Adenuga Adedire Timilehin, Adeyeye Ademola
Department of Surgery, Cedarcrest Hospitals, Abuja, Nigeria.
Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
J Emerg Trauma Shock. 2023 Jan-Mar;16(1):8-12. doi: 10.4103/jets.jets_91_22. Epub 2023 Feb 24.
Abdominal trauma is a major cause of morbidity and mortality in low- and middle-income countries. There is a paucity of trauma data in this region and this study aimed to show the pattern of presentation and outcome of patients with abdominal trauma at a North-Central Nigerian Teaching Hospital.
This was a retrospective, observational study of patients with abdominal trauma who presented at the University of Ilorin Teaching Hospital from January 2013 to December 2019. Patients with clinical and/or radiological evidence of abdominal trauma were identified, and data extracted and analyzed.
A total of 87 patients were included in the study. There were 73 males and 14 females (5.2:1) with a mean age of 34.2 years. Blunt abdominal injury occurred in 53 (61%) patients with 10 patients (11%) having concomitant extra-abdominal injuries. A total of 105 abdominal organ injuries occurred in 87 patients with the small bowel being the most frequently injured organ in penetrating trauma, while in blunt abdominal injury, the spleen was most commonly injured. A total of 70 patients (80.5%) had emergency abdominal surgery with a morbidity rate of 38.6% and negative laparotomy rate of 2.9%. There were 15 deaths in the period accounting for 17% of patients with sepsis as the most common cause of death (66%). Shock at presentation, late presentation >12 h, need for perioperative intensive care unit admission, and repeat surgery were associated with a higher risk of mortality ( < 0.05).
Abdominal trauma in this setting is associated with a significant amount of morbidity and mortality. Typical patients present late and with poor physiologic parameters often resulting in an undesirable outcome. There should be steps targeted at preventive policies focused on reducing the incidence of road traffic crashes, terrorism, and violent crimes as well as improving health care infrastructure to cater to this specific group of patients.
腹部创伤是低收入和中等收入国家发病和死亡的主要原因。该地区创伤数据匮乏，本研究旨在揭示尼日利亚中北部一家教学医院腹部创伤患者的就诊模式和治疗结果。
这是一项对2013年1月至2019年12月在伊洛林大学教学医院就诊的腹部创伤患者进行的回顾性观察研究。确定有腹部创伤临床和/或放射学证据的患者，提取并分析数据。
共有87例患者纳入研究。男性73例，女性14例（5.2:1），平均年龄34.2岁。53例（61%）患者为钝性腹部损伤，10例（11%）伴有腹部外损伤。87例患者共发生105处腹部器官损伤，穿透性创伤中最常受伤的器官是小肠，而钝性腹部损伤中最常受伤的是脾脏。共有70例患者（80.5%）接受了急诊腹部手术，发病率为38.6%，阴性剖腹率为2.9%。在此期间有15例死亡，占患者的17%，败血症是最常见的死亡原因（66%）。就诊时休克、就诊时间>12小时、围手术期需要入住重症监护病房以及再次手术与较高的死亡风险相关（<0.05）。
在这种情况下，腹部创伤与大量发病和死亡相关。典型患者就诊较晚且生理参数较差，往往导致不良后果。应采取针对性措施制定预防政策，重点是减少道路交通事故、恐怖主义和暴力犯罪的发生率，以及改善医疗基础设施以满足这一特定患者群体的需求。
