Factors Associated with Postoperative Digestive Fistulas Following Surgery for Secondary Peritonitis in Mbujimayi

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 (