EVISCERATIONS TRAUMATIQUES DE L’ABDOMEN DANS LE SERVICE DE CHIRURGIE GENERALE DU C.H.U GABRIEL TOURE : ASPECTS DIAGNOSTQUES ET THERAPEUTIQUES

Objective: To study the abdominal traumatic evisceration within the general surgical unit of CHU Gabriel TOURE. Methodology: It’s about a retrospective study dealing with 90 cases of compiled ETA within January 1999 and December 2010. Inclusion standards were the patients introducing the abdominal traumatic evisceration and whose diagnosis in summer in an operative hayfield. Patients have been recruited from the register and file of in-patient clinic within the general surgical unit. Result: We have registered in 12 years, 175 abdominal penetrating wounds of which 90 cases of abdominal traumatic evisceration. The hospital frequency has been: 0,20% of consultations, 0,95% of surgical emergencies, 51,43% of penetrating wounds. The average age of our patients was about 28,97 years old and with a sex ratio of 6,5 in favor of male. Eviscerations through PPAB have been the most manifested with 62 cases or 68,9% of cases. The street has been the most represented accident site with 46 cases or 51,0% of cases. Circumstances occurring were: criminal aggression in 60 cases (66,7%), AVP in 5 cases(5,6%), autolysis attempt in 10 cases (11,1%), work accident(injury on duty) in 15 cases (16,6%). Cutting tool was the most represented vulnerant agent with 61 cases (67,8%). The average time to hospital has been 97,22 min. The abdominal pain was intense in 69 cases (76,7%). The epiploon has been the most eviscerated organ or 64,4% (58 cases) of cases. The hail and the colon have been the most affected or 25,5% (23 cases). The ASP has permitted to objectivize a pneumoperitoneum in 8 cases (8, 9%). The abdominal scan has permitted to objectivize a peritoneal outpouring in 3 cases (3,3%) out of 1. The lesion of intra-abdominal organs has been found in 36 cases (40,0%). The white laparotomy rate has been (33,3%) in 30 cases. The simple suture of the wound was achieved in 24 cases (26,6%). The surgical gestures achieved have summer: a suture of the hail+the settler in 11cases(12,2%), a suture of the stomach in 10cases(11,2%), a resection of the hail+the anastomosis in 3cases(3,3%) , according to the lesions of organs inta abdominal case sutured of a liver in 6 suture cases (6,7%), of the backfire+epilpoom over 2cases(2,2%), a suture of the diaphragm in 2 showcases , ileale’s suture+an ileostomy in 2cases(2,2%). the remaining has been simple in 83 cases, an unwholesomeness of( 4%) 4cases, mortality in (3,3%) 3cases. The average time of hospitalization has been 6,3 days. Conclusion: Traumatic evisceration is frequent in juvenile area. Fighting against criminality and accidents on public highway would decrease this affection. Key words: evisceration, traumatism, abdomen, surgery, Mali