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Analysis Of Acute Abdomen Admissions In The Surgical Emergency Room Of A Developing Third World Country

Mudassir Maqbool Wani
Department of General Surgery
SMHS Hospital Physical Address

Mussadiq A. Khan
Department of General Surgery
SMHS Hospital Physical Address

Mubashir Maqbool Wani
Department of General Surgery
SMHS Hospital Physical Address

Abdul Munnon Durrani
Department of General Surgery
SMHS Hospital Physical Address

Baint Singh
Department of General Surgery
SMHS Hospital Physical Address

Muhhamed Shafi
Department of General Surgery
SMHS Hospital Physical Address

Citation: M. M. Wani, M. A. Khan, M. M. Wani, A. M. Durrani, B. Singh & M. Shafi : Analysis Of Acute Abdomen Admissions In The Surgical Emergency Room Of A Developing Third World Country . The Internet Journal of Surgery. 2007 Volume 11 Number 2

Keywords: Emergency room admissions | acute abdomen | acute appendicitis | ascariasis

 

Abstract

Our objective is to present updated results of the systemic analysis of acute abdomen in surgical emergency of SMHS hospital, Kashmir, India, a hospital in a third world country. The design is a prospective systematic analysis. Our data sources were admissions in the surgical emergency room over a period of 6 months (from April 15th 2006 to October 15th 2006). Only patients admitted for more than 24 hours were included in the study. Outcomes from our study reveal that acute appendicitis and ascariasis are the main reasons for the admission in our region. We conclude that a junior resident in our region and in a surgical emergency room should be well versed in diagnosing acute appendicitis. Also due to poor health education and lack of basic facilities ascariasis continues to be a major cause of admissions in our setup.


Introduction

Acute abdomen is one of the commonest causes of admission in the surgical emergency room even in the present era where trauma cases have increased manifold. The pattern of acute abdomen admissions varies from one place to another depending upon the socioeconomic, dietary, environmental factors and public health setup.

Methods

We carried out a systematic analysis of 800 patients admitted with a diagnosis of acute abdomen. Using an abdominal page chart as used in OMGE series, patients were examined, investigated, diagnosed and treated.

Thumbnail:

Thumbnail: Results From Our Series: On the basis of final diagnosis the following results were found:
Results From Our Series: On the basis of final diagnosis the following results were found:

Thumbnail: Studies of Acute Abdomen from Developed Countries
Studies of Acute Abdomen from Developed Countries

Thumbnail: Pie Chart From Our Series
Pie Chart From Our Series

Discussion

The evidence from our study suggests that more than a quarter of patients had appendix related diseases. Thus, the junior resident should be well versed with diagnosing this condition. Alvarado's score is a very useful tool in this aspect for the surgical resident in the emergency room.

Due to lack of health education and poor facilities, Ascariasis is the second most common reason for admission in our hospital. The pattern of presentation is very varied. Problems of patients admitted range from worm colic and worm obstruction to worms in the hepatobiliary system, the main reason being lack of education and poor sanitary facilities.

Some diseases that are quite common causes of admission as acute abdomen in the west are rare in our society. This variation is attributed to differences in socio-economic, dietary, environmental and public health facilities.

Correspondence address

Mudassir Maqbool Wani
Doctors Hostel Room no 20
GMC Srinagar, JK, India
Pin 190010
Email [mudds_123@Yahoo.co.in]
Phone no. 9906533228

References

1. de Dombal FT. Diagnosis of Acute Abdominal Pain, 2nd ed., Churchill Livingstone, London, 1991. (s)

2. Brever RJ, Golden GT, Hitch DG et al. Abdominal pain; an analysis of 1000 consecutive cases in a university hospital. Am J Surg 131:219, 1976. (s)

3. Haworth IE. Abdominal pain as a cause of acute abdomen admission to hospital. J R Coll Surg Edinb, 37:389, 1992. (s)

4. de Dombal FT. The OMGE acute abdominal pain survey, Progress report 1986. Scand J Gastroenterology 144(suppl):35, 1988. (s)

5. Irvin TT. Abdominal pain , a surgical audit of 1190 emergency admissions. Br J Surg 76:1121, 1989. (s)

6. Wilson DH, Wilson PD, Walmsey RG et al. Diagnosis of acute abdominal pain in the accident and emergency department. Br J Surg 64:249, 1977. (s)

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