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

R. Obame 1,2, A. Matsanga A, P.C.1 Nze Obiang 2, V. Sagbo Ada 1, D.P. Tsogho Ndalegna 1 , L. Bitégué Methé 1, T. Keita Oyoua 3, I. Okome ObiangI 1, C. Mba Mba 3, B. Mpiga Mickoto 1, M. Mouguiama 1, N. Ekeghe 1, D. Ada Aissat 1, A. Sima Zué 2

Résumé

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”.