Prise En Charge Des Plaies PÃ©nÃ©trantes De Lâ€™abdomen Ã€ Lâ€™hÃ´pital National De Niamey
Authors: Y Hama , AA Mohamed , I Kadi , Didier L, James , R Sani 
Published: January 2021

Objectif : rapporter les rÃ©sultats de la prise en charge des plaies pÃ©nÃ©trantes de lâ€™abdomen Ã  lâ€™hÃ´pital national de Niamey au Niger. Patients et mÃ©thodes : il sâ€™agissait dâ€™une Ã©tude rÃ©trospective et descriptive sur une pÃ©riode de 2 ans. Lâ€™Ã©tude a concernÃ© tous les patients de tout Ã¢ge pris en charge Ã  lâ€™hÃ´pital national de Niamey pour plaie pÃ©nÃ©trantes de lâ€™abdomen. RÃ©sultats : lâ€™Ã©tude incluait 51 patients, soit 0,88% des traumatismes. Il sâ€™agissait de 6 femmes et 45 hommes, soit un sex ratio de 7,5. Lâ€™Ã¢ge moyen des patients Ã©tait de 28 ans [Â±10,2]. Le dÃ©lai moyen dâ€™admission Ã©tait de 4,86 heures [Â±2,08]. Dans 84,32% des cas les patients Ã©taient transportÃ©s Ã  lâ€™hÃ´pital dans un vÃ©hicule non mÃ©dicalisÃ©. Les agressions reprÃ©sentaient 78,44% des circonstances de survenue et la plaie abdominale sâ€™intÃ©grait dans un contexte de polytraumatisme chez 21,53% des patients. Une Ã©viscÃ©ration Ã©tait prÃ©sente chez 31,37% des patients. Le traitement Ã©tait opÃ©ratoire chez 90,19% des patients avec 19,56% de laparotomie non thÃ©rapeutique. Lâ€™organe le plus lÃ©sÃ© Ã©tait lâ€™intestin grÃªle dans 31,37% des cas suivi du colon dans 23,52% des cas. La morbiditÃ© globale Ã©tait de 33,37% dominÃ©e par les hÃ©morragies postopÃ©ratoires dans 8,69% des cas. La mortalitÃ© Ã©tait de 13,73% avec 50,14% de dÃ©cÃ¨s en postopÃ©ratoire immÃ©diat par hÃ©morragie secondaire ; 28,58% de dÃ©cÃ¨s par retard de lâ€™hÃ©mostase chirurgicale et 14,28% de dÃ©cÃ¨s par dÃ©faut de compensation des pertes sanguines en urgence.Conclusion : les plaies de lâ€™abdomen sont frÃ©quentes chez lâ€™adulte jeune de sexe masculin. Elles sont souvent dues Ã  une agression par armes blanches avec un taux Ã©levÃ© de dÃ©cÃ¨s.
Objective: to report the results of the management of the penetrating abdominal wounds at the national hospital of Niamey. Patients and method: it was a retrospective and descriptive study over 2 years. The study included the patients of all ages managed for penetrating abdominal wounds at national hospital of Niamey in Niger. Results: the study includes 51 patients whether 0.88 % of trauma. They were 45 men and 6 women, with a sex ratio of 7.5. The average age was 28 [Â±10.2] years old. The average intake time was 4.86 [2.08] hours. In 84. 32% of cases, patients were transported to the hospital in non-medical vehicle. The assault accounted for 78.44% of the circumstances of the occurrence and the penetrating abdominal wound was integrated into a polytrauma in 21.53% of cases. An evisceration was present in 31.37 % of cases. The management was operative in 90.19% of cases with 19.56% of non-therapeutic laparotomy. The most injured organ was the small intestine in 31.37% of cases followed by the colon in 23.52% of cases. The overall morbidity was 33.37%, dominated by postoperative hemorrhages in 8.69% of cases. The mortality was 13.73% with 50.14% of immediate deaths by secondary hemorrhage, 28.58% of deaths by delay of the surgical hemostasis and 14.28% of deaths by a failure of compensation of the blood losses in emergency room. Conclusion: the penetrating abdominal wounds are common in young adult males. They are often due to a stabbing assault with a high death rate.