Trauma of the abdomen, be they open or closed, is an important cause of morbidity and mortality. We then conducted a retrospective study of visceral surgery departement in Al Farabi hospital wich aims to identify risk factors for morbidity and mortality in abdominal trauma. We identified 92 patients. There was a progressive increase of thr number of patients during the 3 years of study and significanr frequency of abdominal trauma during summer.aworked male predominance was found in 72% of our patients had a lower age at 35 years. Only 66.3% of our patients had had a social coverage, in our study, abdominal wounds were the main reason for hospitalisation with a rate of 54.4% ; contusions occupied a second position. Injury circonstances were domineted by attacks tht accounted for 63% followed by acciden in public rod with a rate of 27.2%. 23% of our patients had toxic habits, 7.6% had hypertension and 3.3% of patients were diabetics. Clinically speaking, 65.2% of our patients were stable on the map hemodynamique, eigastruim was the seat of most injuries, abdominal sensivity was found the main sign(56.6%) followed by the defense found in 21.7% of cases. Biologically speaking , 15% of patients with lower hemoglobine and 17.3% had hight rate of leukocyte. The prothrombine rate was normall in all our patients. Radiollogically speaking, abdomen without preparation was carried out for 45% of patients who have shown a PNP in 21.7% of cases. Ultrasonography was perfomed in 71.7% of patients. Splenic lesions ranked first with an estimeted 23.8% rate. Hemoperitoneum was found in the second position (22.8%). Liver injuries were present in 10.9% of patients. Abdominal scanner was perfomed in 48.9% des patients. The abnormalities found were dominated by the spleen 24.1% and liver disease in 9.8%. 40% of our patients got a transfusion. 69 patients underwent surgical treatment (75%). Among 69 operated patients, different diagnoses were selected : spleen with variable severity were found in 33.6%, gastric perfortion in 24.6%, intestinal injuries and diaphragmatic wound were fond, equal to 16.2%¨of oprerated patients. Vascular injury found in 46% of operated patients. Total splenectomy was done in 18.7% of patients. Partial spenectomy and splenic sutures were in equel shares, with 8.7% of patients. Partal gastrectomy was performed in 7.5% and 5% underwent intestinal removal. Other surgical procedures have been realised depending on the case. The mortality rate was 8.7% and morbidity was 17.4%. Hemorrhagic choc represented 37.5% followed by complications by sepsis in 20%. Abcesses wall and digestive fistulas was represented in equal shares 16% of complications. Finally, intra abdominal abcesses reprensented 8.3% of complications. Mortality and morbidity were found preferentially through : Patients with toxic antecedents , -Diabitic patients, -patients having an epigastic impact, -patients receving transfusion, -patients with vascular lesion, -patients undergoing intestinal resection. So as to improve the progonsis for abdominal traum, there should be a fast and multidisciplinary care and we should be vigilant to all patients with cited factors.
| Référence | 1397 |
| Année | 2014 |
| Type | Thèse |
| Lien document | |
| Auteur | Aabdi C |
| Discipline | Centre Hospitalier Universitaire Mohammed VI d'Oujda |
| Encadrant | Bouziane M |
