Occlusion intestinale pendant la grossesse au Centre Hospitalier et Universitaire de Treichville (Abidjan - Côte d'Ivoire)

Introduction : La survenue d'une occlusion intestinale pendant la grossesse est une situation rare qui met en jeu rapidement le pronostic materno-fœtal.Observation : Nous rapportons un cas d'occlusion intestinale diagnostiquée à la 33ème semaine de grossesse chez une patiente de 23 ans, ayant un antécédent de salpingectomie. Le diagnostic a été posé tardivement, sur des arguments cliniques. Le traitement qui a consisté à réaliser en urgence une césarienne première suivi d'une iléostomie proximale, a permis de sauver l'enfant et la mère.Discussion : Cette observation nous permet de discuter les mécanismes physiopathologiques, et les difficultés de la prise en charge de l'occlusion intestinale aiguë au cours de la grossesse dans nos pays tropicaux à plateau technique limité

Dynamic Bowel Obstruction: Aetiology; Clinical Presentation; Management and Outcome at Bugando Medical Centre; Mwanza; Tanzania

Dynamic bowel obstruction is a common and potentially dangerous surgical emergency with high morbidity and mortality worldwide. No prospective study has been done on this subject in our setting. This study was conducted to describe in our region; the aetiology; clinical presentation; management and outcome of dynamic bowel obstruction. Data were analyzed using SPSS software system. A total of 342 patients were studied. Males outnumbered females by a ratio of 2.1: 1. The median age of patients at presentation was 34 years (range 11 to 78 years). Obstructed hernias (32.7) were the commonest cause of dynamic bowel obstruction. Abdominal pain (100) and vomiting (86.5) were the most frequent presenting symptoms. Thirty-one (9.1) patients were HIV positive. Small bowel was the commonest site of obstruction accounting for 89.2 of cases. Herniorrhaphy was the most frequent surgical procedure performed in 112 (32.7) patients. Surgical site infection (38.8) was the most common post-operative complication and it was significantly associated with HIV positivity and low CD 4+ count (p0.001). The overall median of length of hospital stay was 26 days (range 1 to 72 days). Patients who had postoperative complications stayed longer in the hospital and this was statistically significant (p