ABSTRACT
Objective: The aim was to study the pattern and outcome of abdominal trauma managed by Laparotomy in Olabisi Onabanjo University teaching Hospital Sagamu (OOUTH), South Western Nigeria.Method: This is a retrospective study. The records of the patients were retrieved and relevant data extracted such as age, sex, occupation, address, cause of injury, vital signs on admission, abdominal signs, other injuries, number of units of blood transfused, investigations, indications for surgery, operative findings, procedure carried out, complications and outcome.Results: Seventy seven subjects were reviewed. There were 23 females (29.9%), and 54 males (70.1%). The age range was 3years to 68years, 32 patients (41.6%) were in 20-30 years age group. The mechanism of injury was blunt trauma in 61 (79.2%) and penetrating injury in 16 patients (20.8%). Road traffic accident was the commonest cause of injury, in 53 patients (68.8%). 42 patients (54.5%) had extra abdominal injuries. Positive paracentesis abdominis was the commonest indication for surgery, in 53 patients (68.8%). The spleen was the most commonly injured organ, in 31 patients (40.2%) while the organs were normal in 4 patients (5.2%). The complication observed includes acute renal failure, in 5 patients (6.5%), multiple organ failure in 5 patients, and wound infection in 8 patients (10.4%). Ten patients died. (13%)Conclusion: Splenic rupture is the most common abdominal injury treated by Laparotomy in OOUTH Sagamu and the commonest cause is road traffic accident. Mortality was due mainly to acute renal failure and multiple organ failure
Subject(s)
Abdominal Injuries , Laparotomy , NigeriaABSTRACT
Background:Tropical idiopathic lower limb gangrene (TILLG) is also known as Symmetrical gangrene in the African; Idiopathic gangrene in the African and Idiopathic peripheral gangrene of the tropics.The aetiopathogenesis of this clinical entity is a mystery. Objective: To review methods of diagnosing tropical idiopathic lower limb gangrene (TILLG) and highlight its clinical variants. Method: All Literature on idiopathic gangrene of the extremities was searched from libraries; colleagues and internet but only literature on TILLG (in Africans) from 1947 to date was scrutinised. Each case was studied to find out the basis of diagnosis. Result:TILLG is not fully understood and not easy to recognise.Two sets of criteria are known to be helpful in establishing diagnosis. These criteria can be classified as major and minor criteria. Major criteria are those clinical data that can establish the diagnosis of TILLG. No devices are required to identify them. Minor criteria are pathological changes that are consistent with TILLG. Devices are required to identify them.Three pathomorphological types of TILLG were described in literature and are classified as types A; B and C. Conclusions:This review is supposed to sensitise the clinician and make diagnosis easier.This will also encourage more researches.As more information becomes available; aetiopathogenesis of TILLG will be clearer and more clinical variants of the disease may be reported.This additional information will help in the prevention of gangrene; reducing the socioeconomic problems arising from amputation