Fréquence et prise en charge des abdomens aigus chirurgicaux chez l'adulte. Cas du service de chirurgie Dipumba
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Mémoire (de fin d'études) de l'année 2016 dans le domaine Médecine - Chirurgie, Médecine des accidents, cours: Chirurgie digestive, langue: Français, résumé Nous avons mené une étude rétrospective portant sur 319 patients reçus dans le service de chirurgie de l'hôpital général de référence de DIPUMBA pour abdomen aigu chirurgical soit 17,2% sur un effectif total de 1849 malades, durant une période allant du 01 Janvier 2011 au 31 Décembre 2014 soit 4 ans. La douleur abdominale a été le principal motif de consultation. Parmi ces cas nous avons répertorié 290 cas soit 90,9% ayant subi l'intervention chirurgicale et 29 cas non opérés soit 9%. La tranche d'âge dominante est celle comprise entre 15 et 24 ans (42,9% de cas), avec une moyenne d'âge de 19,5 ans. Un écart type de PEARSON de 42. Le sexe le plus touché par l'abdomen aigu chirurgical était le sexe féminin qui représentait 206 femmes soit 64,5% de cas contre les 113 hommes soit 35,4% avec un sex-ratio de 1,8. La douleur localisée dans la fosse iliaque droite était relativement fréquente que d'autres localisations soit 48,5% suivie de la douleur diffuse avec 30,4% des cas. Les douleurs avec le mode de début brutal sont plus fréquentes avec 182 cas soit 57% que celles à début progressif (137 cas soit 42,9%). L'examen physique seul permet dans la plupart des cas de poser le diagnostic. En cas de doute, on fait recours à la paraclinique. Le ballonnement abdominal a été noté dans 120 cas soit 37,6% suivi de vomissement dans 35,7% des cas; et la radiographie a été obtenue 52 fois sur 76 demandes soit 68%. 50% d'ASP avaient montré des niveaux hydroaériques et 25% d'échographies réalisées ont été normales. Les échographies pathologiques avaient montré 18,7% pour les épanchements, les kystes ovariens et les tumeurs. Le diagnostic d'appendicite était plus fréquente soit 57,3% suivi de l'occlusion (22,8%) et de péritonite (10,3%). La prise en charge d'un abdomen aigu est essentiellement chirurgicale et adaptée selon l
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