Pattern of Non-traumatic Acute Abdomen in Patients from Ayder Comprehensive Specialized Hospital, Northern Ethiopia: A retrospective analysis

Abstract

Introduction: - Surgical acute abdomen is one of the commonly encountered emergency conditions in general surgery practice worldwide. However, there is paucity of data on its magnitude and pattern of acute abdomen in Ethiopia in general and in Ayder Comprehensive Specialized Hospital in particular.
Objective: The objective of this study was to assess the magnitude and pattern of non-traumatic acute abdomen in patients from Ayder Comprehensive Specialized Hospital, Northern Ethiopia.
Methods: - This is a 2-year retrospective study conducted on 483 patients who underwent surgery for acute abdomen during the calendar year 2015-2016. Data was collected through a review of all medical records, patients card and from the operative log book for acute abdomen in Ayder Comprehensive Specialized Hospital, Mekelle, Northern Ethiopia. Data was entered into EP-Info and analyzed using SPSS software descriptively.
Result: - During the study period there were 514 emergency surgical operations of which 439 were laparotomies for none-traumatic acute abdomen. The male to female ratio in patients with acute abdomen was 3:1. The mean age of patients was 28.4±19.5 with a range of 30 days – 88 years. Acute appendicitis accounts for 50.3% of the cases and was the leading cause of acute abdomen followed by intestinal obstruction 34.0% and peritonitis 15.7%. Among the appendicitis, 11.6% of them were perforated appendix, and 4.1% Perforated Peptic Ulcer Disease. The causes of large intestinal obstruction were sigmoid volvulus (28%), colonic cancer (6.1%) and ileo sigmoid knotting (3%) and that of small bowel obstruction were small bowel volvulus (20.7%), adhesion (16.5%), hernia (15.2%) and intussusceptions (10.4%). Late presented patients showed a higher frequency of peritonitis.
Conclusion: - Acute abdomen was found to be quite common. The leading cause was acute appendicitis. Besides, higher proportions of patients were with peritonitis due to late presentation. Hence, the emergency management of the hospital should be strengthened to handle the number of patients deserving emergency laparotomy.