Prevalence and management outcome of non- traumatic emergrncy surgical acute abdomen at mettu karl referral hospital, iluababur zone, Ethiopia

Abstract

BACKGROUND: Acute abdomen is an acute onset of abdominal disease entities that require immediate surgical intervention in most of the cases. The causes of non-traumatic surgical acute abdomen and their relative incidence vary in different populations. Intestinal obstruction and acute appendicitis are the leading causes of non-traumatic surgical acute abdomen in African countries and developed world respectively. There are only few studies on non-traumatic surgical acute abdomen in oromia region, Ethiopia. OBJECTIVE: The aim of this study was to assess the prevalence and management outcome of non-traumatic emergency surgical acute abdomen at mettu Karl referral Hospital. METHODES: The study was conducted at mettu Karl referral Hospital from March, 2017 to August, 2017G.C. Institutional based prospective cross sectional study design that was supported by quantitative data collection method was conducted. All patients admitted with a diagnosis of non-traumatic emergency surgical acute abdomen during study period were included in the study. Interview and checklist data collection technique were used. The data were checked for its completeness. Then it was coded, entered, cleaned and analyzed using SPSS version 22. RESULTS: Based on the five months prospective study there were 92 non traumatic emergency surgical acute abdomens admitted in surgical ward and the prevalence was 18.5%. 84.8% of cases were managed surgically and 15.2% were managed conservatively. 24(26.1%) were from mettu town and 68(73.9%) out of mettu town. Abdominal pain, vomiting and nausea were the most frequent symptoms whereas abdominal tenderness, distention and tenderness and guarding were the most frequent clinical signs. More than 54.3% of patients came after 3days duration of illness. The three top causes of acute abdomen were appendicitis accounting 39 (42.4%), followed by bowel obstruction 34 (37%) and Peritonitis secondary to perforated appendicitis 8(8.7%), PPUD 5(5.4%), GSBO 3(3.3%), primary peritonitis 2(2.2) and typhoid perforation (1.1%). The total complications after management were 18(19.6%) of which the commonest early postoperative complications other than death were wound infection (5.4%), sepsis (4.3%) and pneumonia (2.3%) and death rate was 5.4% with five patients. CONCLUSSION: The mortality and morbidity associated with acute abdomen were very high. This higher morbidity and mortality were calls for an integrated effort to decrease its causes.