Open abdomen management and outcomes: two case reports from western Kenya and a review of literature from Africa.


Journal

The Pan African medical journal
ISSN: 1937-8688
Titre abrégé: Pan Afr Med J
Pays: Uganda
ID NLM: 101517926

Informations de publication

Date de publication:
2019
Historique:
received: 07 12 2018
accepted: 09 01 2019
entrez: 31 5 2019
pubmed: 31 5 2019
medline: 8 6 2019
Statut: epublish

Résumé

The open abdomen (OA) is clinically indicated for attenuating the effects of select intra-abdominal insults that may lead to high intra-abdominal pressure with fascial closure. Despite the high incidence of conditions warranting OA in Africa, there are few reports on its use and outcomes. A retrospective chart review was performed for two patients managed with an OA at the Moi Teaching and Referral Hospital. For comparison, a literature review on related studies from Africa was performed. One patient had an anastomotic leak, while the other had a perforated gastric ulcer. A Bogotá bag was used for temporary abdominal content containment. There was no mortality in our series and fascial closure was achieved in one patient. Upon review of studies from Africa, overall mortality stood at 44%, while 25% of surviving patients underwent fascial closure. The use of OA in Africa is associated with high mortality and low rates of fascial closure. Our limited experience shows this technique is a viable treatment option in an attempt to bridge a patient to abdominal closure during critical illness.

Identifiants

pubmed: 31143338
doi: 10.11604/pamj.2019.32.33.17859
pii: PAMJ-32-33
pmc: PMC6522152
doi:

Types de publication

Case Reports Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

33

Déclaration de conflit d'intérêts

The authors declare no competing interests.

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Auteurs

Clifford Mwita (C)

Department of Surgery and Anesthesiology, Moi University School of Medicine, Eldoret, Kenya.
Afya Research Africa, Nairobi, Kenya.

Ruth Negesa (R)

Department of Surgery and Anesthesiology, Moi University School of Medicine, Eldoret, Kenya.

Marissa Boeck (M)

Department of Surgery, New York-Presbyterian Hospital/Columbia, New York, United State of America.

Andrew Wandera (A)

Department of Surgery and Anesthesiology, Moi University School of Medicine, Eldoret, Kenya.

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Classifications MeSH