Aspects Épidémiologiques, Diagnostiques Et Thérapeutiques Des Traumatismes Abdominaux À Bembéréké-Nord Bénin

Objective: describe the epidemiological, diagnostic aspects and therapeutic approaches at Bembereke in northern Benin. Patients and methods: all victims of abdominal trauma received in the department of surgery between 1 st January 2010 and 30 July 2013 and with complete records were included in this retrospective study. Results: The abdominal trauma accounted for 1.1% of hospitalization and 10% of abdominal emergencies. The average age of patients was 28.04 ± 22.25 years with extremes of 02 and 67 years. The sex ratio equaled to 7.17. Half of the patients were children under 15 years. The first three circumstances abdominal trauma was road traffic accidents 31 (31.63%) cases, animal aggression 27 (27.55%) cases and falls from a tree 14 (14,29%) cases. Contusions were found in 73 (74.50%) cases and wounds in 25 (25.50%) cases. Fifty four (55.10%) laparotomy were performed. The rate of white laparotomy is 5.55% with 3 cases. The spleen was the most affected organ (15%) followed by small bowel (13%). Morbidity was 8.16% dominated by parietal suppuration. The rate of mortality was 2.04%. Mean hospital stay was 10.7 days. Conclusion: abdominal trauma interested young adult male in northern Benin. Road traffic accidents and animal injuries were the leading cause

Prise En Charge Des Péritonites Aiguës Dans Un Hôpital De District En Afrique Sub-saharienne : Cas Du Bénin

Introduction: Peritonitis remains a public health problem in Africa. We aim to describe the epidemiological, etiological and therapeutic aspects of acute peritonitis in a district hospital in Sub Saharan Africa. Methods: This was a descriptive study with prospective data collection over a period of 15 months from May 1 st 2015 to July 31st 2016 in Bembereke district hospital. It has taken into account all the patients managed in the general surgery department for acute generalized peritonitis that has been confirmed at laparotomy. Results: Fifty-three patients, 38 men (71.7 %) and 15 women (28.3 %) had been registered. The average age of the patients was 19.8 ± 16.9 years. The main etiologies were: non-traumatic ileal perforation from typhoid infection 52.8%; perforated gastric or duodenal ulcer 17%; complicated appendicitis and abdominal traumas 11.3% each one. Twenty nine patients (54.7%) have been operated by a surgeon and the 24 remaining (45.3%) by a general practitioner with surgical skills. Twenty one patients (39.6%) had postoperative complications of which 11 cases of parietal suppurations (52.4%). The mortality rate was 11.3%. The mean hospital stay was 22.5 ± 4 days. Conclusion: In northern-Benin, peritonitis remains dominated by the complications of typhoid fever. The mortality rate remains high. Prevention requires good hygiene and awareness of early consultations

Kyste De L’ouraque Infecte : A Propos De Trois Cas Cliniques Au Chu De Parakou Au Benin

Bacground: The urachus is a fibrous remnant of the allantois. That connects the bladder dome to the anterior abdominal wall. After birth it is obliterated in general. In some cases it may persist as cyst , fistula , sinus or diverticulum. This persistence of the urachus often is signaled by a complication. Infection is the most common complication and the most dangerous is his degeneration. The infection can be misunderstood and confused with other pathologies of the navel. Methods: Our study reports three clinical cases of infected urachal cyst. Result: these report cases illustrate the need to think of this diagnosis before the painful of the navel and abdomen. The ultrasound examination can help for the diagnosis

acute generalized peritonitis in a peripheral hospital centre in Benin. Can it be managed by a local general practitioner?

Background. Acute generalized peritonitis in resource-poor countries is still a health challenge due to late diagnosis, surgical delay, and specialists’ unavailability. %ese are the foremost determinants of surgical morbidity and mortality. We report the experience of a peripheral hospital in Benin not equipped with specialized surgeons. Methods. %is is an observational, retrospective, and descriptive study including patients operated for acute generalized peritonitis at the Atacora Departmental Hospital Centre, Benin, where unfortunately CTscan and intensive care unit are still not available. Most of surgical activities were performed by a general practitioner with previous surgical training (but no surgical specialization). Age, gender, cause of peritonitis, surgical procedures, and postoperative outcome were evaluated. Results. Sixty-three patients were included. %e mean age was 23.2 years and sex ratio M/F 1.5. %e mean surgical delay was 26 hours (range: 6–92 hours). An ileal typhoid perforation was found in 40 patients (63.5%), and 35 of them (87.5%) underwent a primary perforation repair without bowel resection. 73% of surgical procedures were performed by the general practitioner. Morbidity was 34.9% and mortality was 14.3%. %e average postoperative hospital stay was 12 days (range: 11–82 days). %ese results were comparable to those observed in the subgroup of patients (17 cases) operated by the general surgeons (morbidity 32.6%, mortality 13.0%, and average postoperative hospital stay 11 days, range: 1–58 days). Conclusion. Acute generalized peritonitis requires urgent management, and it can be effectively carried out, in a context of limited resources, by a general practitioner with surgical skills

