Système gastro-intestinal et digestif

Abstrait

Acute Appendicitis and Complications at Bouake University Hospital: Epidemiological, Diagnostic and Therapeutic Aspects

Anzoua Kouakou Ibrahim*, Kouakou Kouame Bernadin, Traore Mamadou, Leh Bi Kalou Ismael, Ekra Serge Amos, Kouakou Blaise Amos, N'dri Ahou Bernadette, Alloka Venance, Binate Alassane, Bamba Inza, Akowendo Emmanuel, Lebeau Roger and Diane Bamourou

Objectives: To describe the epidemiological, diagnostic and therapeutic aspects of acute appendicitis and complications.

Methods: Retrospective descriptive study of patients admitted for acute appendicitis and complications at the University Hospital of Bouake, from January 2010 to December 2018.

Results: We collected 1552 cases of acute appendicitis and complications, which represents 30% of patients admitted to the service. The average age of the patients was 23 ± 9. We noted 56% of men (n=869) and 44% (n=683) of women. The average delay of consultation was 3 days (range 1 and 8 days). The reason for consultation was mainly pain in the right iliac fossa. Abdominal ultrasound was the main complementary examination performed in 1273 patients, i.e. 82% of cases. Acute appendicitis was uncomplicated in 1140 patients, i.e. 73% of the patients. They were complicated in 412 patients, i.e. 27% of cases. Among the complicated forms, 240 cases (14%) of appendicular peritonitis, 119 cases (8%) of appendicular abscesses and 52 cases (3%) of appendicular plastrons were recorded. The appendix was catarrhal, phlegmonous, gangrenous, and perforated in 62% (n=962), 20% (n=310), 13% (n=202), and 5% (n=78) of cases, respectively. All appendicular plastrons had initial medical treatment. All appendicitis cases underwent appendectomy by laparotomy. The average duration hospitalization was 2 days (range 1 and 15 days). The postoperative course was simple in 1151 (98%) patients. Suppuration of the surgical site was observed in 28 patients, i.e. 1.8% of cases. We noted 2 deaths, i.e. a case fatality rate of 0.2%.

Conclusion: Acute appendicitis is a frequent abdominal emergency. It is a condition that mainly affects adolescent and young adult males. The treatment of choice is surgical. The morbidity is dominated by parietal suppuration.