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Management of Postoperative Peritonitis (POP) in a Disadvantaged Environment

Received: 18 February 2023    Accepted: 14 March 2023    Published: 24 March 2023
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Abstract

The aim of this work was to describe the management of POP in a precarious environment. It was a retrospective study of descriptive type from January 2007 to December 2012 on the records of patients with POP. Gender, age, qualification of the operating physician, time to management, initial diagnosis, type of initial surgery, treatment, prognosis were the parameters studied. We noted 32 cases of POP out of 4656 laparotomies, i.e. a frequency of 0.7%. The mean age of our patients was 37.7 years. The sex ratio was 1.3 in favor of the male sex. The majority of our patients were referred from other centers with a rate of 78%. Emergencies accounted for 84% of the initial surgical procedures. Initial diagnoses were dominated by acute appendicitis with a rate of 37.5%. Clinical signs were dominated by abdominal pain 87.5%; vomiting 53.1%; tachycardia 68.7% and fever 75%. The main causes were the release of digestive sutures. The management was multidisciplinary. We noted 41% of favorable follow-up; 9% of morbidity and 50% of death. The delay of the operative recovery, the number of visceral failures, the number of iterative and close reoperations were factors that influenced the prognosis. Post-operative peritonitis rapidly challenges the integrity of most major vital functions. Early diagnosis is the key to improving prognosis.

Published in Journal of Surgery (Volume 11, Issue 1)
DOI 10.11648/j.js.20231101.14
Page(s) 17-21
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

omplications, Postoperative, Reintervention, Surgery

References
[1] Lefèvre J. H, Parc Y. Postoperative peritonitis Encycl. Med Chir Gastroenterology 2012; 9045 A10: Xiongshuang Su, Cheng Chen, Jia Li, Shun Lu & Guihua Xu. (2022). Effect of Polypropylene Microplastics Concentration on Wastewater Denitrification. Science Journal of Chemistry (3). doi: 10.11648/J.SJC.20221003.11.
[2] Hinsdale JG, Jaffe BM. Re-operation for intra-abdominal sepsis: indications and results in modern critical care setting. Ann surg 1984; 199: 31-6.
[3] Montravers P, lepers S, Popesco D. Postoperative management. Resuscitation of intra-abdominal sepsis after surgery. Presse Med 1999; 28: 196-202.
[4] Mariette C. Principles of surgical management of postoperative peritonitis: J. Chir, Masson (Paris), 2006, 148 (2): 84-87.
[5] Butler JA, Huang J, Wilson SE. Repeated laparotomy for postoperativeintra-abdominal sepsis: an analysis of outcome predictors. Arch Surg 1987; 22: 702-6.
[6] Pacelli F, Doglietto GB, Alfieri S, Piccioni E, Sgadari A, Gui D et al. Prognosis in intra-abdominal infections: multivariate analysis on 604 patients. Arch Surg 1996; 131: 641-5.
[7] Sartelli M1, Griffiths EA2, Nestori M3. The challenge of post-operative peritonitis after gastrointestinal surgery. Updates Surg. 2015; 67 (4): 373-81. doi: 10.1007/s13304-015-0324-1. Epub 2015 Aug 12.
[8] Touré AO, Cissé M, Ka I, Dieng M, Konaté I, Ka O et al. Diffuse post-operative intra-abdominal sepsis: epidemiological, diagnostic and therapeutic aspects at the General Surgery Service of the University Hospital Aristide Le Dantec in Dakar. Pan Afr Med J. 2014 Mar 15; 17: 204. doi: 10.11604/pamj.2014.17.204.311.
[9] Coulibaly B, Togola B, Traoré D, Coulibaly M, Diallo S et al. Postoperative peritonitis in department of surgery B at hospital du Point G. Mali medical 2013 tome XXVIII N°3.
[10] Bader FG, Schröder M, Kujath P, Muhl E, Bruch HP, Eckmann C. Diffuse postoperative peritonitis -- value of diagnostic parameters and impact of early indication for relaparotomy. Eur J Med Res. 2009 Nov 3; 14 (11): 491-6. doi: 10.1186/2047-783x-14-11-491. PMID: 19948445; PMCID: PMC3352290.
[11] Marzougui Y, Missaoui K, Hannachi Z, Dhibi Y, Kouka J, Dziri C et al. Postoperative peritonitis: pronostic factors of mortality. Arch Inst Pasteur Tunis. 2014; 91 (1-4): 67-76. French. PMID: 26485772.
[12] Cissé M, Touré FB, Konaté I, Ka O, Dieng M, Dia A et al. Management of postoperative peritonitis in the Surgical Clinic of Aristide le Dantec Hospital, about 15 cases. Dakar Médical 2008; 53: 260-6.
[13] Mohd. Salman Aquib, Ganesh Ashok Swami. Study of abdominal sepsis in post-operative period after emergency abdominal surgery. MedPulse International Journal of Medicine. May 2021; 18 (2): 54-58. https://www.medpulse.in/Medicine/
[14] Tonye TA, Essi MJ, Handy E D, Ankouane A, Minka Ngom E, Ngo Nonga B et al. Early post-operative complications in Yaounde district hospitals: Epidemiological and clinical features. Health Sci. Dis: Vol 16 (1) January – February - March 2015.
[15] Mignonsin. D, Kane. M, Coffi. S, Bondurand. A, N'goui. N. Postoperative peritonitis: diagnosis, treatment, and prognosis about 68 cases. Médecine d'Afrique Noire 1990, 37 (7): 397-401.
[16] Hssaida R, Daali M, Seddiki R, Zoubir M, Elguelaa K, Boughalem M. Postoperative peritonitis in the elderly. Médecine du Maghreb 2000; 81: 20-2.
[17] Hecker, A., Reichert, M., Reuß, C. J. et al. Intra-abdominal sepsis: new definitions and current clinical standards. Langenbecks Arch Surg 404, 257–271 (2019). https://doi.org/10.1007/s00423-019-01752-7.
[18] Alzerwi, Nasser A N. "Diagnostic challenges in postoperative intra-abdominal sepsis in critically ill patients: When to reoperate?" Postępy Higieny i Medycyny Doświadczalnej, vol. 76, no. 1, 2022, pp. 420-430. https://doi.org/10.2478/ahem-2022-0032
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  • APA Style

