Pattern of acute abdomen in a Tertiary hospital in Nigeria

Abstract

Acute abdomen is an acute painful abdominal condition that requires urgent surgent evaluation and treatment. This presents a diagnostic dilemma to emergency room physicians because it could be caused by a plethora of conditions. It is therefore necessary for these physicians to know the pattern of acute abdomen in their centres in terms of age and sex distribution, and causes, for prompt diagnosis and treatment. Aims and Objectives · To determine the causes of acute abdomen in our environment · To determine the age and sex distribution of acute abdomen · To determine the presentation. · To know the outcome of acute abdomen Materials and methods: We retrospectively studied the medical records details of all adult patients admitted via the emergency room from 1 August 2018 to 31 July 2019, and information concerning age, sex, presenting complaints, examination findings, diagnosis, treatment, and outcome was obtained. Data was analyzed by SSPS statistical software. Results: We had a total of 113 respondents consisting of 73(65%) females and 40(35%) males. Highest incidence occurred in the 20-29 age range with 30 (26.5%) respondents. Commonest presenting complaint was abdominal pain (99.1%) followed by vomiting 50(44.2%). Most common diagnosis was appendicitis 37(32.7%) comprising 19 males and 18 females with the highest incidence in the 20-29 age group. Intestinal obstruction is the next commonest cause of acute abdomen 11(9.73%) and occurring most frequently in the age group 50-59. Other causes include peritonitis secondary to perforated viscus. These include ileal typhoid perforation, perforated peptic ulcer disease, gall bladder perforation. A case of primary peritonitis was recorded. There were cases of vaso-occlusive crisis in the series. This could pose significant diagnostic dilemma. Overall, 108/113(95.6%) were treated and discharged. No death was recorded in the series (Table 14). Conclusion: Good history, physical examination, easily accessible imaging, and laboratory tests ensure prompt surgical intervention for those who require surgery, thereby reducing morbidity and mortality.