Pattern and presentation of acute abdomen in a Nigerian teaching hospital

Abstract

Background:Abdominal pain of sudden onset is the hallmark of most non-traumatic emergency surgical presentations. This presents a scenario of urgency to the young surgeon who has to determine which of a myriad of disease conditions the patient is presenting with. Such a physician has to rely on experience and a sound knowledge of the local aetiological spectrum in making a clinical diagnosis.Objective:To determine the epidemiology and aetiological spectrum of diseases presenting as acute abdomen in the adult population at the hospital surgical emergency unit.Patients and Methods:Two hundred and seventy-six patients presenting at the University of Ilorin Teaching Hospital emergency unit and managed by the general surgeons between 1st of May 2009 and 30th of April 2010 were recruited and followed-up throughout the period of admission. The biodata and clinical information inclusive of diagnosis, investigations, treatment modality and outcome were entered in a structured questioner. Standardised treatment was given to all patients and difficulties encountered in their management were also noted. The data collected was evaluated using SPSS16.Results:Acute abdomen constituted 9.6% of total surgical emergency admissions with patients aged 16-45 years constituting 78.3%. The commonest cause of acute abdomen was appendicitis (30.3%) followed by intestinal obstruction (27.9%), perforated typhoid ileitis 14.9% and peptic ulcer disease (7.6%), respectively.Conclusion:The result from the study is similar to what has been reported in other tropical settings with inflammatory lesions being the major problem. There is also a rising incidence of post-operative adhesions and gradual decline in incidence of obstructed hernia.

A prospective study of epidemiology and clinical presentation of non-traumatic acute abdomen cases in a tertiary care hospital of central India

“…In a study done by Yeboah O et al, the common cause of nontraumatic acute abdomen is acute appendicitis (22.4%) followed by perforation peritonitis (16.2%) and study done by Agboola et al, the commonest cause of nontraumatic acute abdomen is acute appendicitis (30.3%) followed by intestinal obstruction (27.9%). 5,11 Hence, findings in our study regarding spectrum of disease is different as compared with other two studies.…”

Clinical profile of acute abdomen cases at a tertiary care hospital

“…Patients may present with vague complaints and varying associated symptoms making diagnosis difficult which ranges from benign to life-threatening conditions. 4 Abdominal pain can be the manifestation of a spectrum of disease processes. Conditions causing acute abdominal pain may vary, from conditions needing immediate intervention, to relatively mild presentations needing careful observation to avoid over investigation and unnecessary interventions.…”

A study the profile of pathological disorders resulting in acute abdominal non-traumatic surgical emergencies in a tertiary care hospital, North India

“…Back home, Jain and Gupta in their study reported vomiting (72%), abdominal distension (50%), constipation (48%) and fever (41.8%) as the major findings in their study. 3,15 In general, vomiting, constipation and fever seem to be the major findings, however, their prevalence varies slightly in different studies which might be owing to difference in underlying etiology and profile of patient population.…”

“…However, in general, majority of the studies, except those that included only female patients had a skewed gender ratio showing a high prevalence of males as compared to females. 3,[11][12][13][14][15] In the present study, major presenting symptoms except abdominal pain were fever (46.7%), constipation (42.86%) and vomiting (40.66%) respectively. In a study from Nigeria, Agboola et al, reported vomiting (68.5%), anorexia (56.9%) and fever (47.8%) as the major associated complaints apart from acute abdominal pain.…”

“…Causes include gastro-intestinal, urological, and Gynecological among others. 3 Acute abdomen has a sudden onset, can persist for several hours to days and is associated with wide variety of clinical features specific to underlying condition or disease.…”