Factors Associated with Postoperative Digestive Fistulas Following Surgery for Secondary Peritonitis in Mbujimayi
DOI:
https://doi.org/10.47941/ijhmnp.3420Keywords:
Postoperative Digestive Fistula, Secondary Peritonitis, Hypoproteinemia, Associated FactorsAbstract
Purpose: Postoperative digestive fistulas (POFs) are a major cause of morbidity and mortality in low‑resource settings. This study aimed to identify the socio‑demographic, clinical, biological, and intraoperative factors associated with the occurrence of POFs in patients operated on for secondary peritonitis in Mbujimayi.
Methodology: A cross‑sectional, multicenter and analytical study was conducted over 15 months (September 2022–December 2023) in three hospitals in Mbujimayi (DRC). Sixty‑seven patients operated on for secondary peritonitis were included. Socio‑demographic characteristics, clinical and biological parameters, and intraoperative findings were analyzed to determine their association with postoperative digestive fistulas. Data were processed using Excel 2007 and SPSS 20. Statistical significance was set at p ≤ 0.05.
Findings: The study population was predominantly young adults (mean age: 23 years), with a slight male predominance (61.2%). Most patients came from peri‑urban areas and presented late, with 85% consulting more than 72 hours after symptom onset; among them, 43.9% developed a fistula. Hypoproteinemia (<5 g/dL) was present in 49.25% of patients and significantly increased the risk of fistula formation (OR ≈ 3). Perforations located within 20 cm of the ileocecal junction showed a tenfold increased risk. Emergency surgery accounted for 98.5% of cases. Nearly half of the fistulas occurred in patients operated on by non‑specialist physicians. Primary suturing resulted in a high fistula rate (44%), whereas ileostomy appeared protective.
Unique Contribution to Theory, Practice and Policy: This study identifies key clinical, biological and surgical factors associated with postoperative digestive fistulas in a low‑resource setting and highlights the need for improved nutritional assessment and surgical expertise to reduce their occurrence.
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Copyright (c) 2026 François Kabumba Kabumba, Godefroid Cibangu Mubiayi, Trésor Kabuya Kabamba, Clément Kadima Mutombo, Joseph Ngandu Tshilunda, Séverin Uwonda Akinja
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