SciELO - Scientific Electronic Library Online

 
vol.48 issue2A review of burn care at an emerging centralised burns unitThe undergraduate paediatric surgery curriculum in Nigeria - how have we fared? author indexsubject indexarticles search
Home Pagealphabetic serial listing  

South African Journal of Surgery

On-line version ISSN 2078-5151

S. Afr. j. surg. vol.48 n.2 Cape Town May. 2010

 

GENERAL SURGERY

 

Emergency abdominal surgery in Zaria, Nigeria

 

 

Adamu AhmedI; Mohammed DaudaI; Stephen GarbaI; Yahaya UkwenyaII

IM.B. B.S., FW.A.C.S.; Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
IIM.B. B.S., F.M.C.S. (nig.), F.W.A.C.S.; Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

 

 


ABSTRACT

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.


 

“Full text available only in PDF format”

 

REFERENCES

1. Cook GC. Gastrointestinal emergencies in the tropics. Baillieres Clin Gastroenterol 1999; 5: 861-886.         [ Links ]

2. Naaeder SB, Achampong EQ. Clinical spectrum of acute abdominal pain in Accra, Ghana. West Afr J Med 1999; 18: 13-16.         [ Links ]

3. McConkey SJ. Case series of acute abdominal surgeries in rural Sierra-Le-onne. World J Surg 2002; 26: 509-513.         [ Links ]

4. Morino M, Pellegrino L, Castagna E, Ferinnella E, Mao P. Acute nonspecific abdominal pain: A randomized controlled trial comparing early lapar-oscopy versus clinical observation. Ann Surg 2006; 244: 881-888.         [ Links ]

5. Okoro LO. A study of the surgical epidemiology, aetiology, bacteriology and leucocytes pattern in appendicitis. FMCS thesis, National Postgraduate College of Nigeria, Lagos, 1987.         [ Links ]

6. Awori MN, Jani G. Surgical implications of abdominal pain in patients presenting to the Kenyatta National hospital casualty department with pain. East Afr Med J 2005; 82: 307-310.         [ Links ]

7. Barker DJP. Acute appendicitis and dietary fibre: an alternative hypothesis. BMJ 1985; 20: 1125-1127.         [ Links ]

8. DeDombal FT, Matharu SS, Staniland JR. Presentation of cancer to hospital as acute abdominal pain. Br J Surg 1980; 67: 413-416.         [ Links ]

9. Paterson-Brown S, Eckerstey JRT, Dudley HAF. The gynaecological profile of acute abdominal surgery. J R Coll Surg Edin 1986; 33: 13-15.         [ Links ]

10. Ohene-Yeboah M. Acute surgical admissions for abdominal pain in adults in Kumasi, Ghana. Aust NZ J Surg 2006; 76: 898-903.         [ Links ]

11. Tzu-Chi H. Comparison of one-stage resection and anastomosis of acute complete obstruction of left and right colon. Am J Surg 2005; 189: 384387.         [ Links ]

12. Yee ML, Wai LL, Kin WC, Ronnie TP. Emergency surgery for obstructing colorectal cancers: A comparison between right-sided and left-sided lesions. J Am Coll Surg 2001; 192: 719-725.         [ Links ]

13. Adesanya AA, Afolabi IR, da-Rocha Afodu JT. Civilian abdominal gunshot wound in Lagos. JR Coll Surg Edin 1998; 43: 230-234.         [ Links ]

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License