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.