Epidemiological aspects of surgical site infections in an income country. The case of regional hospital center, Borgou (Benin)

ABSTRACT Background: Surgical site infection is frustrating for the care team and depressing for the patient. Objective: To determine the epidemiological aspects of surgical site infections in regional hospital, Borgou. Methods: The study was crossed with prospective data collection. Recruitment was done for six months (from February 2013 to July 2013), each patient operated in both surgical services (general surgery and maternity) consents to be followed for one month or year. The surgical site infection was defined according to the CDC/NHSN 2009. Results: The frequency of surgical site infections was 7.3% (44/603). The mean age was 30.7 ± 15.8 years with minimum and maximum of 5 months and 70 years, respectively. They were significantly (p<0.05) more common in general surgery than that of maternity and visceral surgery and obstetrics were more concerned (14/44 each); the median time to SSI onset was 7.8 ± 3.8 days. The deep incisional infection was the most frequent (34/44). The most encountered organism was Escherichia coli (64.7%); multidrug resistance was 41.2%. The healing time averaged 30.5 ± 13.8 days with minimum and maximum of 20 and 92 days. Conclusion: Monitoring measures must be taken to reduce surgical site infection at the Regional Hospital Centre of Borgou.Background: Surgical site infection is frustrating for the care team and depressing for the patient. Objective: To determine the epidemiological aspects of surgical site infections in regional hospital, Borgou. Methods: The study was crossed with prospective data collection. Recruitment was done for six months (from February 2013 to July 2013), each patient operated in both surgical services (general surgery and maternity) consents to be followed for one month or year. The surgical site infection was defined according to the CDC/NHSN 2009. Results: The frequency of surgical site infections was 7.3% (44/603). The mean age was 30.7 ± 15.8 years with minimum and maximum of 5 months and 70 years, respectively. They were significantly (p<0.05) more common in general surgery than that of maternity and visceral surgery and obstetrics were more concerned (14/44 each); the median time to SSI onset was 7.8 ± 3.8 days. The deep incisional infection was the most frequent (34/44). The most encountered organism was Escherichia coli (64.7%); multidrug resistance was 41.2%. The healing time averaged 30.5 ± 13.8 days with minimum and maximum of 20 and 92 days. Conclusion: Monitoring measures must be taken to reduce surgical site infection at the Regional Hospital Centre of Borgou

Insuffisance Rénale Aigue Post-Opératoire Au Centre Hospitalier Universitaire Et Départemental Du Borgou : Fréquence Et Facteurs De Risques Associés

Introduction: Acute renal failure (ARF) post-operative is a specific form of acute deficiencies causing multiple declining factors. Objective: This survey aims to study the incidence and risk factors associated with acute renal failure (ARF) in post-operative surgical intensive care units to University Hospital of Borgou (UH-B): during 2015. Patients and Methods this study is a cross sectional, descriptive and analytical ones with the prospective data collection from March 1st to August 31th, 2015. The research has involved all patients admitted to the operating room for surgery and motherhood whatever reason and then transferred respectively to the intensive care areas at UH-B. The postoperative ARF has been investigated inner patients following inclusion criteria and classification according to RIFLE score. The socio-demographic, clinical and biological variables monitoring, even support and evolution are experimented. A questionnaire is designed for data collection. Data are analyzed by Epi-Info means with 5% of significance level. Results: 130 patients are registered. The mean age is 27.68 ± 12.87 years. The sex ratio is 0.66. The frequency of post-operative ARF reaches 12.31%. The associated risk factors are: hypertension (p = 0.0018), diabetes (p = 0.002), heart failure (p = 0.0104), severe sepsis (p = 0.006) hypovolemic shock (p = 0.002), ASA class ≥ 3 (p = 0.0014), preeclampsia-eclampsia (p = 0.012), the Altémier class classification ≥ 3 (p = 0.0164), a pathological urinary sediment like a proteinuria (p=0.006), haematuria (p= 0.001) and nitrituria (p=0.007). Consequently, three (03) subjects out of sixteen (16) have died (18.75%). Conclusion: The post-operative ARF is a reality in University Hospital Borgou , with a higher mortality rate. Thus, the prevention strategy is the best treatment through the screening and monitoring promotion towards risk factors

RISK FACTORS OF SURGICAL SITE INFECTION AT THE REGIONAL AND TEACHING HOSPITAL CENTER OF BORGOU (BENIN)

