Pathologies of Peritoneo-Vaginal Duct Persistence in the General Surgery Department of Kara Teaching Hospital (Togo)

Abstract

Objective: To report our experience as general surgeon in the management of pathologies of Peritoneo-Vaginal Duct Persistences (PVDP) in the general surgery department of Kara teaching hospital (Togo). Material and Method: This is a retrospective and descriptive study that was carried out for 5 years, from January 1, 2014 to December 31, 2018 in the general surgery department of Kara teaching hospital. It is a study which concerned children or adults managed for pathologies of the persistence of the peritoneo-vaginal duct. Results: During our study period, 82 patients were operated for PVDP. The average age was 5 years of extremes ranging from one month to 56 years. Persistence of peritoneo-vaginal duct sat on the right in 69 cases and on the left in 13 cases. It was bilateral in three cases. We operated on a recurrence of a right inguinoscrotal hernia. Among hernias, 6 (7.3%) of inguoscrotal hernias were strangulated. All patients underwent ligation of the peritoneal-vaginal canal. This gesture was associated with an evacuation of the hydrocele in 29 cases; a cystectomy in 3 cases and a course of treatment according to Bassini in 3 cases (patients aged 15 years and over). The six cases of strangulated inguino-scrotal hernias were operated on urgently. There was no bowel resection. The postoperative course was marked by a bursa hematoma in two children which regressed under after one week of monitoring. The average length of hospital stay was 24 hours. No deaths have been reported. No recurrence was observed after one year of follow-up. Conclusion: Pathologies of the persistence of peritoneo-vaginal duct are frequent. They include several pathologies dominated by hernias which are often found in children under 5 years of age. The postoperative operations are often fraught with complications, the most serious of which is testicular atropia. Reducing complications requires early management, improvement of the technical platform and surgical management by a well-trained team.