TITLE:
Acute Genital Peritonitis in Brazzaville, Congo
AUTHORS:
Massamba Miabaou Didace, Mbongo Jean Alfred, Note Madzélé Murielle, Motoula Latou Noé, Itoua Clautaire, Massamba Alphonse
KEYWORDS:
Peritonitis, Abortion, Uterine Perforation
JOURNAL NAME:
Surgical Science,
Vol.10 No.10,
October
25,
2019
ABSTRACT: Genital peritonitis is rare
in daily surgical practice in Congo-Brazzaville. Clandestine abortions are
incriminated. The purpose of the study is to analyze the epidemiological,
etiological, diagnostic and therapeutic aspects of genital peritonitis. A retrospective
and case series study was realized in departments of Digestive Surgery and
Gynecology-Obstetrics of the University Hospital of Brazzaville. The inclusion
criteria for the diagnosis of peritonitis were abdominal pain, fever, transit
disturbances and signs of peritoneal irritation. The parameters studied were:
age, etiological circumstances, anatomical lesions, type of surgical treatment
and evolution. During the study period (July 1, 2015-December 31, 2017), 306 patients were admitted to both departments for
acute generalized peritonitis. Among them, a genital cause was incriminated in
18 (5.9%) patients. The mean age was 27.6 ± 3.1 years. At the parity and
gestational level, 93% of patients had at least two pregnancies, but not more
than the second trimester. In addition, 50% of the patients had an induced
miscarriage, due to uterine and intestinal lesions. Induced miscarriages accounted for half of etiological
circumstances. Physical examination of the abdomen revealed abdominal
contracture in 61.1% of cases. Main visceral lesions were uterine perforation
(55.5%) followed by rupture of tubo-ovarian abscess (38.9%). The operative follow-up was simple in 83.33%
of cases. In conclusion, genital peritonitis remains unfrequented. Median
laparotomy has been the main therapeutic approach in our context where
emergency laparoscopic surgery is not yet common.