Penetrating abdominal injuries in adults seen at two teaching hospitals in Ghana

M Ohene-Yeboah,Sb Naeeder,F Boakye,Jcb Dakubo

doi:10.4314/gmj.v44i3.68893

Abstract

The incidence of penetrating abdominal injuries (PAI) has increased in the West African sub-region. To determine the pattern and management outcome of penetrating abdominal injuries (PAI) in the two main teaching hospitals in Ghana. A prospective and retrospective descriptive study. Komfo Anokye Teaching Hospital (KATH), Kumasi and Korle-Bu Teaching Hospital (KBTH), Accra. Relevant details of all adult patients admitted with penetrating abdominal injuries over a 11-year period were recorded at KATH and KBTH in Accra. The study in KATH was prospective pro forma based and that in the KBTH was a retrospective case review of all penetrating abdominal injuries. There were 411 patients, mostly men (M: F-8:1). The peak age of patients was 20-29 years, 164 patients (39.9%). Abdominal stab wound injuries accounted for 251 (61.1%). Three hundred and thirty - one patients (80.5%) had an emergency laparotomy. Twelve patients required 16 emergency thoracotomies. The small bowel (23.2%), stomach (12.9%), colon (10.2%), the liver (10.0%), were the most commonly injured organs. In 92 patients (29.0%) no significant intra-abdominal injury was detected at laparotomy Stab wounds are the main penetrating abdominal injuries seen mostly among young male adults in Ghana. Management was by a mandatory laparotomy after clinical assessment. The overall mortality was 4.4%. Selective non-operative management of abdominal stab wounds is possible.

Highlights

In Ghana and other countries of the West African subregion, the pressures of severe economic conditions and rapid social change have led to an increase in social conflict and violent crime especially in the rapidly expanding urban centers. 1-3 The proliferation of small arms - following civil wars and internal armed changes of the political process in many countries in the sub-region - has increased the crime rate and the incidence of penetrating abdominal injuries.[2]
Unlike blunt abdominal injuries a mandatory laparotomy has been the traditional approach to penetrating abdominal injuries.[6,7,8]
The majority of the patients were under 40 years of age – 328 (79.8%), Injury Patterns Two hundred and fifty- one patients (61.1%) were treated for abdominal stab wounds (ASW); 144 in Komfo Anokye Teaching Hospital (KATH) and 107 in Korle-Bu Teaching Hospital (KBTH)

Summary

Introduction

In Ghana and other countries of the West African subregion, the pressures of severe economic conditions and rapid social change have led to an increase in social conflict and violent crime especially in the rapidly expanding urban centers. 1-3 The proliferation of small arms - following civil wars and internal armed changes of the political process in many countries in the sub-region - has increased the crime rate and the incidence of penetrating abdominal injuries.[2]. 1-3 The proliferation of small arms - following civil wars and internal armed changes of the political process in many countries in the sub-region - has increased the crime rate and the incidence of penetrating abdominal injuries.[2] Previous studies have highlighted the economic impact of the increased incidence of trauma in the sub – region as the injuries affect mostly the productive sector of the population.[4] It is nearly three decades since Archampong and Naaeder reported on the patterns of abdominal injuries in Accra a city with a population similar to Kumasi.[1,5] A more recent report from the two major communities in Ghana (Accra and Kumasi) focused on blunt abdominal injuries.[4]. Unlike blunt abdominal injuries a mandatory laparotomy has been the traditional approach to penetrating abdominal injuries.[6,7,8]

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Conclusion