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Outcome of Emergency Abdominal Surgery at Kigali University Teaching Hospital: A review of 229 cases.
Nyundo, M.; Rugwizangoga, E.; Ntakiyiruta, G. & Kakande, I.
Abstract
Background:
Surgical abdominal emergencies constitute an entity of pathologies requiring
immediate medical and surgical management in most of the cases. There is little information
regarding the clinical spectrum of disease in these patients and the outcome after admission
to hospital. This study was conducted at Kigali University Teaching Hospital (KUTH) and the
main objective was to determine the outcome of emergency abdominal surgery at Kigali
University Teaching Hospital.
Methods:
This was a case series study of 229 patients who underwent emergency abdominal
surgery at Kigali University Teaching Hospital over a period of 9 months. Variables analysed
included the socio-demographic, clinical features, management and outcome of treatment.
The multivariate analysis was applied to different factors to analyze their statistical
correlation with mortality and morbidity.
Results:
The patients’ ages ranged from 3 months to 87 years with an average of 28.8 years ±
18.2. The male to female sex ratio was 1.7:1.The majority of patients were referred (83.4%).
The average time interval between onset of symptoms and admission was 3.6 days. Abdominal
pain (100%) and constipation (51.1%) were the commonest complaints and abdominal
distension (59%) and tenderness and guarding (45.4%) the most frequent physical findings.
Abdominal trauma accounted for 11.8% of the cases. The most common operative findings
were peritonitis (41.5%), intestinal obstruction (28.4%) and acute appendicitis (11.8%).
Postoperative complications included wound infection (8.7%) and septicaemia (4.8%). The
overall mortality was 18%. Variables influencing morbidity and mortality included the
transfer (p=0.027), red cell count <4.106 (p = 0.002), haematocrit < 21% (p= 0.023), abnormal
leukocytosis (p= 0.008), duration of surgery more than 1 hour (p= 0.034), presence of
peritonitis (p = 0.005) and duration of hospitalization >7 days (p = 0.009).
Conclusion:
Many patients requiring emergency abdominal surgery presented relatively late
with an average of 3.6 days time interval between onset of symptoms and admission, serious
attention is needed for these patients because the mortality is high.
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