Document Type: Original Article

Authors

1 Department of Surgery, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria

2 Department of Surgery, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria

3 Department of Anaesthesia, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria

4 Department of Epidemiology and Community Health, Ekiti State University, Ado-Ekiti, Nigeria

Abstract

Objective: There has been a global increase in the incidence of abdominal trauma in surgical patients. We conducted this study to evaluate the pattern of abdominal injuries, patient characteristics and the management outcome in our setting.
Methods: It was a descriptive (combined retrospective and prospective) study of all patients with abdominal trauma admitted and managed at Ekiti State University Teaching Hospital, Ado-Ekiti between January 2013 and December 2016. Data on socio-demographics, clinical profile, investigations, treatments and outcome were entered into a spread sheet and analyzed using SPSS version 20.0.
Results: A total of 2728 trauma patients presented during the study period. Of these, 68 (2.5%) suffered from abdominal injuries. Their ages ranged from 6 to 72 years (mean 30.3±13.2). Fifty-nine (86.8%) were males while 9 (13.2%) were females (M: F ratio = 6.6:1). Forty-nine (72.1%) sustained blunt trauma while 19 (27.9%) had penetrating injuries. Road traffic incident (RTI) (n=41; 60.3%) was the most common source of trauma, followed by assault: gunshot (n=9; 13.2%), and stab (n=7; 10.3%). Spleen (n=23; 33.8%) was the most common solid organ injured followed by the liver (n=7; 10.3%) while small bowel (n=8; 11.8%) was the most common hollow viscous injured. Forty-seven (69.1%) required operative intervention. Post-operative complication rate was 17% with wound infection (12.5%) predominating. The mortality rate was 4 (5.9%).
Conclusion: RTI and assault are major causes of abdominal injury. Measures to reduce RTI, youth restiveness and criminal activities will stem the tide.

Keywords

Main Subjects

1. Smith J, Caldwell E, D’Amours S, Jalaludin B, Sugrue M. Abdominal trauma: a disease in evolution. ANZ J Surg 2005; 75(9): 790-4. doi: 10.1111/j.1445-2197.2005.03524.x.
2. Hemmila MR, Wahl WL. Management of the Injured Patient. In: Doherty GM, ed. Current Surgical Diagnosis and Treatment. McGraw-Hill Medical; 2008. p. 227-8.
3. Mock CN, Jurkovich GJ, nii-Amon-Kotei D, Arreola-Risa C, Maier RV. Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. J Trauma 1998; 44(5): 804-12; discussion 12-4.
4. Etonyeaku AC, Ogundipe KO, Omotola CA, Ishola OJ, Olasehinde O, Obonna GC. Spectrum of Gunshot Injuries in Civilian Practice at a Tertiary Hospital in a Semi-rural Community in Nigeria. East Cent Afr J Surg 2014; 19(1): 83-9.
5. Olasehinde O, Adisa AO, Aderibigbe AS, Alatise OL, Etonyeaku AC, Adesunkanmi AR, et al. Pattern and outcome of traumatic gastro- intestinal injuries in ileife. Niger Postgrad Med J 2015; 22(1): 37-40.
6. Oluwadiya KS, Kolawole IK, Adegbehingbe OO, Olasinde AA, Agodirin O, Uwaezuoke SC. Motorcycle crash characteristics in Nigeria: implication for control. Accid Anal Prev 2009; 41(2): 294-8. doi: 10.1016/j.aap.2008.12.002.
7. Aldemir M, Tacyildiz I, Girgin S. Predicting factors for mortality in the penetrating abdominal trauma. Acta Chir Belg 2004; 104(4): 429-34.
8. Baker P. Penetrating Wounds of the Torso. J R Army Med Corps 2001; 147(1): 62-72. doi: 10.1136/jramc147-01-06.
9. Asuquo ME, Bassey OO, Etiuma AU, Ugare G, Ngim O. A Prospective Study of Penetrating Abdominal Trauma
at the University of Calabar Teaching Hospital, Calabar, Southern Nigeria. Eur J Trauma Emerg Surg 2009; 35(3):
277. doi: 10.1007/s00068-008-8089-6.
10. Edino ST. Pattern of abdominal injuries in Aminu Kano Teaching Hospital, Kano. Niger Postgrad Med J 2003;10(1): 56-9.
11. Maske AN, Deshmukh SN. Traumatic abdominal injuries: our experience at rural tertiary care center. Int Surg J 2016; 3(2): 543-8. doi: 10.18203/2349-2902.isj20160982.
12. Musau P, Jani PG, Owillah FA. Pattern and outcome of abdominal injuries at Kenyatta National Hospital, Nairobi. East Afr Med J 2006; 83(1): 37-43.
13. Ayoade BA, Salami BA, Tade AO, Musa AA, Olawoye OA. Abdominal injuries in Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria: Pattern and Outcome. Niger J Orthop Trauma 2006; 5(2): 45-9.
14. Yusufu LM, Sabo SY, Odigie VI. Blunt abdominal trauma in Zaria, Nigeria. S Afr J Surg 2005; 43(2): 46-8.
15. Olaogun JG, Adeojo IP, Ige JT, Briggs PK, Ajayi OO. Bowel prolapse and strangulation following induced abortion: a case report and review of literature. Int J Health Sci Res 2016; 6(12): 364-7.
16. Dogo D, Yawe T, Hassan AW, Tahir B. Pattern of abdominal trauma in North Eastern Nigeria. Niger JSurg Res 2000; 2(2): 48-51. doi: 10.4314/njsr.v2i2.12184.
17. Adejumo AA, Thairu Y, Egenti N. Profile of abdominal trauma in federal teaching hospital, Gombe, North-east,
Nigeria: A cross sectional study. Int J Innov Med Health Sci 2015; 4: 41-5.
18. Ahmed I, Hashmi SK, Tanwir F, Ahmed S, Saad M. Hepatic trauma and associated injuries- experience in a tertiary care hospital. Pakistan Oral & Dental Journal 2014; 34(2): 242-4.
19. Saaiq M, Niaz ud D, Zubair M, Shah SA. Presentation and outcome of surgically managed liver trauma:experience at a tertiary care teaching hospital. J Pak Med Assoc 2013; 63(4): 436-9.
20. Chalya PL, Mabula JB, Giiti G, Chandika AB, Dass RM, McHembe MD, et al. Splenic injuries at Bugando Medical Centre in northwestern Tanzania: a tertiary hospital experience. BMC Res Notes 2012; 5: 59. doi:10.1186/1756-0500-5-59.
21. Chalya PL, Mabula JB. Abdominal trauma experience over a two-year period at a tertiary hospital in northwestern Tanzania: a prospective review of 396 cases. Tanzan J Health Res 2013; 15(4): 230-9.
22. Dodiyi-Manuel A, Jebbin NJ, Igwe PO. Abdominal injuries in university of port harcourt teaching hospital. Niger J Surg 2015; 21(1): 18-20. doi: 10.4103/1117-6806.153191.
23. Munns J, Richardson M, Hewett P. A review of intestinal injury from blunt abdominal trauma. Aust N Z J Surg
1995; 65(12): 857-60. doi: 10.1111/j.1445-2197.1995.tb00576.x.