A study on acute surgical abdomen in paediatric age group

Authors

  • M. Amin Memon Department of Paediatric Surgery, Dr. BRAM Hospital, Pt. J.N.M. Medical College, Raipur, Chhattisgarh, India
  • Jiwan Lal Patel Department of Paediatric Surgery, Dr. BRAM Hospital, Pt. J.N.M. Medical College, Raipur, Chhattisgarh, India
  • Mahendra Dhuware Department of Paediatric Surgery, Dr. BRAM Hospital, Pt. J.N.M. Medical College, Raipur, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20162818

Keywords:

Acute abdomen, Etiology, Paediatric age

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.

References

Alexander KC, David L, Sigalet. Acute abdominal pain in children. Am Fam Physician. 2003;67:2321-6.

Abubakar AM, Ofoegbu CPK. Factors affecting outcome of emergency paediatric abdominal surgery. Nigerian J Surg Res. 2003;5(3):85-91.

Aviral, Chana RS. Role of ultrasonography in the evaluation of children with acute abdomen in the emergency set- up. Indian Assoc Pediatr Surg. 2005;10(1):41-3.

Christopher H. The effect of anaemia on wound healing. Ann Surg. 1974;119(2):932-40.

Chabas E. Postoperative respiratory function in children after abdominal surgery. Blackweell Synergy Anaesthesia. 1998;53(4):393-7.

Erkan T. Clinical spectrum of acute abdomen in Turkish pediatric patients: a prospective study. Paediatric Int. 2004;46(3):325-9.

The acute abdomen. Available at ots1.narod.ru/oxford/part3/acute_abd.htm. Accessed on 2 March 2016.

Simeone JF. Comparison of plain films and sonography in evaluation of acute abdomen. Am J Roent. 1985;144:49-52.

Mendelson RM. Ultrasound examination of paediatric acute abdomen: preliminary findings. British J Radiol. 1987;60:414-6.

Walsh PF. The value of immediate ultrasound in acute abdominal conditions: A critical appraisal. Clin Radiol. 1990;42:47-9.

Overbo KK. Acute abdomen among children and adolescents: a retrospective study of 470 children and adolescents with acute abdomen. Pedtr J Norwegian. 1993;113(26):3244-7.

Waldhausen JH. Paediatric postoperative abdominal wound dehiscence: transverse versus vertical incisions. Am Cool surg. 2000;190(6):688-91.

Cigdem MK. Postoperative abdominal evisceration in children: possible risk factors. J Pedtr Surg International. 2006;22(8):677-80.

Cohn SM. Prospective randomised trial of wound management strategies for dirty abdominal wound. Ann Surg. 2001;233(3):409-13.

Downloads

Published

2016-12-24

Issue

Section

Original Research Articles