Acute Genital Peritonitis in Brazzaville, Congo — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
Acute Genital Peritonitis in Brazzaville, Congo
Digestive Surgery Department, Brazzaville University Hospital, Brazzaville, Congo
,
Gynecology-Obstetrics Department, Brazzaville University Hospital, Brazzaville, Congo
,
Digestive Surgery Department, Brazzaville University Hospital, Brazzaville, Congo
,
Digestive Surgery Department, Brazzaville University Hospital, Brazzaville, Congo
,
Gynecology-Obstetrics Department, Brazzaville University Hospital, Brazzaville, Congo
,
Laboratory of Numerical Analysis, Computer Science and Applications (LANIA), Faculty of Sciences and Technology, Marien Ngouabi University, Brazzaville, Congo
1 Digestive Surgery Department, Brazzaville University Hospital, Brazzaville, Congo
2 Gynecology-Obstetrics Department, Brazzaville University Hospital, Brazzaville, Congo
3 Digestive Surgery Department, Brazzaville University Hospital, Brazzaville, Congo
4 Digestive Surgery Department, Brazzaville University Hospital, Brazzaville, Congo
5 Gynecology-Obstetrics Department, Brazzaville University Hospital, Brazzaville, Congo
6 Laboratory of Numerical Analysis, Computer Science and Applications (LANIA), Faculty of Sciences and Technology, Marien Ngouabi University, Brazzaville, Congo
Genital peritonitis is rare in daily surgical practice in Congo-Brazzaville. Clandestine abortions are incriminated. The purpose of the study is to analyze the epidemiological, etiological, diagnostic and therapeutic aspects of genital peritonitis. A retrospective and case series study was realized in departments of Digestive Surgery and Gynecology-Obstetrics of the University Hospital of Brazzaville. The inclusion criteria for the diagnosis of peritonitis were abdominal pain, fever, transit disturbances and signs of peritoneal irritation. The parameters studied were: age, etiological circumstances, anatomical lesions, type of surgical treatment and evolution. During the study period ( July 1, 2015-December 31, 2017) , 306 patients were admitted to both departments for acute generalized peritonitis. Among them, a genital cause was incriminated in 18 (5.9%) patients. The mean age was 27.6 ± 3.1 years. At the parity and gestational level, 93% of patients had at least two pregnancies, but not more than the second trimester. In addition, 50% of the patients had an induced miscarriage, due to uterine and intestinal lesions. Induced miscarr iages accounted for half of etiological circumstances. Physical examination of the abdomen revealed abdominal contracture in 61.1% of cases. Main visceral lesions were uterine perforation (55.5%) followed by rupture of tubo-ovaria n abscess (38.9%). The operative follow-up was simple in 83.33% of cases. In conclusion, genital peritonitis remains unfrequented. Median laparotomy has been the main therapeutic approach in our context where emergency laparoscopic surgery is not yet common.
KeywordsPeritonitisAbortionUterine Perforation
Aubert, F. and Guittart, P. (1995) Essentiel médical de poche. 2nd Edition, Editions Marketing/Ellipse, Paris.
Ross, J.T., Matthay, M.A. and Harris, H.W. (2018) Secondary Peritonitis: Principles of Diagnosis and Intervention. BMJ, 361, k1407. https://doi.org/10.1136/bmj.k1407
Calandra, T. and Cohen, J. (2005) International Sepsis Forum Definition of Infection in the ICU Consensus Conference. The International Sepsis Forum Consensus Conference on Definitions of Infection in the Intensive Care Unit. Critical Care Medicine, 33, 1538-1548. https://doi.org/10.1097/01.CCM.0000168253.91200.83
Dogra, Y. and Pal, A. (2017) Spontaneous Bacterial Peritonitis during Pregnancy: A Rare Occurrence. Journal of Gynecology and Women’s Health, 3, Article ID: 555611. https://doi.org/10.19080/JGWH.2017.03.555611
Le Treut, Y.P. and Houssin, D. (1991) Pathologie Chirurgicale. In: Fagniez, P.L. and Houssin, D., Eds., Chirurgie digestive et thoracique, Tome 2, éditions Masson, Paris Milan Barcelone, 337-342.
Mohsine, R., Ismael, F., Lekhal, B., El Faricha, E.H., Errougham, A., Chkoffi, M.R., et al. (1996) Péritonite et grossesse. Médecine du Maghreb, 7, 27-29.
Falindes, A. and Hardy, E. (1997) Illegal Abortion: Consequences for Women’s Health and the Health Care System. International Journal of Gynecology & Obstetrics, 58, 77-83. https://doi.org/10.1016/S0020-7292(97)02860-9
Sokal, R.F. and Rolhf, S.W. (1995) Biometry. 7th Edition, Freeman and Co., San Francisco.
Harouna, Y.D., Abdou, I., Saidou, B. and Bazira, L. (2001) Les péritonites en milieu tropical: Particularités étiologiques et facteurs pronostiques actuels. A propos de 160 cas. Médecine d’Afrique Noire, 48, 103-106.
