Diagnostic and therapeutic approach to abdominal masses in a country with limited resources

Abstract

Objective To report the diagnostic and therapeutic approach for the management of abdominal masses in the General Surgery department of the Niamey General Reference Hospital (HGR). Materials and methods This were a retrospective and preliminary study of 2 years and 3 months on patients operated for abdominal masses in the General Surgery department of the HGR. A palpable mass and/or its size on imaging (40 mm) were the inclusion criteria. Results Abdominal masses accounted for 6.7% (n = 53) of other pathologies. The average age of the patients was 41.26 years, with a standard deviation of 14.2 and a female predominance of 75.5% (n = 40) with a sex ratio of 0.32. The abdominal mass was clinically palpable in 75.5% (n = 40). Abdominal pelvic ultrasound was performed as a first step in all patients and in 75.5% (n = 40) it specified the origin of the mass. Contrast-enhanced abdomino-pelvic CT scan, performed in 52.8% of patients (n = 28) and in 89.3% (n = 25) specified the preoperative diagnosis. The most frequent etiologies were uterine fibroids, 35.8% (n = 19). In 5.6% (n = 3) the diagnosis was not precise preoperatively despite the two imaging studies, and these patients had underwent exploratory laparotomy. Surgery was the initial therapeutic approach for all patients, and laparoscopy accounted for 22.6% (n = 12). Postoperative complications occurred in 7.5% (n = 11). The death rate was 5.6% of cases (n = 3). Conclusion Imaging remains important in the etiological research for abdominal masses. Definitive treatment remains surgical; mortality would be linked to the malignant nature and the significant volume of the mass.