Serious abdominal traumatic emergencies in the emergency department of a “Trauma Center” hospital of Libreville (Gabon): Epidemiological, diagnosis and outcomes aspects

• R. Obame

  emergency department of a “Trauma Center” hospital of Libreville (Gabon)

Background: Abdominal trauma (AT) represents about 15-20% of lesions observed in traumatology. It may be serious and a life-threatening condition. This study aimed to describe the epidemiological, diagnosis and outcomes aspects of severe AT (SAT) admitted to the emergency department of Owendo University Hospital (Gabon).
Methods: A cross-sectional and descriptive study with retrospective collection of data. It was conducted over a period of twenty-four months, in the Emergency Department of the CHUO. Only patients with traumatic abdominal pathology classified as serious were included. The variables of the study were: age, sex, mechanism of trauma, pre-hospital management, clinical signs, paraclinical assessment carried out, surgical treatment and evolution. The data were analyzed by Microsoft Excel Pro version 2019 software.
Results: during this period, 4.6% (n=105) of patients presented with abdominal trauma. The average age of the patients was 29.8 ± 13.8 years. In 70% of cases (n=49), road traffic accidents (RTA) were the main etiologic mechanism, then assaults (11.4%). In per operative settings, the splenic lesions were the most found in 60% (n=42) of the cases. Crude mortality was 20% (n=14). Deaths occurred in 64.2% of patients during the first forty-eight hours.
Conclusion: Serious abdominal trauma is still responsible for high mortality in Gabon, as in other African countries, and the above-mentioned factors remain the cornerstone. Improving its management requires better development of pre-hospital medicine in Gabon, emphasis on training in the use of "Fast-echo" in emergencies and perhaps by strengthening surgical practices such as "damage control” or “abbreviated laparotomy”.

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