The changing pattern of acute abdomen in Port Harcourt, Nigeria

Abstract

Background: Acute abdomen is common. The causes are many and vary somewhat from place to place and may change over time.

Aim: To study the present epidemiology of acute abdomen in Port Harcourt.

Methods: All patients with acute abdomen in the University of Port Harcourt Teaching Hospital (UPTH) between January and December 2004 were prospectively studied with respect to their biodata, clinical presentation, investigations, diagnosis, treatment and outcome. Data analysis was done using tables and the SPSS package version eleven.

Results: Out of 189 patients recruited into the study, 9 left the hospital against medical advice. Therefore, 180 patients formed the basis of the study. The mean age of the patients was 25.7±15.9 years. The peak age incidence was in the 20-29 years bracket. The male to female ratio was 1.3 :1. Acute appendicitis (47.2 %) was the commonest cause of  acute  abdomen,  followed  by abdominal trauma  (25.6%) and intestinal obstruction ( 19.4 %). Abdominal pain (96.7 %) was the commonest symptom, followed by anorexia and vomiting (46.7 % each). The mean duration of symptoms before presentation was 2.0±2.9 days. Only 73 (40.6 %) patients presented to the hospital within 24 hours of onset of symptoms.  Complications of treatment occurred in 18.9% of patients  while the mortality rate  was 10 %.

Conclusion: There was a slight male preponderance and the mortality was fairly high. Abdominal trauma has replaced intestinal obstruction as the second commonest cause of acute abdomen while adhesion bands now equal obstructed inguinal hernia as the commonest causes of intestinal obstruction. 

Keywords: Acute abdomen, Change in pattern, Epidemiology, Port Harcourt