Abdominal trauma in south-eastern Nigeria

In a review of 74 consecutive patients with abdominal trauma operated upon at the University of Calabar Teaching Hospital, Calabar, Nigeria, between March 1983 and March 1988, 84 pc were males and 16 pc were females. Seventy-eight percent were aged below 30 years. Fifty (67.6 pc) patients sustained blunt trauma and 24 (32.4 pc) penetrating, from Road Traffic Accidents (50 pc), falls (34 pc), stabs and fights (7 pc) and gun shot (3 pc). Forty-eight (64.9 pc) patients presented within six hours of injury. Diagnosis and the decisions to operate were by a combination of clinical features and ancillary investigations which included abdominal X-rays, paracentesis abdominis in 45 (60.8 pc) and peritoneal lavage in three (4.1 pc). The spleen was the commonest organ damaged (40.5 pc) followed by small bowel (27.0 pc) and large bowel (13.5 pc). Eight (10.8 pc) deaths were recorded post-operatively. Delaying operation beyond 24 hours of presentation contributed significantly to the mortality rate. Prompt evacuation of the injured, early evaluation and timely surgical intervention are advocated to further reduce mortality.