Diagnostic Errors in the General Surgery Department of Ignace Deen National Hospital, Conakry University Hospital

Introduction: Diagnostic errors result from failure to correctly complete one or more steps of the diagnostic process. They may lead to inappropriate treatment, delayed management, complications, and, in severe cases, death. The aim of this study was to report our experience with diagnostic errors in the General Surgery Department of Ignace Deen National Hospital, Conakry University Hospital. Materials and Methods: This was a prospective, descriptive study conducted over 18 months, from January 1, 2024, to June 30, 2025, in the General Surgery Department of Ignace Deen National Hospital-Conakry University Hospital. We included all operated patients in whom a discrepancy was identified between the preoperative diagnosis and the definitive diagnosis established during surgery and/or subsequent evaluation. Sociodemographic, clinical, paraclinical, therapeutic, and postoperative variables were analyzed. Data were entered and analyzed using SPSS version 21.0. Results: Among 1094 operated patients reviewed during the study period, 36 cases of diagnostic error were identified, corresponding to a frequency of 3.3%. The mean age was 38.3 years (range, 3 - 77 years). There were 21 women (58.3%) and 15 men (41.7%), corresponding to a female-to-male ratio of 1.4. The mean interval between symptom onset and consultation was 20.1 days (range, 5 - 67 days). All patients underwent laboratory investigations. The main imaging examinations performed were abdominopelvic ultrasonography (77.8%), upper gastrointestinal contrast examination (16.7%), upper gastrointestinal endoscopy (30.5%), and abdominopelvic computed tomography (8.3%). Gastric tumor was the most frequent preoperative diagnosis (19.4%). All patients underwent laparotomy. Gastric tumor remained the most frequent intraoperative diagnosis (11.1%). The mean time to treatment was 12.5 days (range, 8 - 26 days). The postoperative course was uneventful in 31 patients (86.1%), while two patients (5.6%) developed postoperative complications. Three patients died, giving a mortality rate of 8.3%. Conclusion: Diagnostic errors remain an important issue in surgical practice in Guinea because of their potential impact on the quality and safety of patient care. Systematic analysis of diagnostic discrepancies, improvement of clinical reasoning, appropriate use and interpretation of complementary investigations, and continuous professional learning may contribute to reducing these errors.