ABSTRACT
Our aim was to define the epidemiological profile of acute generalized peritonitis in N'Djamena, Chad. This retrospective study, conducted in the general surgery department of the National Reference General Hospital, examined the files of 492 patients who underwent surgery for acute generalized peritonitis from June 2007 to December 2012. Epidemiological, clinical, paraclinical, and therapeutic characteristics were described. Acute generalized peritonitis accounted for 35.2 % of all visceral surgical emergencies. Male patients were at highest risk (sex-ratio 6.5). The patients' mean age was 25.8 years (range 1 to 70 years). All patients had abdominal pain. The leading cause was traumatic visceral perforation by stabbing or a firearm in 226 cases (46 %), followed by diffuse appendiceal peritonitis. Primary peritonitis was rare. The principal procedure was surgical excision and suture. The mean time to consultation was 3 days and the mean hospital stay 8.5 days. The morbidity rate was 16.8 %, dominated by wound infection. The mortality rate was 6.8 %. Abdominal trauma is the major cause of acute generalized peritonitis in N'Djamena. Prognosis depends on time to surgical management.
Subject(s)
Peritonitis , Acute Disease , Adolescent , Adult , Aged , Chad , Female , Humans , Male , Middle Aged , Peritonitis/diagnosis , Peritonitis/epidemiology , Peritonitis/etiology , Peritonitis/therapy , Retrospective Studies , Young AdultSubject(s)
Adipose Tissue , Alopecia/diagnosis , Scalp Dermatoses/diagnosis , Adolescent , Adult , Alopecia/complications , Child , Female , Humans , Middle Aged , Scalp Dermatoses/complicationsSubject(s)
Arthritis, Rheumatoid/genetics , Arthritis, Rheumatoid/immunology , Genes, MHC Class II , HLA-DR Antigens , Synovial Fluid/immunology , Adult , Aged , Aged, 80 and over , Analysis of Variance , Female , HLA-DR4 Antigen , HLA-DRB1 Chains , Humans , Leukocytes/immunology , Male , Middle AgedABSTRACT
Agranulocytosis and septicaemia developing in a patient with rheumatoid arthritis after 3 years' intermittent treatment with diclofenac, cimetidine and flucloxacillin for staphylococcal osteomyelitis is described. Treatment with recombinant granulocyte-colony-stimulating factor and high-dose methylprednisolone had no effect on the neutropenia which resolved on stopping all drug therapy. Relapse of agranulocytosis followed reintroduction of flucloxacillin and cimetidine 3 months later.
