The range of abdominal surgical emergencies in children older than 1 year at the Komfo Anokye Teaching Hospital, Kumasi, Ghana
The range of abdominal surgical emergencies in children older than 1 year at the Komfo Anokye Teaching Hospital, Kumasi, Ghana
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DOI：
10.4103/1596-3519.59578
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发表时间：
2009-10-01
影响因子：
0.9
通讯作者：
Amoah, M.
中科院分区：
文献类型：
--
作者：
Abantanga, F. A.;Nimako, B.;Amoah, M.
背景：急性腹部疾病是儿童紧急入院的常见原因。关于我们次区域（尤其是加纳）此类情况的文献很少。 目的：本研究的目的是调查该次区域儿童紧急腹部手术情况的范围，特别是加纳库马西 Komfo Anokye 教学医院。对所有 1 岁以上接受紧急腹部手术的儿童进行了前瞻性调查。 方法：将 5 年内因急性腹部外科手术而接受手术的所有儿童（婴儿除外）的详细信息输入专门设计的表格中，记录患者特征、紧急情况的手术原因、手术过程、并发症、发病率和死亡率。 结果： 955 名年龄 > 1 岁但 > 15 岁的儿童纳入研究。平均年龄为 8.8 岁至 3.2 岁。腹部外科急症的主要原因是胃肠道（GIT）伤寒穿孔（TP），占 68%；急性阑尾炎，16%；腹部外伤和肠梗阻（包括肠套叠）各 4.7%；不可复性外疝，2.5%；原发性腹膜炎，1.0%；胆囊疾病和胃穿孔各占0.8%。许多儿童死于 TP 组；仅 TP 的病死率为 12.6%。总死亡率为9.7%。严重腹膜污染、持续性腹膜炎和手术部位感染（SSIs）会影响发病率，从而导致住院时间较长。结论：在我院，胃肠道TP、急性阑尾炎、肠梗阻、难复性外疝和原发性腹膜炎是婴儿期后儿童最常见的腹部急症。 TP 的高发病率和死亡率可归因于无知、卫生条件差和延迟到医院报告治疗。
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 perpendicular to 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.