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Digestive fistulas are one of the most embarrassing and demanding emergencies of abdominal pathology resulting in a three-pronged resuscitation emergency, general, locoregional, and nutritional. The purpose of our study on post-laparotomy external digestive fistulas was to determine the frequency, the etiologies and to assess the management as well as the evolution of digestive fistulas. Patients and Methods: This was a cross-sectional descriptive study carried out in two university hospital units, namely, the University Clinics of Lubumbashi and the Janson SENDWE Provincial Referral Hospital over a period from January 2013 to May 2019. It had involved 81 patients with fistula. Statistical analyzes were performed using Excel 2007 and Epi info 7.2.2.6 software. Results: We collected 81 patients with post-laparotomy external digestive fistula whose frequency was 7.07%. The majority of patients were young with a median age of 31 years. The sex ratio was 1.13 in favor of female patients. More than 2/3 of the patients were admitted and operated in emergency. The diagnosis was mainly based on clinical examination (based on the exteriorization of digestive secretions). Half of the cases of fistulas were early, appearing in the first 5 days post laparotomy. The small bowel was the most frequent site (60.49%), the output was low in 58 patients (71.61%). Generalized acute peritonitis provided digestive fistulas with 56.79% of cases, including 63.04% of ileal typhic perforation. The causes were partial dehiscence of the anastomosis and / or the release of the digestive suture performed in a septic cavity. Fifty patients (61.73%) had received exclusive medical treatment. It was made of an antibiotic (100.00%), rehydration (100.00%), an antisecretory / anticholinergic (91.36%) and an enteral nutritional intake (72.84%). The Operative treatment consisted essentially of an stomy (enteral or colic) with 54.84%. The general and local complications observed were dominated by anemia, malnutrition, sepsis, evisceration and skin corrosion lesions. The evolution was unfavorable with a crude mortality rate of 53.09%. The median hospital stay was 21 days. Conclusion: External digestive fistulas remain a relatively frequent pathology which complicates any laparotomy. They are marred by high mortality in our environment. Prophylaxis must remain the concern of any practitioner of surgery, especially since the management remains complex.

Epidemiological profile of post-laparotomy external digestive fistulas in two university hospital units in Lubumbashi