Clinical Spectrum of Acute Abdomen in Cape Coast

Abstract

Background: Central Regional Hospital, Cape Coast, Ghana is the main referral center for the region. The hospital has been redesignated a Teaching Hospital to serve as the main teaching base for the School of Medical Sciences, University of Cape Coast. This study was done as part of assessment of the hospital’s emergency surgical needs for purpose of planning and resource allocation. Objectives: The study objectives were to quantify and to characterize cases of acute abdominal emergencies operated at the Central Regional Hospital, and to assess the clinicians diagnostic accuracy by comparing the preoperative diagnosis with the postoperative findings. Methodology: A retrospective and comparative study was performed based on the records of the Accident/emergency, wards, and theatre units, over a period from October 2009 to September 2010. A total of 122 cases were recorded. Results: Ruptured ectopic cyesis(23.8%) was the most frequent preoperative diagnosis, followed by non specific abdominal pain(18.9%), typhoid perforation(13.1%), acute appendicitis(12.3%) and intestinal obstruction(9.8%). Post operatively, ruptured ectopic cyesis(38.9%), acute appendicitis(16.7%) and typhoid perforation(12.5%) were recorded. The preoperative diagnosis was wrong in 2.7% (n=2) of cases. Conclusion: Ruptured ectopic cyesis was the most common abdominal condition operated on and incidence of typhoid perforation is high. Preoperative diagnoses was wrong in 2 cases. Key words: Acute abdomen, ectopic cyesis