Acute bbdomen at El Obeid Hospital,Western Sudan.

Background : Acute abdominal pain is the presenting complaint in emergency departments of all hospitals worldwide, resulting in a huge drain of human and non-human resources. Objectives : To study the pattern, causes and management outcomes of patients presenting with acute abdomen to El Obeid Hospital, Western Sudan. Patients and Methods : This was a prospective study. All patients who presented with acute abdomen to the University Surgical Unit at El Obeid Hospital between January 1999 and December 2000 were included. The patient characteristics, clinical features, investigations, management and postoperative care were recorded in a pre-designed sheet. Results : There were 421 patients. 242 were males (57.5%). Acute appendicitis was the commonest cause accounting for 63% of the patients, followed by acute intestinal obstruction 20.4% and abdominal trauma 11.6%. One third of the patients with acute appendicitis reported with complications. The majority of acute intestinal obstruction cases were due to obstructed and/or strangulated hernia. Acute cholecystitis and perforated duodenal ulcers were not common. Perforated typhoid ulcers and tuberculous peritonitis were less frequent but had high mortality. The overall mortality was 8.5% and those deaths occurred mostly in patients presenting late with generalized peritonitis. Conclusions : Acute abdomen was a common surgical emergency at El Obeid Hospital, Western Sudan. The leading causes were acute appendicitis, acute intestinal obstruction and abdominal trauma. Awareness of the seriousness of the condition and better hospital facilities and care may reduce an unacceptable high mortality. Key words : Appendicitis, intestinal obstruction, abdominal trauma; Western Sudan.