학술논문
Emergency abdominal surgery in Zaria, Nigeria
General Surgery
General Surgery
Document Type
Clinical report
Source
South African Journal of Surgery. May 2010, Vol. 48 Issue 2, p59, 4 p.
Subject
Language
English
ISSN
0038-2361
Abstract
Abdominal surgical emergencies constitute a significant portion of a surgeon's clinical experience and often present diagnostic and treatment challenges, particularly in poorly resourced environments with a lack of modern medical [...]
Background. The causes of abdominal surgical emergencies in a particular setting may change because of alterations in demographic, socio-economic or geographical factors. We present the pattern, management and outcome of such emergencies in Zaria, Northern Nigeria. Methods. This is a retrospective review of prospectively collected data conducted in a tertiary health centre between 2001 and 2005. Patients aged 14 years and over with abdominal surgical emergencies were consecutively entered into the study at the time of admission. The frequencies of different diagnoses, management and outcome were recorded. The indications for and outcome of operative treatment were compared with a similar study performed about two decades ago in our institution. Results. There were 3 717 patients, accounting for 29.5% of all emergency surgical admissions. The mean age was 32.5 years. The most common diagnoses were appendicitis (996, 26.8%), nonspecific abdominal pain (871, 23.4%), intestinal obstruction (498, 13.4%) and abdominal trauma (245, 6.6%). In all, 1 788 patients (48.1%) had operations during their emergency admission compared with 37.0% in our previous study. Appendicectomy (903, 50.5%) was the most common operation. Operations for abdominal trauma and typhoid ileal perforation have increased, while operations for strangulated external hernia and perforated duodenal ulcer have decreased. Of the 169 (4.5%) patients who died, 107 (6.0%) died after an operation. Delayed presentation increased mortality. Conclusions. Operations for appendicitis, infectious diseases and trauma have increased while those for strangulated external hernia have decreased. The expense of surgery contributes to late presentation and delayed intervention, which impact negatively on treatment outcome.
Background. The causes of abdominal surgical emergencies in a particular setting may change because of alterations in demographic, socio-economic or geographical factors. We present the pattern, management and outcome of such emergencies in Zaria, Northern Nigeria. Methods. This is a retrospective review of prospectively collected data conducted in a tertiary health centre between 2001 and 2005. Patients aged 14 years and over with abdominal surgical emergencies were consecutively entered into the study at the time of admission. The frequencies of different diagnoses, management and outcome were recorded. The indications for and outcome of operative treatment were compared with a similar study performed about two decades ago in our institution. Results. There were 3 717 patients, accounting for 29.5% of all emergency surgical admissions. The mean age was 32.5 years. The most common diagnoses were appendicitis (996, 26.8%), nonspecific abdominal pain (871, 23.4%), intestinal obstruction (498, 13.4%) and abdominal trauma (245, 6.6%). In all, 1 788 patients (48.1%) had operations during their emergency admission compared with 37.0% in our previous study. Appendicectomy (903, 50.5%) was the most common operation. Operations for abdominal trauma and typhoid ileal perforation have increased, while operations for strangulated external hernia and perforated duodenal ulcer have decreased. Of the 169 (4.5%) patients who died, 107 (6.0%) died after an operation. Delayed presentation increased mortality. Conclusions. Operations for appendicitis, infectious diseases and trauma have increased while those for strangulated external hernia have decreased. The expense of surgery contributes to late presentation and delayed intervention, which impact negatively on treatment outcome.