    Fode Baba Toure, Fode Ibrahima Kourala Keita, Mamadouba Camara. (2023). Management of Postoperative Peritonitis (POP) in a Disadvantaged Environment. Journal of Surgery, 11(1), 17-21. https://doi.org/10.11648/j.js.20231101.14

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    ACS Style

    Fode Baba Toure; Fode Ibrahima Kourala Keita; Mamadouba Camara. Management of Postoperative Peritonitis (POP) in a Disadvantaged Environment. J. Surg. 2023, 11(1), 17-21. doi: 10.11648/j.js.20231101.14

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    AMA Style

    Fode Baba Toure, Fode Ibrahima Kourala Keita, Mamadouba Camara. Management of Postoperative Peritonitis (POP) in a Disadvantaged Environment. J Surg. 2023;11(1):17-21. doi: 10.11648/j.js.20231101.14

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  • @article{10.11648/j.js.20231101.14,
      author = {Fode Baba Toure and Fode Ibrahima Kourala Keita and Mamadouba Camara},
      title = {Management of Postoperative Peritonitis (POP) in a Disadvantaged Environment},
      journal = {Journal of Surgery},
      volume = {11},
      number = {1},
      pages = {17-21},
      doi = {10.11648/j.js.20231101.14},
      url = {https://doi.org/10.11648/j.js.20231101.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20231101.14},
      abstract = {The aim of this work was to describe the management of POP in a precarious environment. It was a retrospective study of descriptive type from January 2007 to December 2012 on the records of patients with POP. Gender, age, qualification of the operating physician, time to management, initial diagnosis, type of initial surgery, treatment, prognosis were the parameters studied. We noted 32 cases of POP out of 4656 laparotomies, i.e. a frequency of 0.7%. The mean age of our patients was 37.7 years. The sex ratio was 1.3 in favor of the male sex. The majority of our patients were referred from other centers with a rate of 78%. Emergencies accounted for 84% of the initial surgical procedures. Initial diagnoses were dominated by acute appendicitis with a rate of 37.5%. Clinical signs were dominated by abdominal pain 87.5%; vomiting 53.1%; tachycardia 68.7% and fever 75%. The main causes were the release of digestive sutures. The management was multidisciplinary. We noted 41% of favorable follow-up; 9% of morbidity and 50% of death. The delay of the operative recovery, the number of visceral failures, the number of iterative and close reoperations were factors that influenced the prognosis. Post-operative peritonitis rapidly challenges the integrity of most major vital functions. Early diagnosis is the key to improving prognosis.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Management of Postoperative Peritonitis (POP) in a Disadvantaged Environment
    AU  - Fode Baba Toure
    AU  - Fode Ibrahima Kourala Keita
    AU  - Mamadouba Camara
    Y1  - 2023/03/24
    PY  - 2023
    N1  - https://doi.org/10.11648/j.js.20231101.14
    DO  - 10.11648/j.js.20231101.14
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 17
    EP  - 21
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20231101.14
    AB  - The aim of this work was to describe the management of POP in a precarious environment. It was a retrospective study of descriptive type from January 2007 to December 2012 on the records of patients with POP. Gender, age, qualification of the operating physician, time to management, initial diagnosis, type of initial surgery, treatment, prognosis were the parameters studied. We noted 32 cases of POP out of 4656 laparotomies, i.e. a frequency of 0.7%. The mean age of our patients was 37.7 years. The sex ratio was 1.3 in favor of the male sex. The majority of our patients were referred from other centers with a rate of 78%. Emergencies accounted for 84% of the initial surgical procedures. Initial diagnoses were dominated by acute appendicitis with a rate of 37.5%. Clinical signs were dominated by abdominal pain 87.5%; vomiting 53.1%; tachycardia 68.7% and fever 75%. The main causes were the release of digestive sutures. The management was multidisciplinary. We noted 41% of favorable follow-up; 9% of morbidity and 50% of death. The delay of the operative recovery, the number of visceral failures, the number of iterative and close reoperations were factors that influenced the prognosis. Post-operative peritonitis rapidly challenges the integrity of most major vital functions. Early diagnosis is the key to improving prognosis.
    VL  - 11
    IS  - 1
    ER  - 

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Author Information
  • Faculty of Health Sciences and Techniques, University of Gamal Abdel Nasser, Conakry, Guinea

  • Faculty of Health Sciences and Techniques, University of Gamal Abdel Nasser, Conakry, Guinea

  • Faculty of Health Sciences and Techniques, University of Gamal Abdel Nasser, Conakry, Guinea

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