Surgical and Gynaecological Abdominal Emergencies in Adults: The Experience of Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria.

Abstract

The objective of this study is to highlight the clinical spectrum of surgical and gynaecological abdominal emergencies in an urban teaching hospital in Nigeria. All emergency abdominal operations carried out in LASUTH between July, 2004 and December, 2006 were retrospectively studied. Data extracted from case files of patients, theatre operation registers and ward registers were analyzed. A total of 803 patients were reviewed. There were 254(31.6%) males and 549(68.4%) females. Ectopic pregnancy accounted for 44% of the emergencies. Acute appendicitis and intestinal obstruction were the reasons for surgery in 22% and 17% of the patients respectively. Less common indications were trauma(5.4%), septic abortion(3.6%), typhoid ileal perforation(3%) and gastroduodenal perforation(2.6%). Obstructed external hernia was the leading cause of intestinal obstruction while complicated appendicitis was the major cause of generalized peritonitis. Mortality rate was 4.5%. Ectopic gestation is the commonest indication for emergency exploratory laparotomy in our centre and should be considered in the diagnosis of acute abdomen in females. Early elective surgery for external hernia and prompt surgical treatment of acute appendicitis may decrease the burden of intestinal obstruction and generalized peritonitis in our practice.

Key words: abdominal emergencies, gynaecological emergencies, acute abdomen, surgical abdomen.