Unusual causes of acute abdomen in a Nigerian hospital.
Acute abdomen is the most common abdominal emergency associated with high morbidity and mortality in General surgical practice. Over a 7-year period, a study of unusual causes of acute abdomen was undertaken, with the aim of identifying these causes and outcome of operative management. Eleven cases were identified accounting for 4% of cases of acute abdomen seen during the period of the study. Four cases of liver diseases (33.3%) comprising 2 patients (16.7%) with ruptured primary liver cell carcinoma, 1 (one) case each of haemoperitoneum due to ruptured liver haemangioma and haemorrhagic disorders from liver cirrhosis. One patient had acute leukaemia with massive haemoperitoneum and acute abdomen. Five (45.5%) had gastrointestinal perforations; 1 patient (9%) each had multiple jejunal perforations, perforation of stomal ulcer at gastrojejunostomy site, perforation of gastric cancer; perforated carcinoid tumour of sigmoid colon and idiopathic perforation of the caecum. There was also a case of caecal volvulus. Mortality was 7 patients (63.6%). All patients with liver pathology and acute leukaemia died. The cases of malignant tumour perforation were well and alive 4-6 years after the operation.


CONCLUSIONS
Operation could have been avoided in 45.5% of these cases if the appropriate investigations, had been available and carried out.
Adesunkanmi
A R K
AR
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile Ife.
Ogunrombi
O
O
D000006:Abdomen, Acute / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged