Management of Pediatric Abdominal Surgical Emergencies in Northern Benin

Background: Pediatric abdominal surgical emergencies are major causes of morbidity and mortality. The goal was to identify the main determinants of their management and access to assess their evolution. Patients and methods: This is a prospective, descriptive and analytical study performed at Parakou teaching hospital and Tanguieta district hospital. It has been conducted from January 1st to July 31st 2016. All children were included aged 0 to 15 years and admitted for an abdominal surgical emergency with a Clinical Classification of Emergency Patients listed from 3 to 5. Results: Pediatric abdominal surgical emergencies accounted for 42.8% of pediatric surgical emergencies. The average age was 9.3 ± 3.5 years old. The sex ratio was 1.7. The most encountered etiologies were peritonitis (36.76%), abdominal trauma (16.17%) and anorectal malformations (14.71%). The comparison of the delay in operative treatment with the World Society of Emergency Surgery shows a delay in 82.35% of cases. Mortality was high preoperatively and was related to the neonatal period (p = 0.027) and to a resuscitation length of stay higher than 36 hours (p = 0.035). Conclusion: Surgical care was delayed, mainly due to the lack of technical capacities. Morbidity and mortality were relatively low.

Congenital Diaphragmatic Hernia: A Benin Teaching Hospital Experience

Congenital diaphragmatic hernia is the outcome of the abdominal contents in the thorax by a breach caused by a failure to close the pleuroperitoneal canal. It is a rare and serious disease. Our teaching hospital had registered these seven last years five cases of congenital diaphragmatic hernia, operated, but never published. We report the most recent one, a case of a newborn baby seen at the 5th hour of life for respiratory distress. Initial examination revealed: an asymmetric thorax, respiratory distress with 88% oxygen saturation at ambient air, tachycardia and abolition of vesicular murmur in the left lung field. L-abdomen was flat and soft. Thoraco-abdominal radiography revealed a clear left intra-thoracic image with mass effect on the left lung parenchyma. He has benefited from a reduction of the herniated visceras and a successful closing of the breach. The operation had few after-effects after five months follow-up with a very good recovery of the cardio-pulmonary function.