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Pattern of Emergency Surgical Operations Performed for Non-Traumatic Acute Abdomen at Ayder Referral Hospital, Mekelle University, Tigrai, Ethiopia by the Year 2000-2003 Ec

Melese Takele Wossen

Background: Acute is defined as a sudden onset abdominal pain which often requires an immediate intervention. The causes of acute abdomen are several and their relative incidence varies in different populations. Several factors are described to be responsible for these differences. Socioeconomic factors and diet have mostly been incriminated to be responsible for the observed differences.

Intestinal obstruction has been the leading cause of acute abdomen in several African countries whereas acute appendicitis is the most frequently seen cause in the developed world. The leading causes of intestinal obstruction in Africans have mostly been hernia and volvulus whereas adhesions are most frequent in the developed world. There are, however, some African studies which are pointing to a change in these established patterns. This study was aimed at assessing the magnitude, pattern of acute abdomen in Ayder referral hospital.

Methods: This was a 3 years retrospective study conducted on all patients operated for non-traumatic acute abdomen in Ayder hospital, Mekelle, during the year of September, 2000-2003 E.C.

Results: During the study period there were 514 emergency surgical operations of which 439 were laparotomies for acute abdomen. The male to female ratio 3:1, the age ranged from 30 days-88 years with a mean of 28.4 ± 19.5 years. Two hundred fifty patients (57%) were urban dweller, 189 (43%) cases were from rural area; of which 152 (34.6%) were referred from nearby health centers and affiliated hospitals presented late with duration of illness more than 5 days. Acute appendicitis accounting for 55.35% of cases was the leading cause of acute abdomen followed by intestinal obstruction 37.35% and peritonitis 17.3% among which 10% was resulted from perforated appendix, and 4.6% from PPUD. A higher frequency of peritonitis was observed on patients who presented late.

Conclusion and recommendation: Acute abdomen is a surgical condition with high rate of morbidity and mortality if not managed timely and appropriately. To alleviate this problem creation of health awareness on acute abdomen to the general population in general and to the low and mid-level health care providers in particular is of paramount importance. As most of the complicated cases with delayed presentation are referred cases and most of them can be handled by properly trained MSC in emergency surgery such resources should be available at the most commonly referring health institutions.