective — to study the state of iodine supply in children with chronic gastroduodenal pathology.
 Materials and methods. The study included 23 children with chronic gastroduodenitis: 13 girls (56 %) and 10 boys (43.5 %) aged 8 to 18 years. The control group consisted of 11 children matched in age and sex. All patients underwent endoscopic examination of the upper digestive tract. H. pylori infection was tested with a rapid urease breathing test «Helik‑test». All children underwent determination of iodine level in single portions of urine using the cerium‑arsenite method Sandell‑Koltoff modified by Dunn, with the following calculation of the median.
 Results. The frequency of iodine deficiency in children with chronic gastroduodenitis was 60.9 ± 10.2 %, which significantly exceeded this parameter in the control group (8.7 ± 8.6 %; p < 0.01). A mild degree of iodine deficiency was noted in 43.5 ± 10.3 % of patients, which was also significantly higher than in the control group (9.09 ± 8.6 %; p < 0.05). Moderate iodine deficiency was observed only in children of the main group (21.7 ± 8.5 %). Severe iodine deficiency in the study was not found among all children. The median ioduria in patients was 81.9 mg/l, which was significantly lower than in children in control group (183.7 mg/l; p < 0.05). Analysis of ioduria level, taking into consideration the endoscopic picture of gastrointestinal tract lesions, showed that both in frequency (p < 0.05) and median (p < 0.05), children with a more severe inflammation of the gastric mucosa and duodenum had the worst indices of iodine supply. In children infected with H. pylori iodine deficiency was observed significantly more often (p < 0.05), the median ioduria was significantly lower (p < 0.05) than in uninfected children.
 Conclusions. In children with chronic gastroduodenal pathology, a significant frequency of iodine deficiency is revealed, which increases with the severity of inflammatory changes in the mucous membrane and the presence of H. pylori infection. Determination of the state of iodine supply in children with digestive tract pathology is advisable to prevent the development of concomitant diseases, primarily thyroid dysfunction.

A survey of the pediatric radiation doses during multiphase abdominal computed tomography examinations

This work investigates pediatric patients' radiation doses during multiphasic computed tomography (CT) abdomen procedures in six hospitals. A total of 58 (14 (24% females)) and 44 males (44, 76%) underwent CT single or multiphase procedures. A single phase and triple phase CT examination were carried a wide range of clinical indications, including renal and digestive systems pathologies. All procedures were performed at six radiology departments. Three departments are equipped with 16 slice CT machines, and the other three departments are equipped with 160, 128 and 16 slice CT machines. The overall 3rd quartile values for CTDIvol (mGy) and DLP (mGy.cm) were 8.6 ± 4.7 (mGy) and 1580 ± 594.64 (mGy.cm) per CT abdomen procedure. The current study indicates the need for dose optimization for pediatric patients by establishing proper imaging protocols based on the international guidelines. The variation in patients’ doses is attributed to variation in the imaging protocols, scan length and number of phases performed per pediatric CT abdomen procedure.

Hospital mortality in the surgical service of University Clinics of Lubumbashi in the Democratic Republic of the Congo: retrospective study over 6 months

Introduction: The study of mortality in a community permits to define the axes of disease prevention and readjust health policies. In a hospital department, such a study allows monitoring and revision of therapeutic measures; these are likely to deteriorate in their implementation over the years, which requires periodic criticism. The aim of our work was to record the frequency of deaths in the surgical department of the university clinic of Lubumbashi, to specify the characteristics of the deceased population as well as the main causes of death. Patients and method: This is a descriptive cross-sectional study with retrospective data collection, examining mortality in the surgical department of the university clinic of Lubumbashi over a six-month period, from January 15, 2020 to July 15, 2020. The data were collected from the hospitalization registers and files of patients in intensive care and from the operating protocol registers, grouped together on a three-fold sheet: epidemiological-clinical, therapeutic and progressive and processed in Word and Excel. We excluded from the study patients whose death was noted on admission to the emergency room. Results: The mortality rate was 18.8%, the mean age was 49.21 ± 21.87 (Extremes: 2-93 years) and the sex ratio M / F 5.14. Emergency was the most common mode of admission in 65.12% of cases (n = 28). 51.16% of death cases (n = 22) occurred postoperatively, while in 41.86% of cases (n = 18) patients had died without being operated. There were no reported comorbidities in 74.42% of the deaths (n = 32), and diabetes mellitus was the most common comorbidity in 16.28% of the cases (n = 7). 80% of the deaths were classified ASA III (n = 20). The initial cause of death was more abdominal and digestive pathologies (emergencies) in 39.53% (n = 17) of the whole series. In our study, patients who had had surgery before death accounted for 58.14% of cases, and 40% of them had been operated on at least once. The abdominal and digestive operations were more reoperated than the others with 9/10 cases, or 90% of re-intervention. The mean operating time was 6.54 ± 3.41 (Extreme: 0 and 9 days), and the mean hospital stay was 8.4 ± 14.5 (Extreme: 0 and 61 days). Conclusion: Our work has shown that the mortality rate found at 18.8% remains high given the university status of our establishment where the patients treated are often carriers of serious pathologies and where the interveners are varied. This forces us to question ourselves, not to make ourselves feel guilty but to draw the attention of general surgery nursing staff to our shortcomings, and to correct them.