TITLE:
Peritonitis Management through Appendicular Perforation in the Department of Surgery Bougouni Hospital (Mali)
AUTHORS:
Sidiki Keita, Koniba Keita, Mahamadou Coulibaly, Moussa Sissoko, Lamine Soumare, Oumar Sacko, Sekou Koumaré, Adama K. Koita, Soumaîla Keita, M. Doumbia Dramane, Zimogo Zié Sanogo
KEYWORDS:
Appendicular, Peritonitis, Surgical Emergencies, Appendectomy
JOURNAL NAME:
Surgical Science,
Vol.11 No.12,
December
18,
2020
ABSTRACT: Introduction: Appendicular peritonitis is a complication of acute appendicitis characterized by the spread of the infectious process in the peritoneal cavity thus achieving wide spread or localized purulent peritonitis; it’s a medico-surgical emergency. Our objectives are to determine the frequency, describe the clinical, therapeutic and prognostic aspects of peritonitis by appendicular perforations. Patients-Method: This was a 24-month retro, prospective, descriptive study from January 1, 2018 to December 31, 2019; conducted in the Bougouni Reference Health Center Surgery Unit. All patients of appendicular peritonitis at the Bougouni Reference Health Centre were included. Results: During the study period, 68 cases of generalized acute peritonitis including 30 appendicular peritonitis cases were collected. Appendicular peritonitis accounted for 44.1% of surgical procedures. Males accounted for 71.0% with a sex ratio of 1.2 at risk of men, the average age was 26.07 years. Abdominal pain and vomiting were the reasons for consultation in 86.7% and 76.7% of cases. Physical examination was used in most cases to make the diagnosis. X-ray of the abdomen without preparation, and abdominal ultrasound were performed systematically. Surgical treatment consisted of an appendectomy with peritoneal toilet followed by drainage. The average length of hospitalization was 8.8 days with extremes of 1 - 44 days. Hospital mortality was 3.3%; morbidity and high mortality were related to delayed consultation. Conclusion: Appendicular generalized acute peritonitis is a medical-surgical emergency with a high mortality rate associated with delayed management.