La Procalcitonine, facteur prédictif dans l’indication chirurgicale des occlusions intestinales du grêle sur brides ? Is procalcitonin predictive factor in surgical indications of adhesion- related small bowel obstruction?
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Abstract
Introduction
La mortalité liée à l’occlusion intestinale aigue du grêle sur brides (OIAGsb) avoisine les 8 % selon les données rapportées dans la littératur [1]. Les couts de la prise en charge non chirurgicale (conservative) de ces OIAGsb sont estimés à 9000$ par patient ; ils sont multipliés par 4 chez les malades opérés (30 000$ à 40 000$) [2].
La prise en charge repose sur le suivi de la résolution de l’épisode occlusif (la reprise d’un transit intestinal) ou l’apparition de signes
suggérant une souffrance intestinale (étranglement ou péritonite).
Le transit intestinal non repris chez un patient admis pour OIAGsb, et qui ne présente ni des signes de souffrance viscérale liée à l’étranglement,
ni des signes de péritonite, pose le problème du choix thérapeutique chirurgicale ou non.
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