Doui Doumgba Antoine¹*, Moute Jerry Martial², Ngboko Mirotiga Pétula Anicette³ and Piamale Germain⁴

¹Doctor, Surgeon, Associate Lecturer, Head of General and Visceral Surgery, CHU of Sino-Central African Friendship, Bangui, Central African Republic

*Corresponding Author: Doui Doumgba Antoine, Doctor, Surgeon, Associate Lecturer, Head of General and Visceral Surgery, CHU of Sino-Central African Friendship, Bangui, Central African Republic.

Received: October 27, 2021; Published: December 13, 2021

Abstract

Introduction: Wounds of the abdomen are traumas with rupture of the continuity of the abdominal wall. The circumstances of their occurring are varied but are often related to the increase in crime in civilian practice or during armed conflicts. Objective: to study the epidemiological, diagnostic and therapeutic aspects of penetrating wounds of the abdomen at the level of the general surgery department of the Bangassou Regional University Hospital in the south-east of the Central African Republic. Patients and methods: This is a descriptive retrospective study of cases of penetrating wounds of the abdomen recorded and treated during the period from May 12, 2017 to May 12, 2019 at the said CHU. Results: The series consisted of 84 patients and male subjects accounted for 88.1%. The sex ratio (M/F) was 7.4. The average age of patients was 30.4 years (± 12.7 years). Patients aged 14-23 years were more affected (39.29%). Nearly 2/3 of the victims were under 45 years of age. Many of the victims came from the area of the locality of Bangassou (44%) and Gambo (21%) which constituted the epicenter of armed conflict in the region. The injured were willingly unemployed (45.2%) followed by farmers (27.4%). The circumstances of the wounds were clashes during armed conflicts (51.2%) and criminal assaults (42.8%). The wounded had arrived under the guidance of a non-governmental organization (40.5 per cent) or their relatives (33.33 per cent). The average time to admission was 1.2 days. The firearm was the most incriminated vulnerable agent in 76.2% of cases. Wounds were mainly in the right hypochondrium (35.7%), the left iliac fright (17.9%) and the hypogastrium (17.9%). In 81% of cases these wounds were ponctiform. The diagnosis of penetration was based on signs of hemoperitoneum (57.1%) and peritonitis (27.4%). Abdominal wounds were associated with extra abdominal lesions in 17.8% of cases consisting of open fractures of limbs, bursa lesions and chest wounds. All the injured were operated on after brief medical resuscitation. A safe iso rhesus whole blood transfusion was useful in 55 injured (65.5%), including 30 in pre-operative and 15 intraoperatively. General anesthesia was used in all patients with orotracheal intubation. The first route was the median laparotomy above and sub umbilical. The lesions concerned the liver (37.1%), hail (29.8%), and colon (12.7%). In 5.8% of cases no lesions were found. The main surgical procedures performed were excision-suture of organs (50 cases) and resection-anastomosis (10 cases). Morbidity is dominated by infection of the surgical site in 1.2% of cases. The average length of hospital stay was 09 days (extremes 5 and 25 days). We deplore 8 cases of death or 9.5%, deaths occurred in a hypovolemic shock table.

Conclusion:Abdominalwoundsarecommonintimesofarmedconflict.Theyaffectyoungsubjects,mostlymen.Organiclesionsareoftenmultiple.Inourcontext,laparotomyhasidentifiedandtreatedseveralsolidandholloworganlesionsthatcouldcompromisethelifeprognosisoftheinjured.Ourattitudewasguidedbytheremoteness,thecontextandthenthelackofhumanandmaterialresourcesthatdidnotallowustooptforarmedsurveillance.

Keywords: Surgery; Abdominal Trauma; Penetrating Wound; Laparotomy; Central African Republic

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Citation

Citation: Doui Doumgba Antoine., et al. “Penetrating Wounds of the Abdomen: Treatment in Times of Conflict at the Bangassou Regional University Hospital in the Central African Republic". Acta Scientific Medical Sciences 6.1 (2022): 126-133.

Copyright

Copyright: © 2022 Doui Doumgba Antoine., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.