Introduction: The reduction of the SSI rate requires knowledge of its risk factors. Objective: To analyze the risk factors of SSI occurrence at CHD-B Methods: Prospective, descriptive and analytical study involving 603 patients undergoing general surgery (218) and obstetrics and gynecology (385) from 1st&nbsp;January to 31st&nbsp;July 2013. Results: 44 patients have developed SSI (7.3%). The SSI frequency was 12.8% in general surgery and 4.2% in gynecology-obstetrics (p significant). The mean age of patients developing SSI was 30.7 ± 15.8 years with a minimum and maximum 5 months and 70 years, respectively; and for general surgery patients, there were 23 men and 5 women (p not significant). The presence of preoperative infectious spot at admission (P = 0.003), the preoperative shaving of the site to be incised (p = 0.000), the ASA score (p = 0.000), the surgery contamination class (p = 0.000), and the NNIS score (p = 0.000) were all significantly related to SSI occurrence. Considering all these factors, the NNIS score ≥2 remained the predictive tool by multiplying by 3.4 the risk of SSI occurrence. Conclusion: NNIS score is the best SSI prediction tool at CHD-B. KEYWORDS: Surgical site infection; Risk factor; NNIS score

RISK FACTORS OF SURGICAL SITE INFECTION AT THE REGIONAL AND TEACHING HOSPITAL CENTER OF BORGOU (BENIN)

Introduction: The reduction of the SSI rate requires knowledge of its risk factors. Objective: To analyze the risk factors of SSI occurrence at CHD-B Methods: Prospective, descriptive and analytical study involving 603 patients undergoing general surgery (218) and obstetrics and gynecology (385) from 1st&nbsp;January to 31st&nbsp;July 2013. Results: 44 patients have developed SSI (7.3%). The SSI frequency was 12.8% in general surgery and 4.2% in gynecology-obstetrics (p significant). The mean age of patients developing SSI was 30.7 ± 15.8 years with a minimum and maximum 5 months and 70 years, respectively; and for general surgery patients, there were 23 men and 5 women (p not significant). The presence of preoperative infectious spot at admission (P = 0.003), the preoperative shaving of the site to be incised (p = 0.000), the ASA score (p = 0.000), the surgery contamination class (p = 0.000), and the NNIS score (p = 0.000) were all significantly related to SSI occurrence. Considering all these factors, the NNIS score ≥2 remained the predictive tool by multiplying by 3.4 the risk of SSI occurrence. Conclusion: NNIS score is the best SSI prediction tool at CHD-B. KEYWORDS: Surgical site infection; Risk factor; NNIS score

Aspects Bacteriologiques Des Infections Du Site Operatoire Au Centre Hospitalier Departemental Du Borgou A Parakou (Benin)

Objective : Describe the bacteriological aspects of surgical site infections (SSI) at the regional hospital centre Borgou. Methods : From a descriptive, prospective study from february 2013 to july 2014, about 603 patients operated during the recrutment period(six mounths), the bacteriological data of 44 cases of SSI diagnosed according to the criteria CDC/NHSN have been analysed. Results : The frequency of SSI was 7.3% of the operated (44/603). The superficial incisional infections were 6, the deep infections were 34 and the organ infections or infections of space were 4. The sampling culture of the liquid was negative with 12 cases (27.3%) and positive with 32 cases (72.7%). Two germs were isolated in two cases. The negative Gram germs were the most isolated with 22 cases (64.7%) of Escherichia coli. The multiresistance was noted with 14 cases out of 34 (41.2%). Conclusion : The negative Gram germs were those which predominate in the infections of the operating site at the regional hospital center Borgou. The high rate of resistance to usual antibiotics must raise preventive and hard actions in order to inflect the graph of frequency and protect the antibiotics

Postoperative pain management in non-traumatic emergency general surgery : WSES-GAIS-SIAARTI-AAST guidelines

Background Non-traumatic emergency general surgery involves a heterogeneous population that may present with several underlying diseases. Timeous emergency surgical treatment should be supplemented with high-quality perioperative care, ideally performed by multidisciplinary teams trained to identify and handle complex postoperative courses. Uncontrolled or poorly controlled acute postoperative pain may result in significant complications. While pain management after elective surgery has been standardized in perioperative pathways, the traditional perioperative treatment of patients undergoing emergency surgery is often a haphazard practice. The present recommended pain management guidelines are for pain management after non-traumatic emergency surgical intervention. It is meant to provide clinicians a list of indications to prescribe the optimal analgesics even in the absence of a multidisciplinary pain team. Material and methods An international expert panel discussed the different issues in subsequent rounds. Four international recognized scientific societies: World Society of Emergency Surgery (WSES), Global Alliance for Infection in Surgery (GAIS), Italian Society of Anesthesia, Analgesia Intensive Care (SIAARTI), and American Association for the Surgery of Trauma (AAST), endorsed the project and approved the final manuscript. Conclusion Dealing with acute postoperative pain in the emergency abdominal surgery setting is complex, requires special attention, and should be multidisciplinary. Several tools are available, and their combination is mandatory whenever is possible. Analgesic approach to the various situations and conditions should be patient based and tailored according to procedure, pathology, age, response, and available expertise. A better understanding of the patho-mechanisms of postoperative pain for short- and long-term outcomes is necessary to improve prophylactic and treatment strategies.Peer reviewe