Management of blunt abdominal trauma in Maiduguri: a retrospective study.

BACKGROUND: Blunt abdominal trauma (BAT) presents special surgical problems and is a continuous challenge to the surgeon's ability to make an early diagnosis and provide adequate treatment. The aim of this paper is to study retrospectively the patterns, surgical management and outcome of treatment among patients with BAT.

METHODS: The records of BAT patients managed at the University of Maiduguri Teaching Hospital (UMTH) between January 1998 and December 2000 were studied. Information about the age, sex, cause of injury, main investigations, diagnostic procedures and treatment of these patients were extracted from the files and analysed.

RESULTS: There were 48 males and 10 females. The mean age was 25.17 years, and the patients ranged between 8 and 50 years in age. Incidence of BAT was most prevalent in the 20-40 year age group (68.96%). Road traffic injuries (RTI) accounted for majority of injuries. The main findings at presentation were abdominal pain, abdominal tenderness and hypovolaemic shock. The spleen and the liver were the most frequently injured solid organs while the small intestine was the most frequently injured hollow viscus. 28 of the patients had associated injuries involving the extremities, chest and head. Fifty patients underwent exploratory laparotomy where definitive management depended on findings. Complications included wound infection, pneumonia, and intra-abdominal abscesses. The mortality rate was 17.24%. Non-operative management was possible in 8 patients.

CONCLUSION: BAT affects mainly the young people below 40 years of age. Definite preoperative diagnosis and the decision to operate was based on clinical assessment and some diagnostic procedures. 20.68% of patients were subjected to non-therapeutic laparotomies. This could be reduced by routine use of modern imaging techniques and thus avoiding unnecessary laparotomies and promoting non-operative management of BAT.