Annals of African Medicine
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ORIGINAL ARTICLE
Year : 2009  |  Volume : 8  |  Issue : 4  |  Page : 236-242

The range of abdominal surgical emergencies in children older than 1 year at the komfo anokye teaching hospital, Kumasi, Ghana


1 Department of Surgery, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science & Technology, Kumasi; Directorate of Surgery, Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi, Ghana
2 Directorate of Surgery, Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi, Ghana

Correspondence Address:
F A Abantanga
Directorate of Surgery, Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi
Ghana
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1596-3519.59578

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Background : Acute abdominal conditions are a common reason for emergency admission of children. Little is available in the literature about such conditions in our subregion, especially Ghana. Objective : The aim of this study was to investigate the range of emergency abdominal surgical conditions amongst children in the subregion, with particular reference to Komfo Anokye Teaching Hospital, Kumasi, Ghana. A prospective survey of all children older than 1 year undergoing an emergency abdominal surgery was carried out. Methods : Details of all children (except infants) operated for an acute surgical abdominal condition over a 5-year period were entered into a specially designed form, capturing patient characteristics, surgical causes of the emergency, operative procedure, complications, morbidity and mortality rates. Results : Nine hundred fifty-five children aged > 1 year but < 15 years were enrolled in the study. The mean age was 8.8 ± 3.2 years. The leading causes of surgical abdominal emergencies were typhoid perforation (TP) of the gastrointestinal tract (GIT), 68%; acute appendicitis, 16%; abdominal trauma and intestinal obstruction (including intussusception), 4.7% each; irreducible external hernias, 2.5%; primary peritonitis, 1.0%; gallbladder disease and gastric perforation, 0.8% each. Many children died from the TP group; case fatality for TP alone was 12.6%. The overall mortality was 9.7%. Morbidity was influenced by the presence of major peritoneal contamination, continuing peritonitis and surgical site infections (SSIs), which led to long hospital stay. Conclusions : In our hospital, TP of the GIT, acute appendicitis, intestinal obstruction, irreducible external hernias and primary peritonitis were the most common abdominal emergencies encountered in children after infancy. The high morbidity and mortality in TP is attributable to ignorance, poor sanitation and delay in reporting to hospital for treatment.


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