OCCLUSION INTESTINALE AIGUE PAR STRANGULATION : ASPECTS EPIDEMIOLOGIQUES, CLINIQUES ET THERAPEUTIQUES DANS LE SERVICE DE CHIRURGIE GENERALE DE L’HOPITAL NATIONAL IGNACE DEEN CHU DE CONAKRY

The aim of this study was to describe the epidemiological, clinical and therapeutic characteristics of acute mechanical intestinal obstruction by strangulation in the general surgery department of the Ignace Deen CHU national hospital in Conakry. Material and methods: This was a retrospective analytical study lasting 3 years from January 1st of 2020 to December 31, 2022, carried out in the general surgery department of the Ignace Deen national hospital of the Conakry University Hospital. Results: We collected a total of 76 cases of OIA by strangulation, including 39 men and 37 women, a sex ratio of 1.05. The average age was 41.26 years with extremes of 8 and 84 years. The Clinic was dominated by abdominal pain, vomiting, cessation of intestinal transit of materials and gases and abdominal meteorism. The occlusion was high in 57 cases (75%), low in 16 cases (21.05%) and mixed in 3 cases (3.95%). X-ray of the ASP was done in all our patients (100%) and ultrasound in 2 patients. The etiologies were: Bridles and adhesions 70.67% (n=53), volvulus of the pelvic colon 21.33% (n=16), and small intestine 72% (n=54), hernial strangulations 6.67% (n=5), acute intestinal intussusceptions 1.33 (n=2). The surgical procedures were the section flanges and adhesiolysis 53 cases, 13 cases of left hemicolectomy, 5 hernia repairs and 3 colostomies. The average length of stay was 14 days. Postoperative complications were: 14 surgical site infections, 2 stercoral fistulas and 4 deaths. Conclusion: Straps and adhesions were the most common etiologies of strangulation occlusions; pre- , intra- and post-operative resuscitation could reduce the post-operative morbidity and mortality of this condition. Keywords: intestinal obstruction, mechanical, strangulation, Conakry