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

Abstract

Objective: Report the diagnostic and therapeutic approach for the management of abdominal masses in the General Surgery Department of the Reference General Hospital (RGH) of Niamey. Materials and methods: This were a retro-prospective and preliminary study of 2 years 3 months on patients operated for abdominal mass in the general surgery department of the RGH. Palpable mass and/or imaging size (40 mm) were the criteria for inclusion. Results: Abdominal masses accounted for 6.7% (n=53) of other pathologies. The average age of patients was 41.26 years, standard deviation 14.2 and a female predominance in 75.5% (n=40) with a sex ratio of 0.32. The abdominal mass was clinically palpable in 75.5% (n=40). The abdominal pelvic ultrasound was performed in all patients and in 75.5% (n=40) it had specified the origin of the mass. The injected abdominal-pelvic scanner, performed in 52.8% of patients (n=28) and 89.3% (n=25), had specified the pre-operative diagnosis. The most common etiologies were uterine myomas in 35.8% (n=19). In 7.5% (n=4) the diagnosis was not accurate in pre-operative despite both imaging, and these patients had benefited from an exploratory laparotomy. Surgery was the initial therapeutic gesture for all patients and coelioscopy was 22.6% (n=12). Post-operative complications were 7.5% (n=11). The death rate was 5.6% of cases (n=3). Conclusion: Imaging remains important in the etiological research of abdominal masses. The definitive treatment remains surgical; mortality would be related to the malignant nature and the large volume of the mass.