ORIGINAL ARTICLES Pattern of Abdominal Trauma and Treatment Outcome in a Nigerian Tertiary Hospital

West Afr J Med . 2023 Mar 31;40(3):321-328.

Abstract

Abstract  in English, French

Background: Trauma is the leading cause of mortality in young adults, often with the involvement of the abdomen.

Aims: To report the pattern and treatment outcome of abdominal trauma in a Nigerian tertiary hospital.

Patients and methods: A retrospective observational study of abdominal trauma cases managed in the University of Port Harcourt Teaching Hospital Port Harcourt, Rivers State, Nigeria from April 2008 to March 2013. The variables studied included socio-demographic, mechanism and type of abdominal injury, initial pre-tertiary hospital care, haematocrit level at presentation, abdominal ultrasound scan, treatment options, operative findings and outcome. Statistical analyses of the data were performed using IBM SPSS Statistics for Windows, Version 25.0 Armonk, NY, USA.

Results: A total of 63 patients with abdominal trauma were included with a mean age of 28.1 ± 7.0 years (16 - 60 years), of which 55 cases (87.3%) were males. A mean injury to arrival time of 33.75±53.1 hours and a median revised trauma score of 12 (8-12) were recorded among the patients. Penetrating abdominal trauma was seen in 42 (66.7%) and operative treatment was performed on 43 (69.3%) patients. At laparotomy, hollow viscus injury was predominant - 32/43(52.5%). A postoperative complication rate of 27.7% was recorded with 6(9.5%) mortality. The type of injury (B = -22.1), initial pre-tertiary hospital care (B = -25.9), RTS (B = -10.1) and age (B = -0.367) respectively all had a negative influence on mortality.

Conclusion: Hollow viscus injury is frequently detected at laparotomy for abdominal trauma and negatively influences mortality. The more frequent use of diagnostic peritoneal lavage to detect cases that need urgent surgical intervention is strongly advocated in this low-middle-income setting.

Keywords: Abdomen; Outcome; Pattern; Trauma; Treatment.

E Ray-Offor ¹, V Enebeli ¹, S E B Ibeanusi ¹