Penetrating abdominal injuries in an emerging semi-urban teaching hospital

Objective: There has been a worldwide rise in the prevalence of penetrating abdominal injury (PAI), and there are both inter-country and intra-country variations in frequencies. This study evaluates the mechanisms and pattern of penetrating abdominal injuries and the treatment outcome in our center.Methods: This descriptive study of adult patients managed for PAI was conducted at the Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti from January ۲۰۱۵ to December ۲۰۱۸. Data were prospectively collected and analyzed by using descriptive statistics from Statistical Package for Social Sciences (SPSS) version ۲۰.۰.Results: There were ۹۶ patients managed for abdominal injuries during the study period. Forty-six (۴۷.۹%) of them had PAI, while ۵۰ (۵۲.۱%) others sustained blunt trauma. Patients ages ranged from ۱۷-۷۲ years (mean = ۳۴.۲±۱۰.۸ years; median = ۳۴ years). Majority, ۴۲ (۹۱.۳%), were males, while ۴ (۸.۷%) were females (M: F=۱۱:۱). The most afflicted age group was in the ۴th decade. Majority of the injuries were due to gunshot (۶۰.۹%) followed by stab (۲۶.۱%), unsafe abortion (۶.۵%), road traffic injury (۴.۳%) and fall (۲.۲%). Gastrointestinal injuries were the most common with small bowel perforations predominating. Solid organ injuries were only seen in ۳ (۷.۹%) patients. Eight (۱۷.۴%) had associated extra-abdominal injuries. Thirty-eight (۸۲.۶%) patients required exploratory laparotomy, while ۸ (۱۷.۴%) were managed non-operatively. The negative laparotomy rate was ۲.۶%. Seven (۱۵.۲%) patients developed complications which were mostly wound infection (۱۰.۸%). The duration of hospital stay was ۱-۵۸ days (mean ۱۲.۷±۱۰.۵). Three patients (۶.۵%) with gunshot injuries died.Conclusion: Gunshot wounds were the major variant of PAI, and the highest cause of mortality from it. Gut injuries were most common, and exploratory laparotomy remains the main-stay of treatment, while non-operative management is practicable in carefully selected cases.

Keywords:

Penetrating abdominal injury , Pattern , Non-operative management , laparotomy , outcome , Nigeria