Penetrating Abdominal Trauma: Experience in A Teaching Hospital, Calabar, Southern Nigeria
ABSTRACT
Background: Penetrating abdominal trauma (PAT) typically involves the violation of the abdominal cavity by a gun-shot wound (GSW) or stab wound Recently several studies have favored a more conservative approach as opposed to mandatory exploratory laparotomy. Methods: Patients admitted in the University of Calabar Teaching Hospital (UCTH), Calabar, with PAT from January 2008 to December 2010 were prospectively studied based on a questionnaire. The total number of patients with PAT was compared with total number of emergencies, traumatic injuries and abdominal trauma seen during the same period. Results: A total of 48 patients presented with abdominal trauma: PAT 29 (60%) and blunt abdominal trauma (BAT) 19 (40%). The ages of the patients (28 male, 1 female) ranged from 3 - 62 years (mean 28.1 years). Gunshot wound (GSW) 11 (38%) patients, stab wound 8 (27.6%) patients and machete cut 4 (13.8%) patients ranked first, second and third respectively as causes of PAT. The commonest organ injury was perforation of the small intestine. Four (13.8%) patients were managed conservatively while 25 (86.2%) patients had laparotomy. The duration of admission ranged from 2 - 19 days (mean 10.5 days). Morbidity [surgical site infection (SSI)] and mortality were recorded in 2 (6.9%) and 3 (10.3%) patients respectively. Conclusion: Key areas that require attention have been highlighted. Revamping the ailing economy and gainful employment for youths are paramount areas that require prompt, dedicated and sustained intervention for reduction in violent crimes.
Background: Penetrating abdominal trauma (PAT) typically involves the violation of the abdominal cavity by a gun-shot wound (GSW) or stab wound Recently several studies have favored a more conservative approach as opposed to mandatory exploratory laparotomy. Methods: Patients admitted in the University of Calabar Teaching Hospital (UCTH), Calabar, with PAT from January 2008 to December 2010 were prospectively studied based on a questionnaire. The total number of patients with PAT was compared with total number of emergencies, traumatic injuries and abdominal trauma seen during the same period. Results: A total of 48 patients presented with abdominal trauma: PAT 29 (60%) and blunt abdominal trauma (BAT) 19 (40%). The ages of the patients (28 male, 1 female) ranged from 3 - 62 years (mean 28.1 years). Gunshot wound (GSW) 11 (38%) patients, stab wound 8 (27.6%) patients and machete cut 4 (13.8%) patients ranked first, second and third respectively as causes of PAT. The commonest organ injury was perforation of the small intestine. Four (13.8%) patients were managed conservatively while 25 (86.2%) patients had laparotomy. The duration of admission ranged from 2 - 19 days (mean 10.5 days). Morbidity [surgical site infection (SSI)] and mortality were recorded in 2 (6.9%) and 3 (10.3%) patients respectively. Conclusion: Key areas that require attention have been highlighted. Revamping the ailing economy and gainful employment for youths are paramount areas that require prompt, dedicated and sustained intervention for reduction in violent crimes.
Cite this paper
M. Asuquo, M. Umoh, V. Nwagbara, G. Ugare, C. Agbor and E. Japhet, "Penetrating Abdominal Trauma: Experience in A Teaching Hospital, Calabar, Southern Nigeria," International Journal of Clinical Medicine, Vol. 3 No. 5, 2012, pp. 426-430. doi: 10.4236/ijcm.2012.35079.
M. Asuquo, M. Umoh, V. Nwagbara, G. Ugare, C. Agbor and E. Japhet, "Penetrating Abdominal Trauma: Experience in A Teaching Hospital, Calabar, Southern Nigeria," International Journal of Clinical Medicine, Vol. 3 No. 5, 2012, pp. 426-430. doi: 10.4236/ijcm.2012.35079.
