A study on acute surgical abdomen in paediatric age group

Abstract

Background: Acute abdomen is common surgical problem therefore it is important to understand its epidemiological and clinical aspects in order to adopt appropriate line of management. It is important to distinguish between causes requiring surgical treatment and those do not. Hence this study is undertaken to recognise the pattern of acute abdomen in paediatric age group. Methods: The present study conducted in paediatric surgery unit of department of surgery, Dr. BRAM Hospital, Raipur, Chhattisgarh, India, during January 2013 to December 2015. Patients were admitted and conservative line of management was started. Routine and specific investigations were done. After proper resuscitation and assessment patients were managed either by conservatively or by appropriate surgical procedures. Postoperative care was done and outcome of the study was noted. Results: In the present study, most of the patients were in the age group of 6-10 years (27.5%) followed by neonates (21.67%). Majority of patients were male. Etiology of acute abdomen was congenital in 21.66% cases and acquired in 78.33% cases. In acquired causes most common was non-penetrating abdominal trauma followed by acute appendicitis. In congenital causes most common was anorectal malformations followed by congenital megacolon. Most common presenting symptom was abdominal pain (83.33%) and vomiting (79.17) while most common sign was tachycardia and tenderness. Inflamed appendix was the most common intraoperative finding (16.67%) and colostomy was the most commonly performed operative procedure (25.57% cases) followed by appendicectomy (19.69%). Fever was most common postoperative complication followed by chest infection. Mortality was higher in operative group (16.67%) as compared to non-operative (9.25%) and neonatal mortality was higher followed by infants. Conclusions: Early diagnosis and prompt intervention is crucial factor to improve the outcome in acute surgical abdomen cases.