Management of Acute Abdominal Emergencies at the Niamey National Hospital - Abstract
Objectives: The aim of this study was to evaluate the management of surgical acute abdominal emergencies at the National Hospital of Niamey.
Methods: Prospective study was conducted in emergency unit of the Niamey National Hospital, from March to September, 2010. Data collected included: age, sex, mean of transportation used, clinical signs, indication of surgery, delay of admission, pre operative check, American Society of Anesthesiologists (ASA) physical status classification, preoperative prescriptions, delay of the intervention, technique of anesthesia, incidents, accidents and the outcome of the patient.
Results: The sample included 255 patients. The functional signs were: abdominal pain and vomit. The delay of admission was 72 hours. The radiography of the abdomen has been realized in 58%. Seven patients have an abdominal computed tomography (CT). The indications of surgery were: peritoneal syndrome (38.4%), occlusive syndrome (24.5%) and appendicitis (15.9%). The abdominal contusions represented 10.9%, penetrating wounds 1.9%. The gynecological emergencies represented 2.7%. 54.5% of the patients were classified ASA E 1; 35.3% ASA E 2. The delay of the surgery was 8 hours. 220 patients have been operated. General anesthesia was performed in 94%. Anesthetic drugs used were: ketamine in 94% of cases, fentanyl was the only narcotic available. We have 36 cases of incidents or accidents during the anesthesia (16.3%). The average expenses occurred for the families were US$ 240. Duration of hospitalization average was 12 days and 7.4% of patients were deaths.
Conclusion: The management of acute abdominal emergencies at the Niamey represents public health problem, the solution to this problem passed by the empowerment of the people, reforms in the management of emergencies in the peripheral medical centers and medically transportation of the patients.