Abscess rate of patients with penetrating abdominal injury in Zaria

Abstract

Background: Penetrating abdominal injury occurs when a foreign object pierces the skin. The morbidity and mortality associated with penetrating abdominal trauma is related to the intra-abdominal complications. This study is, therefore, intended to determine the abscess rate resulting from penetrating abdominal trauma in Ahmadu Bello University Teaching Hospital Zaria. Method: A 6-year (January 2006-December 2011) retrospective study of penetrating abdominal trauma emphasizing on the rate of development of intra-abdominal abscess. Information was obtained from patients’ case notes, operating room log books and surgical audit data. Information extracted included cases of penetrating abdominal trauma, intra-operative findings and cases of intra-abdominal abscesses. Results: A total of 39 cases of penetrating abdominal trauma were treated within this period of six years. 3 (7.7%) were treated in 2006, 6 (15.4%) in 2007, 3 (7.7%) in 2008 and 11 (28.2%) in 2009, 8 (20.5%) in 2010, 9 (23.1%) in 2011. 26 (66.7%) were adult while 13 (33.3%) were paediatric cases. The male were 37 (94.9%) and the female were 2 (5.1%), with a sex ratio of 18.5:1 (male to female). The age range was 5 -60 years (39.92 mean). The commonest cause of injury was road traffic accident. At exploration, 13 (33.3%) had organ injury only, 17 (43.6%) suffer from both organ injury and intra-peritoneal emorrhage, 9 (23.1%) had retroperitoneal haemorrhage only. The intra-abdominal abscess rate of penetrating abdominal injury in Zaria was found to be 2.6%. Conclusion: Contamination from either foreign object or organ injury is found to increase the risk of post-operative intra-abdominal abscess. In this center, the abscess rate of penetrating abdominal trauma is comparatively low.

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Makama, J. and Garba, E. (2013) Abscess rate of patients with penetrating abdominal injury in Zaria. Health, 5, 769-773. doi: 10.4236/health.2013.54102.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Feliciano, D.V. and Rozcyki, G.S. (1995) The management of penetrating abdominal trauma. Advances in Surgery, 28, 1-39.
[2] Isenhour, J.L. and Marx, J. (2007) Advances in abdominal trauma. Emergency Medicine Clinics of North America, 25, 713-733. doi:10.1016/j.emc.2007.06.002
[3] Deitch, E.A., Livingston, D.H. and Hauser, C.J. (1999) Septic complications in the trauma patient. New Horizons, 7, 158-172.
[4] Hasper, D., Schefold, J.C. and Baumgart, D.C. (2009) Management of severe abdominal infections. Recent Patents on Anti-Infective Drug Discovery, 4, 57-65. doi:10.2174/157489109787236265
[5] Dente, C.J., Tyburski, J., Wilson, R.F., Collinge, J., Steffes, C. and Carlin, A. (2000) Ostomy as a risk factor for posttraumatic infection in penetrating colonic injuries: Univariate and multivariate analyses. Journal of Trauma, 49, 628-637.
[6] Nicholas, J.M., Rix, E.P., Easley, K.A., et al. (2003) Changing patterns in the management of penetrating abdominal trauma: The more things change, the more they stay the same. Journal of Trauma, 55, 1095-1108. doi:10.1097/01.TA.0000101067.52018.42
[7] Cotton, B.A. and Nance, M.L. (2004) Penetrating trauma in children. Seminars in Pediatric Surgery, 13, 87-97. doi:10.1053/j.sempedsurg.2004.01.004
[8] Maurer, E. and Morris Jr., J.M. (2004) Injury severity scoring in trauma. McGraw-Hill Companies, New York, 87-91.
[9] Fariñas-Alvarez, C., Fariñas, M.C., Fernandez-Mazarrasa, C., Llorca, J., Casanova, D. and Delgado-Rodríguez, M. (2000) Analysis of risk factors for nosocomial sepsis in surgical patients. British Journal of Surgery, 87, 1076- 1081.
[10] Eberhardt, J.M., Kiran, R.P. and Lavery, I.C. (2009) The impact of anastomotic leak and intra-abdominal abscess on cancer-related outcomes after resection for colorectal cancer: A case control study. Diseases of the Colon & Rectum, 52, 380-386. doi:10.1007/DCR.0b013e31819ad488
[11] Morales, C.H., Villegas, M.I., Villavicencio, R., González, G., Pérez, L.F., Peña, A.M. and Vanegas, L.E. (2004) Intraabdominal infection in patients with abdominal trauma. Archives of Surgery, 139, 1278-1285.
[12] Varin, D.S., Ringburg, A.N., Van Lieshout, E.M., Patka, P. and Schipper, I.B. (2009) Accuracy of conventional imaging of penetrating torso injuries in the trauma resuscitation room. European Journal of Emergency Medicine, 16, 305-311. doi:10.1097/MEJ.0b013e32832c3ab9
[13] DeMaria, E.J., Dalton, J.M., Gore, D.C., Kellum, J.M. and Sugerman, H.J. (2000) Complementary roles of laparoscopic abdominal exploration and diagnostic peritoneal lavage for evaluating abdominal stab wounds: A prospective study. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A, 10, 131-136. doi:10.1089/lap.2000.10.131
[14] Udobi, K.F., Rodriguez, A., Chiu, W.C. and Scalea, T.M. (2001) Role of ultrasonography in penetrating abdominal trauma: A prospective clinical study. Journal of Trauma, 50, 475-479. doi:10.1097/00005373-200103000-00011
[15] Martinez, M., Briz, J.E. and Carillo, E.H. (2001) Video thoracoscopy expedites the diagnosis and treatment of penetrating diaphragmatic injuries. Surgical Endoscopy, 15, 28-32. doi:10.1007/s004640002090
[16] Neal, M.D., Peitzman, A.B., Forsythe, R.M., et al. (2011) Over reliance on computed tomography imaging in patients with severe abdominal injury: Is the delay worth the risk? Journal of Trauma, 70, 278-284. doi:10.1097/TA.0b013e31820930f9
[17] Oberholzer, A., Keel, M., Zellweger, R., Steckholzer, U., Trentz, O. and Entel, W. (2000) Incidence of septic complications and multiple organ failure in severely injured patients is sex specific. Journal of Trauma, 48, 932-937.
[18] Kimura, T., Shibata, M. and Ohhara, M. (2005) Effective laparoscopic drainage for intra-abdominal abscess not amenable to percutaneous approach: Report of two cases. Diseases of the Colon & Rectum, 48, 397-399. doi:10.1007/s10350-004-0846-y
[19] Delgado Jr., G., Barletta, J.F., Kanji, S., Tyburski, J.G., Wilson, R.F. and Devlin, J.W. (2002) Characteristics of prophylactic antibiotic strategies after penetrating abdominal trauma at a level I urban trauma center: A comparison with the East guidelines. Journal of Trauma, 53, 673-678. doi:10.1097/00005373-200210000-00009
[20] Hasper, D., Schefold, J.C. and Baumgart, D.C. (2009) Management of severe abdominal infections. Recent Patents on Anti-Infective Drug Discovery, 4, 57-65. doi:10.2174/157489109787236265
[21] Alzamel, H.A. and Cohn, S.M. (2005) When is it safe to discharge asymptomatic patients with abdominal stab wounds? Journal of Trauma, 58, 523-525. doi:10.1097/01.TA.0000152987.21630.39
[22] Adams, J.M., Hauser, C.J., Livingston, D.H., et al. (2001) The immunomodulatory effects of damage control abdominal packing on local and systemic neutrophil activity. Journal of Trauma, 50, 792-800.

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