References
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[1] Osime CO, Oludiran OO. Penetrating abdominal injury cases admitted in University of Benin Teaching Hospital. Ann Biomed Sci, Vol 3(1/3),2004, pp 39-44. [2] Offner P, Geibel J, Stanton-Maxe KJ, Bjerke HS et al. Penetrating abdominal trauma. Available at http://emedicine.medscape.com/article/2036859-overview updated Jan 23 2012. [3] Asuquo ME, Bassey OO, Etiuma AU, Ugare G, Ogbu N. A prospective study of penetrating abdominal trauma at the University of Calabar Teaching Hospital, Calabar, Southern Nigeria. Eur J Emerg Surg, Vol 3, 2009, pp 277-280. [4] Christensen W. Small bowel and mesentery. In: Blaisdell FW, Trunkey DD. Editors Abdominal trauma vol. 1, Newyork NY USA. Thieme-Stratton 1982. [5] Dongo AE, Kesieme EB, Irabor DO, Ladikpo JK. A review of posttraumatic bowel injuries in Ibadan. ISRN Surg 2011; 2011: 478042. Published online 2011 Aug 17. doi10.5402/2011/478042. [6] Hope WW, Smith ST, Medieros B, Hughes KM, Kotwall CA, Clancy TV. Non-operative management in penetrating abdominal trauma: Is it feasible at a level 11 trauma centre? Emerg Med 2011 [ Epub ahead of print]. [7] Baker P. Penetrating wounds of the torso. JR Army Med Corps, Vol 147, 2001, pp 62-72. [8] Ohanaka CE, Irib-hoghe PC, Ofoegbu RO. Gunshot injuries in Benin City. Nig J Surg Sci, Vol 10, 2000, pp 81-85. [9] Ayoade BA, Salami BA, Tade AO, Musa AA, Olawoye OA. Abdominal injuries in Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Nig J Orthop and Trauma, Vol5(2), 2006, pp 45-49. [10] Osime C, Kpolugbo J. Penetrating injuries in Irrua. A suburban community in Nigeria. Afr J Trauma, Vol 2(1), 2004, pp 40-42. [11] Naeder SB. Pattern of abdominal injuries in Korle BU Teaching Hospital, Accra. Ghana Med J, Vol 24, 1990, pp 184-190. [12] Mong SJ, Lyle JA, Black M. A review of gunshot deaths in Strathclyde 1989-1998. Med Sci Law, Vol 41, 2001, pp 260-265. [13] Edino ST. Pattern of abdominal injuries in Aminu Kano Teaching Hospital, Kano. NPMJ, Vol 10, 2003, pp 56-59. [14] Navsaria PH, Berli JU, Edu S, Nicol AJ, Non-operative management of abdominal stab wounds: an analysis of 186 patients. S Afr J Surg, Vol 45(4), 2007; pp 128-130. [15] Hoyt DB, Mossa AR. Abdominl injuries. In Cuschieri A, Giles GR, Mossa AR editors. Essential Surgical Practice vol 3. Boston, Mass. USA: Butter Worth Heinemann; 1995. pp 531-544. [16] Asuquo M, Nwagbara V, Ugare G, Inyang A. Penetrating abdominal trauma. Nig J Surg Sci, Vol 1(2), 2005, pp 47-50. [17] Feliciano DV, Burch JM, Spjut-Patrinely V, Mattox KL, Jordan GL Jnr. Abdominal gunshot wounds: an urban trauma centre experience with 300 consecutive patients Ann Surg, Vol 208, 1988, pp 362-370. [18] Van Brussel M, Van Hee R. Abdominal stab wounds: a five year patient review. Eur J Emerg Med, Vol 8, 2001, pp 83-88. [19] da Silva M, Navsaria PH, Edu S, Nicol AJ. Evisceration following stab wounds: analysis of 66 cases. World J Surg, Vol 33(2), 2009, pp 215-219. [20] Clarke DL, Allorto Nl, Thomson SR. An audit of failed non-operative management of abdominal stab wounds. Injury, Vol 41(5), 2010, pp488-491. [21] Saghafinia M, Nafissi N, Motamedi MRK et al. Assesment and outcome of 496 penetrating gastrointestinal warfare injuries. J Royal Army Med Corps, Vol 156(1), 2010, pp 25-27.