RESUMO
INTRODUCTION: Gallstone disease is a disorder characterised by the formation of stones in the biliary tract. It is the most common biliary condition accounting for more than 98% of all gallbladder and biliary tract disorders. In Africa, previous studies have shown a relative rarity of this condition with a prevalence less than 5%; since it is between 2 and 5 times higher in other continents. A good knowledge of the profile of patient with gallstone disease in a surgical setting could allow to reduce gallstone disease complications and to tailor better the treatment. To our knowledge, there was no previous study about gallstone disease in this region even if there is a high prevalence of metabolic factors of gallstone disease. METHODS: This study objective is to describe the epidemiological, diagnostic and therapeutic profile of patients with gallstone disease at the Department of General Surgery of Saint-Louis Hospital (Senegal). It will be a single-centre retrospective cohort study in a period of 5 years (January 2015 - December 2020). The patients' record of the department of general surgery will be consulted and the patient contacted if there are missing data. Patients with gallstone disease diagnosed with imaging (ultrasonography and/or CT scan) regardless the presentation (asymptomatic, biliary colic, cholecystitis, common bile duct lithiasis, angio-cholitis, pancreatitis) will be included. Adults and paediatric patients will be enrolled. Patient records lacking sufficient data will be excluded. Studied parameters will be epidemiological, clinical, paraclinical and therapeutic aspects. ETHICS AND DISSEMINATION: Anonymity and confidentiality of information collected in patients will be respected. This research protocol will be submitted to the Ethics Committee of our institution for approval. The knowledge of the profile of patients with gallstone disease in a surgical setting could allow to reduce gallstone disease complications and to tailor better the treatment. Finally, it will help to reduce the burden of gallstone disease. HIGHLIGHTS: Gallstone disease is the most common biliary tract conditionTo our knowledge, there was no previous study about gallstone disease in this region even if there is a high prevalence of risk factors of gallstone disease (sickle cell disease, diabetes, obesity, hypercholesterolemia)Good knowledge of the profile of patients with gallstone disease in a surgical setting could allow to reduce gallstone disease complications and to tailor better the treatment.
RESUMO
AIM: The aim of this work was to evaluate the diagnostic performance of imaging examinations in the presence of acute non-traumatic abdominal pain. MATERIALS AND METHODS: This was a prospective, cross-sectional and descriptive study over 6 months in the radiology and medical imaging department of the Kaolack Regional Hospital, including any patient received for acute non-traumatic abdominal pain with informed consent in whom the etiological diagnosis is supported by an imaging examination. We investigated the etiologies of acute abdominal pain and compared the imaging findings with surgical exploration. Our data were analyzed using SPSS 24.0 and Excel 2013 with a coefficient of significance of less than 5%. RESULTS: 106 patients were enrolled. The mean age was 32 years and the gender-ratio was 1.52 in favour of women. Acute abdominal pain was diffuse in 25.5% of patients and localized in 74.5%, of which 18.9% were at right iliac fossa.Abdominal X-ray was performed alone in 4 patients (3.8%), ultrasound alone in 46 patients (43.3%) and abdominal CT scan in 34 patients (32%). CT was combined with ultrasound in 6 patients (5.7%) and with abdominal X-ray in 16 patients (15%). The initial clinical diagnosis was corrected in 49.1% of patients. The sensitivity of the imaging compared to the final diagnosis retained was 96.2%. CONCLUSION: Imaging represents a turning point in the management of patients with acute non-traumatic abdominal pain by providing better diagnostic guidance and avoiding serious complications and unnecessary interventions.
BUT: le but de ce travail était d'évaluer les performances diagnostiques des examens d'imagerie devant des douleurs abdominales aigües non traumatiques. MATÉRIELS ET MÉTHODES: il s'agissait d'une étude prospective, transversale et descriptive sur 06 mois dans le service de radiologie et imagerie médicale de l'hôpital régional de Kaolack, incluant tout patient reçu pour douleur abdominale aigue non traumatique avec son consentement éclairé chez qui le diagnostic étiologique est appuyé par un examen d'imagerie. Nous avons recherché les étiologies des douleurs abdominales aigues et confronter les résultats de l'imagerie à l'exploration chirurgicale. Nos données ont été analysés avec les logiciels SPSS 24.0 et Excel 2013 avec un coefficient de significativité inférieur à 5%. RÉSULTATS: 106 patients ont été retenu. L'âge moyen était de 32 ans et le genre-ratio de 1,52 en faveur des femmes. La douleur abdominale aigüe était diffuse chez 25,5% des patients et localisée chez 74,5% dont 18,9% à la FID. L'ASP a été réalisé seul chez 4 patients (3,8%), l'échographie seule chez 46 patients (43,3%) et le scanner abdominal chez 34 patients (32%). Le scanner a été couplé à l'échographie chez 6 patients (5,7%) et avec l'ASP chez 16 patients (15%). Le diagnostic clinique initial a été rectifié chez 49,1% des patients. La sensibilité de l'imagerie par rapport au diagnostic final retenu était de 96,2%. CONCLUSION: L'imagerie constitue un tournant décisif dans la prise en charge des patients présentant une douleur abdominale aigüe non traumatique en apportant une meilleure orientation diagnostique évitant aux patients des complications graves et des interventions inutiles.
