Non-trauma related paediatric abdominal surgical emergencies in Lagos, Nigeria: epidemiology and indicators of survival

ABSTRACT

Background: Pediatric surgical emergencies are associated with higher morbidity and mortality. The aim of this study is to describe the epidemiology of non-trauma related pediatric abdominal surgical emergencies in our centre and determine the indicators for survival in a cohort of patients. Patients and Methods: A retrospective study of children aged 1 day to 15 years who presented with non-trauma related abdominal emergencies at the Lagos University Teaching Hospital (LUTH). Results: There were 129 children. The median age at presentation was 5 months (range 1 day-15 years). There were 104 males and 25 females. Sixty-four (49.6) patients presented within 48 hours of the onset of the symptoms while 65 (50.4) presented after 48 hours. Intestinal obstruction is the commonest indication for pediatric emergency surgery in our centre accounting for 76 patients (58.9). Appendicitis is the second most common indication for emergency surgery with 13 patients (10.1). Thirteen patients (10.1) had postoperative complications. There were 13 deaths in all (10.1mortality rate). Eleven out of 43 (25.6) neonates died compared with 2 (2.3) out of 86 patients in the other age groups (P=0.002). Seven out of 107 (6.5) patients that had surgery within 72 hours died while 5/22 (22.7) patients died who had surgery after 72 hours (P=0.003). There were 4 mortalities (28.6) among patients with postoperative complications compared with 9 (7.8) mortalities among 116 patients without any postoperative complications (Pp=0.001). Conclusion: Intestinal obstruction is the commonest pediatric surgical emergency seen in LUTH. Neonatal age; admission to surgery intervention time 72 hours; and severe postoperative complications are associated with high mortality