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.

Risk factors and strategy for surgical incision infection in department of abdominal surgery

Objective To study the risk factors of surgical wound infection among the patients in department of abodominal surgery. Methods The factors on surgical wound infection were investigated by retrospective study. The diagnosis standard was based on Diagnosis Standard of Hospital Infection published by Ministry of Health.

Non-Malformative Emergency Abdominal Surgery in Children Aged 0 - 5 Years

Childhood abdominal surgery emergencies are a major challenge and problematic for the surgeon. The objective is to assess the pattern of non-malformative emergency abdominal surgery in children under 5 years old and to evaluate their management. Patients and Methods: A retrospective study of children under five years of age operated between January 2015 and December 2019 who presented with non-malformative abdominal surgical emergency at the Niamey National Hospital. Results: We collected 327 patients aged 0 to 5 years who underwent surgery for abdominal emergency. The average age was 2.8 ± 0.7 years. Boys accounted for 70.64% (n = 231) of the cases. Non-traumatic emergencies accounted for 97% (n = 317) of the cases. They were dominated by peritonitis in 44.6% (n = 146) and strangulated hernia in 43.7% (n = 143). Peritonitis was attributed to ileal typhoid perforation in 85.61% (n = 125) cases. The strangulated hernias were umbilical at 87.41% (n = 125) and inguinal at 12.59% (n = 18). Abdominal trauma accounted for 3% (n = 10);including 6 cases of abdominal contusion and 4 cases of penetrating wound. Intestinal resection with or without stoma was performed in 28.44% (n = 93). Postoperative complications were observed in 8.5% (n = 28) of the cases and mortality was 5.5% (n = 18). Conclusion: Non-malformative emergency abdominal surgery for children under 5 years was dominated by peritonitis. The morbidity and mortality are high. Fight against disease due to dirty hands and fecal peril like such as typhoid fever will reduce their frequency, but also improve the prognosis.

Effect of retension sutures on abdominal pressure after abdominal surgery

To evaluate the effect of retention sutures on abdominal pressure and postoperative prognosis in abdominal surgery patients. Methods： This prospective cohort study included patients who were admitted to Daping Hospital from May 15, 2014 to October 11, 2014. A total of 57 patients were enrolled, including 18 patients in the ＂U＂ type retention suture group, 17 patients in the intermittent retention suture group, and 22 patients in non-retention suture group. The demographic data, clinical data and risk factors for abdominal wound dehiscence were recorded. The bladder pressure （IVP） was monitored preoperatively, intraoperatively, and four days postoperatively. Additionally, the incidence of abdominal wound dehiscence and infection 14 days after the operation was recorded. Results： During the operation, the IVP decreased and then increased; it was at its lowest I h after the start of the operation （5.3 mmHg _＋ 3.2 mmHg） and peaked after tension-reducing （8.8 mmHg _＋ 4.0 mmHg）. The IVP values in the ＂U＂ type retention suture group and intermittent retention suture group were higher than in the non-retention suture group 4 days after operation （p 〈 0.005）. The Visual Analogue Scale （VAS） pain scores were 3.9 ~ 2.2, 3.8 ~ 2.0, and 3.0 _＋ 1,0 in the retention suture group, intermittent retention suture group and non-retention suture group, respectively. The VAS pain scores in the ＂U＂ type tension-reducing group and intermittent tension-reducing group were higher than in the non-tension-reducing group （p 〈 0,005）. Conclusion： Although retention sutures may reduce the incidence of postoperative wound dehiscence in abdominal surgery patients, they can increase the IVP and postoperative pain.