Presentation and Outcome of Acute Abdomen in a Tertiary Care Unit

Objective: To evaluate the outcome of patients with acute abdomen presenting in a tertiary care unit. Study Design: Descriptive Case series. Place and Duration of Study: From July 01,2010 to 31st December 2010, Surgical Unit III, Pakistan Institute of Medical Sciences, Islamabad. Materials and Methods: All adult patients of either gender admitted for acute abdomen were included in the study. Their demographics like age, sex, clinical presentation, diagnosis, management, complications and follow up were recorded on detailed proforma. Results: Out of 127 patients, 64 had acute appendicitis and 17 had acute pancreatitis, while other causes included perforated duodenal ulcer (n=13), acute intestinal obstruction (n=11), acute cholecystitis (n=9), abdominal tuberculosis (n=8), enteric perforations, diaphragmatic hernia, obstructive jaundice, psoas abscess, strangulated umbilical hernia, carcinoma of rectum (with intestinal obstruction) and pelvic abscess. All cases were managed conservatively or surgically according to the set protocol. Wound infection was the most common complication (n=10%) followed by chest infection (n=7%). Mortality rate was 10%. Conclusion: Acute appendicitis is the most common condition in patients presenting with acute abdomen. Lack of health education, improper health services and late presentations are common factors for increased morbidity. Sepsis is the major cause of morbidity and mortality in acute abdomen.