Abdominal trauma experience over a two-year period at a tertiary hospital in northwestern Tanzania: a prospective review of 396 cases

Abdominal trauma continues to be a major cause of trauma admissions all over the world and contributes significantly to high morbidity and mortality. A descriptive prospective study was conducted at Bugando Medical Centre in north-western Tanzania to describe our experience on the management of abdominal trauma outlining the causes, injury characteristics and treatment outcome of these patients. Statistical data analysis was done using SPSS programme. A total of 396 patients were studied. Male to female ratio was 3.2: 1. The median age was 28 years. More than three quarter of patients sustained blunt abdominal injuries. Road traffic accidents (RTAs) were the most common cause of injury accounting for 64.9% of cases. None of our patients received any pre-hospital care. The spleen was the most common injured organ in blunt abdominal trauma occurring in 176 (75.9%) patients, while in penetrating injury; gastrointestinal tract was the most common in 24(10.3%) patients. One hundred twenty-four (31.3%) patients had associated extra-abdominal injuries of which the head/ neck region (46.8%) was commonly affected. A total of 232 (58.6%) patients were treated surgically with a negative laparotomy rate of 7.8%. Complication and mortality rates were 20.7% and 17.9% respectively. The age of patients, presence of associated extra-abdominal injuries, severity of injury (Kampala Trauma Score II ≤ 6), admission Systolic Blood Pressure < 90mmHg, injury-arrival time > 24 hours and presence of postoperative complications mainly surgical site infections significantly predicted mortality (p < 0.001). The overall median length of hospital stay was 12 days. Patients who had severe trauma (KTS II ≤6) and those with associated injuries stayed longer in the hospital (p < 0.001). Abdominal trauma resulting from RTAs is still rampant in our environment and remains a major source of morbidity and mortality. Preventive strategies should be focused on reduction of road traffic accidents, violent crimes and social conflicts.

Keywords
abdominal trauma; aetiology; injury patterns; treatment; outcome; Tanzania