[Digestive surgical emergencies in Sub-Saharan Africa: a prospective study of a series of 622 patients at the National Hospital of Zinder, Niger]

Bull Soc Pathol Exot. 2017 Aug;110(3):191-197. doi: 10.1007/s13149-016-0499-9. Epub 2016 Jun 14.
[Article in French]

Abstract

The purpose of this study was to describe the epidemiologic, therapeutic, and prognostic aspects of surgical acute abdomen at the National Hospital of Zinder (HNZ). This was a prospective study of patients undergoing digestive surgical emergencies in HNZ over 24 months (January 2013-December 2014). During the study period, 622 digestive surgical emergencies were operated. The mean age was 22.91 ± 18.14 years old, with a sex-ratio of 3:1. The average admission time was 64.31 ± 57.90 h. Abdominal pain was the main reason for admission in 61.90% (N = 385) of the cases, with or without fever throughout the course in 26.05% (N = 162) of the cases. The average time before surgery was 9.13 ± 5.97 h. Acute peritonitis accounted for 51.61% (N = 321) of cases, led by ileal perforation maybe from typhoid (N = 175). The acute intestinal obstruction and acute appendicitis accounted for 27.49% (N = 171) and 9.65% (N = 60) of the cases, respectively. Abdominal trauma had affected 53 patients (8.52%). The average length of hospital stay was 8.71 ± 5.29 days. Postoperative morbidity was 38.10% (N = 237). Septic complications (N = 187) were predominant. Overall lethality of 13.67% (N = 85), was associated with the delay of diagnosis and treatment (P < 0.001). The incidence and the high morbidity and lethality of digestive surgical emergencies in the Sub-Saharan context, could be avoided through prevention, early consultation, and adequate intra-hospital management.

Keywords: Diagnosis delay; Digestive surgery; Emergency; Etiologies; Hospital; Mortality; Niger; Sub-Saharan Africa; Zinder.

MeSH terms

  • Abdomen, Acute / diagnosis
  • Abdomen, Acute / epidemiology
  • Abdomen, Acute / etiology
  • Abdomen, Acute / surgery*
  • Adolescent
  • Adult
  • Africa South of the Sahara / epidemiology
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Digestive System Diseases / diagnosis
  • Digestive System Diseases / epidemiology
  • Digestive System Diseases / etiology
  • Digestive System Diseases / surgery*
  • Emergencies
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Niger / epidemiology
  • Retrospective Studies
  • Young Adult