Clinical Profile, Indications and Findings of Emergency Exploratory Laparotomies in a Teaching Hospital in Nigeria: A Retrospective Review for Policy and Practice

Abstract

Background: Emergency exploratory laparotomy entails abdominal procedure done for the purpose of making diagnosis of an acute intraabdominal condition requiring immediate surgical intervention. The procedure is associated with significant morbidity and mortality, particularly in developing countries like ours, due to its emergent nature, delayed presentation, and limited time for perioperative correction of deranged parameters and optimization of patients before surgery. Knowledge of clinical profile, indications and intra-operative findings is crucial for improving perioperative care and patient survival, especially in teaching hospitals where these very sick patients presents to.

The study aimed to highlight the clinical profile, indications and findings of emergency exploratory laparotomies in a teaching hospital in Nigeria.

Method: This three-year tertiary hospital-based observational study of emergency exploratory laparotomies performed at the University of Benin Teaching Hospital (UBTH), Nigeria from 2023-2025.  A total of 104 patients presenting with acute abdominal conditions requiring emergency surgical intervention were recruited in the study. Data were obtained from patients' hospital record included patients' demographic characteristics, clinical presentations, indications and intraoperative findings.

Results: A total of 104 patients underwent emergency exploratory laparotomy with male preponderance of 60.6%. The most common age group who had emergency exploratory laparotomy were <10years (18.3%), followed by that of 40-49years (15.4%) while the least was 80-89years old age group which accounted for 2.9%. 100 patients (96%) presented with abdominal pain, 98 (94.2%)%  had abdominal tenderness/guarding while bilious vomiting was noted in 68(65.4%) patients who had emergency exploratory laparotomy. Intra-operative findings of emergency exploratory laparotomy should high incidence of Acute mechanical intestinal obstruction 51 (49.1%) and peritonitis from perforated viscera 43(41.3%) while negative emergency exploratory was 4 (3.8%).

Conclusion: Emergency exploratory laparotomy entails urgent surgical intervention to diagnose and treat patient with acute abdomen. The paediatric age group constituted the highest number of cases, Majority of the patients presented with abdominal pain and tenderness and acute mechanical intestinal obstruction accounted for the most common indication and intra-operative findings of emergency exploratory laparotomy.