Non-traumatic perforations of the small bowel in pediatric surgery department of the National hospital Donka in Conakry Guinea

Introduction: Non-traumatic perforations of the small intestine are conditions with a serious prognosis in the absence of early and effective management. In Guinea, very few studies have been carried out on this subject. The aim of this study was to describe the epidemiological, diagnostic and therapeutic aspects of this condition. Methodology: This was a retrospective descriptive study. All patients aged less than or equal to 16 years operated on for intra-operatively confirmed non-traumatic perforations of the small bowel between January 1, 2004 and December 31, 2009 were included. Epi-info version 6 FR software was used for data entry and analysis. Results: A total of 92 patients were registered. Males accounted for 67.0% and the mean age was 9.37 ±1.13 years. Typhoid perforation was the predominant cause (92.4%). Postoperative outcome was uncomplicated in 32.6% of cases. Parietal suppuration (42.39%), fistula (12%) and peritonitis (5.4%) were the major complications. Mortality due to peritonitis was 23.9%. Mortality from non-traumatic bowel perforation was statistically associated with deterioration in the patient's clinical condition (malnutrition, important weight loss, hemodynamic disorders) (p < 0.04); with a delay in management of more than 72 hours (p < 0.01); hospital stay (p < 0.001); with the number of multiple perforations (p < 0.0001); and with a complicated post-operative course (p < 0.0001). Conclusion: Non-traumatic perforations of the small intestine in children were relatively frequent. The vast majority was due to typhoid, and mortality was fairly high.