Abstract
OBJECTIVE: to describe the diagnostic and therapeutic aspects of acute intestinal obstruction in the general surgery department of the Sino-Central African Friendship University Hospital in Bangui PATIENTS AND METHOD: This is a descriptive retrospective study over 5 years (2015-2019). The records of patients operated on for acute intestinal obstruction were used as well as hospitalization registers and operating reports.
RESULTS: Acute bowel obstruction accounted for 9.4% (n=150) of abdominal surgical emergencies (n=1598). The number of patients included 98 men (65.3%) and 52 women (34.7%). The mean age was 45.52 years (standard deviation ± 14.6). 51.3% of patients had a history of surgery (n=77) including appendectomy (n=58). The average consultation time was 28.7 hours. The functional signs consisted of abdominal pain (76.7%), cessation of matter and gas (68.0%) and vomiting (94%). The patients were asthenic (32.6%) and had abdominal meteorism (98.6%) associated with abdominal defense (83.3%). The radiological signs were diffuse opacity (41.3%), pneumoperitoneum (30%) or fluid levels (28.7%). At laparotomy, the obstacle was located on the colon (82.6%) and the intestine (17.3%). The main causes of obstruction were bridles and adhesions (52%), colon tumors (21.3%),
intestinal necrosis (13.3%). The procedures performed were adhesiolysis to cut intestinal adhesions and bridles (37%). Colectomy was performed for colon tumors (29%), and resected necrotic loops followed by anastomosis (20%). The average stay was 13 days. Overall mortality was 14% (n=21).
CONCLUSION: Acute intestinal obstruction affects young adults with a male predominance. The obstacle sits mainly on the colon. Postoperative bridles and adhesions represent the main cause with high mortality. Management must be earlyby a multidisciplinary team.
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