Laparotomy for Abdominal Injury Indication & Outcome of patients at a Teaching Hospital in Addis Ababa, Ethiopia

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Kirubel Abebe
Mahteme Bekele
Ayelign Tsehaye
Befekadu Lemmu
Engida Abebe

Abstract

BACKGROUND: Abdominal injury is among the major causes of trauma admissions. The aim was to determine etiology, commonly injured organs, indication and outcome of patients with abdominal injuries requiring laparotomy.
METHODS: A retrospective study of all adult patients who underwent laparotomy for abdominal injury at St. Paul’s Hospital Millennium Medical College was conducted from January 2014 to December 2016. The factors associated with outcome were identified with bivariate and multivariate logistic regressions.
RESULTS: Laparotomy for abdominal injury was performed for  145 patients. Of these, 129 (89%) case records were retrieved. The male to female ratio was 6.2:1. The mean age was 29 years, and most of them were unemployed. Penetrating trauma was the commonest injury, stab (46, 35.7%) and Road Traffic Accidents (RTA) (27, 20.9%) being the  leading causes. Extra-abdominal injuries were seen in 33.3% (46) of the cases. Hollow organs were commonly injured than solid organs. Small intestine (35, 43.8%) and Spleen (17, 34.7%) were the leading injured organs in penetrating and blunt respectively. The main procedure performed was repair of hollow and solid organ laceration/perforation (70,54.3%). The negative laparotomy rate was 4.6% (6). Complications were seen in 23(17.8%) patients, the commonest being irreversible shock (7,30.4%). The mortality rate was 8.5 % (11), and it was significantly associated with blunt abdominal injury (AOR=7.25; 95% CI 1.09-48.37; p=0.041) and systolic blood pressure<90mmHg (AOR=8.66; 95% CI 1.1-68.41; p=0.041).


CONCLUSION: Stab and RTA were the commonest indications of laparotomy. The mortality was significantly associated with blunt abdominal injury and hypotension (SBP<90mmHg).

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Original Article
Author Biographies

Kirubel Abebe, University of Health and Allied Sciences- Nursing

University of Health and Allied Sciences- Nursing, Ghana

Mahteme Bekele, University of the Western Cape

University of the Western Cape,
South Africa –Nursing, Cape Town,
Western Cape, South Africa

Ayelign Tsehaye, University of Health and Allied Sciences- Nursing

University of Health and Allied
Sciences- Nursing,  Ghana

Befekadu Lemmu, University of Health and Allied Sciences- Nursing

University of Health and Allied
Sciences- Nursing, Ghana

Engida Abebe, University of Health and Allied Sciences- Nursing

University of Health and Allied
Sciences- Nursing, Ghana