Diagnosis and Treatment of Acute Peritonitis in Douala (Cameroon)
Author(s): Jean Paul Engbang, Basile Essola, Reine Motah Koundo, Ambroise Ntama, Matthieu Motah, Marcelin Ngowe Ngowe.
Introduction: Acute peritonitis defined as inflammation or infection of the peritoneal serosa. Most often found in young male adults. The diagnosis is clinical and paraclinical. The management consists of medical resuscitation and the surgery itself. Our study aimed to study the epidemiological, diagnostic and therapeutic aspects in five hospitals in the city of Douala.
Patients and methods: A descriptive study was conducted from January 2015 to May 2020, including patients of all ages and both sexes who presented with acute peritonitis in any clinical form, and who underwent surgery within one of our hospitals We collected patients’ parameters through a survey, from complete history to clinical examination, then followed them up from surgery to post-operative period. Gathered information was analyzed by stata15 (Statistical and Data).
Results: At the end of our study 400 patients were included for acute peritonitis, among 35 in prospective and 365 in retrospective. Acute peritonitis represented the second digestive surgical emergency with 28% of all surgical emergencies. Our target population included 76% (n = 304) of men against 24% (n = 96) of women, observing a sex-ratio of 3.16. The mean age of the patients was 37 ± 13 years, with extreme values of 17years and 70 years. Etiologically, leading pathologies were digestive peritonitis (77%, 308 cases), genital peritonitis (10%), Post operatory peritonitis (8.25%) and post traumatic peritonitis obstruction (4, 75%). Most patients underwent surgery within 3-4 hours, and were routinely given intravenous fluids (normal saline, lactated ringers, dextrose), analgesia, and antibiotics before and after surgery. Laparotomy was the primary method used, and laparoscopy (3%) was dedicated to appendicular perforated peritonitis.
Conclusion: Acute peritonitis represents the second most frequent visceral surgical emergency (28%) after acute appendicitis in Douala. It’s mainly affects young adult males. The care combines preoperative, surgery, and postoperative treatment.