Pathologies appendiculaires à l’hôpital national de Niamey : étude prospective et descriptive sur le profile épidémeologiques, diagnostic et thérapeutiques dans un contexte de ressources limitées.

Abstract

Introduction : Pathologies of the appendix are diverse and varied, dominated by appendicitis.  Other less common conditions such as malformation and tumor pathologies are also described in the appendix.  Objective : Describe the epidemiological, diagnostic and therapeutic aspects of appendicular pathologies at the Niamey national Hospital. Patients and Methods : This was a prospective and descriptive study carried out over a period of 12 months from May 1, 2022 to April 30, 2023. Results : During this study 110 patients were identified appendicular pathologies represented 7.8% of abdominal pathologies and 11.07% of abdominal emergencies.  The average age of the patients was 27.19 years with extremes of 5 years and 76 years.  The male gender was the most represented in 65.45% with a M/F sex ratio of 1.89.  Most patients, i.e. 71.81%, consulted between the 2nd and 7th day of disease progression with an average duration of 4.1 days. Pain was the main reason for consultation with 100% associated with other signs: fever, vomiting, anorexia with respectively 99.09%; 76.36% and 67.27%. The initial site of abdominal pain was FID in 46.36%, sudden onset in 56.36%, Torsion type in 66.36%, without irradiation in 62.73%, permanent in 60.91 % and definitive site in IDF in 70%. On the CBC, the patients had leukocytosis with a neutrophil predominance in 68.18% and the CRP was positive in 89.61% of cases.  Ultrasound was the most frequently performed examination, i.e. 79.09%, and revealed appendicular thickening in 29.89% and an oval image in 25.29%.  The most performed approach was that of Mac Burney in 67.91%. The Aspects épidémiologiques, cliniques et thérapeutiques des pathologies appendiculaires à l’hôpital national de Niamey. appendix after exploration was gangrenous in 38.67% and appendectomy was the surgical procedure performed in 99%.  Early postoperative outcomes were complicated in 9 patients or 8.49%.  The average length of hospitalization was 7.06 days with extremes ranging from 3 to 25 days. The mortality rate was 1.88%. The average cost was 119,880.39 F CFA with extremes of 43,000 and 241,865 F CFA.  Conclusion : Appendicular pathologies are characterized by the polymorphism of their symptoms.  They are most often treated by appendectomy using the traditional approach.