Ouangre, E., Zida, M., Bonkoungou, P.O., Sanou, A. and Traoré, S.S. (2013) Les péritonites aigues généralisées en milieu rural au Burkina Faso: A propos de 221 cas. Revue CAMES, 1, 75-79.
Kanté, L., Diakité, I., Togo, A., Dembélé, B.T., Traoré, A., Maiga, A., Samaké, H., Kéita, M., Traoré, I. and Diallo, O. (2013) Péritonites aigues généralisées à l’Hopital Sominé Dolo de Mopti: Aspects épidémiologique et thérapeutique. Mali Médical, 28, 20-23.
Ngo Nonga, B., Mouafo Tambo, F.F., Ngowe Ngowe, M., Takongmo, S. and Sosso, M.A. (2010) Etiologies des péritonites aigues généralisées au CHU de Yaoundé. Revue Africaine de Chirurgie et Spécialités, 4, 30-32. https://doi.org/10.4314/racs.v4i7.66378
Iloki, L.H., Zakouloulou-Massala and Gbala-Sapoulou, M.V. (1997) Complications des avortements clandestins: A propos de 221 cas observés au CHU de Brazzaville (Congo). Médecine d’Afrique Noire, 44, 262-264.
Ibrahim, K.A., Papa Saloum, D., Amalou Bocar, N., Aliou Coly, F., Ndyaye, J.M. and Babacar, F. (2016) Péritonite aigue généralisée par perforation utérine post-abortum à propos d’une observation. Pan African Medical Journal, 24, 98-101. https://doi.org/10.11604/pamj.2016.24.98.9307
Takongmo, S., Bimam, F., Simeu, C.H., Ngassa, P., Kouam, L. and Mulngu, E. (2000) Aspect thérapeutique des péritonites génitales au CHU de Yaoundé. Medecine d’Afrique Noire, 47,19-21.
Coffman, C. (2001) Bowel Injury as a Complication of Induced Abortion: A Case Report and Literature Review. The American Surgeon, 67, 924-926.
Jhobta, R.S., Attri, A.K. and Jhobta, A. (2007) Bowel Injury Following Induced Abortion. International Journal of Gynecology & Obstetrics, 96, 24-26. https://doi.org/10.1016/j.ijgo.2006.07.010
Hilal, G.F., Thiam, L.P., Ndiaye, P.I. and Diouf, El. (2014) Une complication grave des avortements provoqués clandestins: Le choc septique secondaire à une péritonite par perforation caecale avec rétention d’instruments. RAMUR, 19, 88-92.
Kambiss, S.M., Hibbert, M.L., Macedonia, C. and Potter, M.E. (2000) Uterine Perforation Resulting in Bowel Infarction: Sharp Traumatic Bowel and Mesenteric Injury at the Time of Pregnancy Termination. Military Medicine, 165, 81-82. https://doi.org/10.1093/milmed/165.1.81
Oludiran, O.O. and Okonofua, F.E. (2003) Morbidity and Mortality from Bowel Injury Secondary to Induced Abortion. African Journal of Reproductive Health, 7, 7-12. https://doi.org/10.2307/3583290
Lebeau, R., Guié, P., Bohoussou, é., Akpa-Bédi, é.S.A., Loukou, Y., Kouassi, J.C. and Anongba, S. (2013) Une complication rare mais grave des avortements provoqués clandestins: L’évisceration iléale per vaginum. Gynécologie Obstétrique & Fertilité, 41, 193-195. https://doi.org/10.1016/j.gyobfe.2011.11.001
Wright, H.K., Dun, D., Mac Arthur, J.D. and Pelucia, O. (1982) Specific Bit Limited Role of New Imaginy Techniques in Decision Making about Intra-Abdomonal Abcesses. The American Journal of Surgery, 143, 456-459. https://doi.org/10.1016/0002-9610(82)90195-7
Aulagner, G., Foumier, B., Prudhomme, B., et al. (1981) Perforation utérine et sigmoidienne après interruption volontaire de grossesse par aspiration. Journal de Chirurgie, 118, 339-341.
Bourgoin, A., Leone, M. and Martin, C. (2004) Prise en charge thérapeutique des péritonites. Médecine et Maladies Infectieuses, 34, 183-195. https://doi.org/10.1016/j.medmal.2004.03.002
Savoie, P.H., Peycru, T., Mingoutaud, L.A., Sow, N., Biance, G., Pauleau, L., Garcia, P. and Farthoua, T. (2011) Péritonites primitives en Afrique subsaharienne: A propos de 15 cas. Annals of African Medicine, 5, 213-219.
Strauss, E. and Cal, Y.W.R. (2006) Spontaneous Bacterial Peritonitis: A Therapeutic Update. Expert Review of Anti-Infective Therapy, 4, 249-260. https://doi.org/10.1586/14787210.4.2.249
Sheerta, L. and Runyonba, B. (2005) Spontaneous Bacterial Peritonitis. Digestive Diseases, 23, 39-46. https://doi.org/10.1159/000084724
Caruntufa, H. and Bene, A.L. (2006) Spontaneous Bacterial Peritonitis: Pathogenesis, Diagnosis, Treatment. Journal of Gastrointestinal and Liver Diseases, 15, 516.