Research Article
Volume 8 Issue 11 - 2021
Non-Traumatic Gastro-Intestinal Perforations in Bujumbura. About 141 Cases

Jean Claude Mbonicura1,2*, Clovis Paulin Baramburiye1,2, Thierry Sibomana3, Jean Paul Mugisha1, Merlin Kazobavamwo1, Stanislas Harakandi4 and Come Moibeni Amani5

1Department of General Surgery, University of Burundi, Kamenge University Teaching Hospital, Bujumbura, Burundi
2General Surgery, College of Surgeons of Eastern Central and Southern Africa, Bujumbura, Burundi
3Department of Internal Medicine, Pulmonology Unit, University of Burundi, Kamenge University Teaching Hospital, Bujumbura, Burundi
4Department of Anesthesia and Reanimation, University of Burundi, Kamenge University Teaching Hospital, Bujumbura, Burundi
5Department of Internal Medicine, Gastro-Enterology Unit, University of Burundi, Kamenge University Teaching Hospital, Bujumbura, Burundi
*Corresponding Author: : Jean Claude Mbonicura, Department of General Surgery, University of Burundi, Kamenge University Teaching Hospital, Bujumbura, Burundi.
Received: September 14, 2021; Published: October 28, 2021




Abstract

Aim: The aim of our study was to determine etiologic, therapeutic and prognostic aspects of non-traumatic Gastro-Intestinal (GI) perforations in the three main hospitals of Bujumbura.

Patients and Methods: It was a retrospective and descriptive study carried out in the departments of General surgery of the Kamenge University Teaching Hospital, Kamenge Military Hospital and Prince Regent Charles Hospital for a 2 years period between September 1st, 2018 to August 31st, 2020. We have included all the cases of non-traumatic perforations of the GI tract diagnosed and operated during the period of the study. A total of 141 cases have met the criteria and been included.

Results: Non traumatic GI perforations represented 10.6% of all abdominal emergencies. The male gender was represented at 71.63% with a sex-ratio of 2.52. and the mean age was 33.37 years. The chief complaint was abdominal pain in 96.45% and physical signs were dominated by abdominal tenderness in 87.94% of the cases. Abdominal X-ray was the most performed imaging examination and revealed a pneumoperitoneum in 51.31% of the cases. The time between symptoms onset and surgery was superior to 48h in 80% of the patients. Pre-operatory resuscitation was dominated by the sole administration of analgesics in 73.75%. The approach that was used for surgery was an extended midline laparotomy in 82.98%. Upon perioperative exploration, the perforated gastroduodenal peptic ulcer was the main etiology in 41.13% followed by appendicular perforation in 30.49% and small bowel perforation in 10.63% of the cases. Excision and suture were the most performed procedures in 48.22% of the patients followed by appendectomy in 30.49% and anastomosis after a segmental resection in 13.47%. The of the hospital stay duration was 13.1 days and the mortality rate averaged 14.18%.

Conclusion: Non-traumatic GI perforations are attached to a high mortality and morbidity which are highly linked to factors such as delayed consult and management which are mainly encountered in low resource areas. Perforated gastroduodenal ulcers and appendicitis are the main etiologies and can be avoided as well when managed in time and appropriately. The age, the perforated organ and the surgical procedure are also well reported factors determining the outcome of the pathology.

Keywords: GI Perforation; Peritonitis

References

  1. Domart A and Bourneuf J. “Petit Larousse de médecine”. Dictionnaire 6145 (2002): 580.
  2. Makeieff M and Barazer M. “Perforations oesophagiennes. Editions techniques”. Encycl Méd Chir Paris-Fr.Gastro-Enterol (1994): 203-210.
  3. Hakizimana M. “Morbi-mortalité post-opératoire de la péritonite sur perforation non traumatique d’un viscère creux au CHUK et à l’HPRC”. Thèse de Med. Bujumbura (2014).
  4. Ngo Nonga B., et al. “Etiologies des péritonites aigues généralisées au CHU de Yaoundé”. Revue Africaine de Chirurgie et Spécialités7 (2010): 30‑32.
  5. Sanogo ZZ., et al. “Perforations digestives au CHU du Point G”. Mali Méd1 (2012): 19-22.
  6. Coulibaly M., et al. “Perforation digestive non traumatique à Koutiala: aspects épidemio-cliniques et thérapeutiques”. Mali Med4 (2019): 7-11.
  7. Harouna YD., et al. “Les péritonites en milieu tropical. Particularités étiologiques et facteurs pronostiques actuels”. Médecine D’Afrique Noire 7 (2001): 4.
  8. Ciza OD. “Les péritonites aigues dans les deux grands hôpitaux de Bujumbura: Etude prospective sur 18 mois à propos de 67 cas”. Thèse de Méd. Bujumbura (2005).
  9. Mulari K and Leppäniemi A. “Severe secondary peritonitis following gastrointestinal tract perforation”. Scandinavian Journal of Surgery 93 (2004): 204-208.
  10. Harissou A., et al. “Retard diagnostique et implication pronostique en milieu africain. Cas des urgences en chirurgie digestive à l’hôpital national de Zinder”. Niger 5 (2015): 12.
  11. Doumgba D., et al. “Aspects diagnostiques et thérapeutiques des péritonites aigues généralisées à propos de 214 cas à Bangui”. Revue Africaine de Chirurgie et Spécialités, Centrafrique8 (2015): 2-11.
  12. Dieng M., et al. “Etiology and therapeutic aspects of generalized acute peritonitis of digestive origin. a survey of 207 cases operated in five years”. Mali4 (2006): 47-51.
  13. Camara B. “La péritonite par perforation appendiculaire”. Thèse de Méd. Bamako (2008).
  14. Kassegne I. “Management of generalized peritonitis in Kara teaching hospital”. Revue Africaine d’Anesthésiologie et de Médecine d’urgence, Togo 9 (2013): 22.
  15. Rasoamalala ME. “Péritonite aigue par perforation d’organe creux au CHU Tambohobe Fianarantsoa”. Thèse de Méd. Antananarivo (2017).
  16. Gupta S and Kaushik R. “Peritonitis-The Eastern experience”. Department of Surgery Government Medical College and Hospital Chandigarh, India (2006).
  17. Kambiré JL., et al. “Étiologies et pronostic des péritonites secondaires au centre hospitalier universitaire de Bobo-Dioulasso (Burkina Faso)”. Journal Africain d'Hépato-Gastroentérologie 11 (2017): 149-151.
Citation: Jean Claude Mbonicura., et al. “Non-Traumatic Gastro-Intestinal Perforations in Bujumbura. About 141 Cases”. EC Gastroenterology and Digestive System 8.11 (2021): 80-83.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


December Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 20, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.