Epidemiology, diagnostic and management of abdominal trauma in two hospitals in the city of Douala, Cameroon
Keywords:Abdominal trauma, Epidemiology, Diagnostic, management, Cameroon
Background: Abdominal trauma remains quite common in the general world and in developing countries in particular. The accidents in the public roads are the main cause and also the assumption of responsibility which remains questionable.
Methods: It was a descriptive longitudinal study, carried out from 31 December 2018 to 19 April 2019, in Laquintinie and General hospital in Douala, Cameroon. Patients admitted for abdominal trauma and treatment in the emergency department, operating theater and visceral surgery were included in the study.
Results: We found 21.2% (43 cases) of abdominal trauma in our series. Abdominal trauma mainly affected adults between 20 and 39 years old (27 cases, 63%) in our series. The male sex was most affected, with sex ration of 3.3. Road accidents occupy the first place with 34.9% (15 cases). Wounds in our series represented 27.9% (12 cases) and contusions 72.1% (31 cases). In fact, Abdomen without preparation was performed in 7.0% (3 cases) of cases, abdominal ultrasound in 48.8% (21 cases) and abdominal CT scan in 25.6% of patients (11 cases). The organs affected in order were the spleen, small intestine, colon, stomach and liver. We recorded postoperative complications with a morbidity of 11.6% with a single case of parietal suppuration and no death.
Conclusions: In our context abdominal trauma remains quite frequent and concern particularly young people. The prevention of accidents on the public highway and the improvement of diagnostic and surveillance methods are the key for reducing this phenomenon leading to good management.
Isenhour JL, Marx J. Advances in abdominal trauma. Emerg Med Clin North Am. 2007;25(3):713-33.
Sambo TB, Hodonou MA, Allode SA, Mensah E, Youssouf M, Menhinto D. Aspects Epidemiologiques, Diagnostiques Et Therapeutiques Des Traumatismes Abdominaux À Bembéréké-Nord Bénin. European Scientific J. 2016;12(9):395-405.
Fakhry SM, Brownstein M, Watts DD, Baker CC, Oller D. Relatively short diagnostic delays (<8 hours) produce morbidity and mortality in blunt small bowel injury: an analysis of time to operative intervention in 198 patients from a multicenter experience. J Trauma. 2000;48(3):408-14.
Kambire JL, Ouedraogo S, Zida M, Ouedraogo S, Sanon BG. Abdominal Trauma: Epidemiological and lesional Aspects at the Regional Teaching Hospital Center of Ouahigouya, Burkina Faso. Rev Int Sci Med RISM. 2018;20(1):71-5.
Vivien B, Langeron O, Riou B. Closed abdomen trauma. National Congress of Anesthesia and Resuscitation. 2007;433-43.
Peitzman AB, Heil B, Rivera L, Federle MB, Harbrecht BG, Clancy KD, et al. Blunt splenic injury in adults: Multi-institutional Study of the Eastern Association for the Surgery of Trauma. J Trauma. 2000;49(2):177-87.
Chalya PL, Mabula JB. Abdominal trauma experience over a two-year period at a tertiary hospital in north-western Tanzania: a prospective review of 396 cases. Tanzan J Health Res. 2013;15(4):230-9.
Alastair CJ, Pierre JG. Abdominal trauma. In: John M, Graeme D, Kevin OM, eds. Surgical Emergencies. 1st ed. Italy: Blackwell Science; 1999: 224-236.
Arnaud JP, Turbelin JM. Acute abdominal pain: What investigations. EM Consolute. 1982;10:3.
Dembele B. Digestive surgical emergencies at the Kayes Regional Hospital (Mali) about 112 cases. Thesis Med Bamako. 2005;61:234.
Ibrahima G, Pape AL, Mamadou MT, Pape IN, Elhadji B, Mamadou DB. Pre-operative management of surgical emergencies. Pan Afr Med J. 2016;24:190.
Harouna Y, Ali L, Seibou A, Abdou I, Gamatie Y, Rakotomalala J. Two years of emergency digestive surgery at the national hospital. Med African Noire. 2009;48(2):50-4.
Lakhoo K, Bass D, Cywes S. Blunt splenic trauma in children. S Afr J Surg 2000;29(3):108-9.
Bordon LM Penetrating abdominal spear injuries. Centr Afr J Med. 1992;38(4):155-61.
Karim A. Activity report of digestive surgical emergencies at the prefectural hospital of Inezgane over 2 years 2014-2015. Faculty Med. 2017.
Ntundu HS, Herman MA, Kishe A, Babu H, Jahanpour FO, Msuya D, et al. BMC Surg. 2017; 19:69.
Menyar A, Abdelrahman H, Thani H, Zarour A, Parchani A, Peralta R, et al. Compartmental anatomical classification of traumatic abdominal injuries from the academic point of view and its potential clinical implication. J Trauma Manag Outcomes. 2014;8:14.
Gad MA, Saber A, Farrag S, Shams ME, Ellabban GM. Incidence, Pattern, and Factors Predicting Mortality of Abdominal Injuries in Trauma Patients N AMJ Med Sci. 2012;4(3):129-34.
Raherinantenaina F, Rakotomena SD, Rajaonarivony T et al. Blunt and penetrating trauma to the abdomen: retrospective analysis of 175 cases and review of the literature. Pan African Med J. 2015;20:129.
Idriss AM, Tfeil Y, Baba JS, Boukhary SM, Hamad B, Abdllatif M, et al. Abdominal trauma: five years’experience in National Centre Hospital, Mauritania. Open J Emerg Med. 2018;6(1):6.
Gaudeuille A, Doui DA, Ndemanga KJ, Sacko E, Nali NM. Abdominal trauma in Bangui (Central africa). Epidemiologic and et anatomical aspects. Mali Med. 2007;22(2):19-22.
Mnguni MN, Muckart DJ, Madiba TE. Abdominal trauma in Durban, South Africa: factors influencing outcome. Int Surg. 2012;97(2):161-8.
Ba SS. Traumatic perforations of the colon- Aspects at CHU. Beep. 2012;127:120.
Sani R, Ngo Bissemb NM, Illo A. Epidemiological, Diagnostic And Therapeutic Aspects national de Niamey-Niger. Med Afr Noire. 2004;51(7):399-402.
Sanou ML. Primary peritonitis- 57 caes. Anne University. 2008.
Diabate A. Traumatisme abdomen at hospital Somine Dolo. Anne University. 2002.