Causes, associated factors and sonographic patterns of non-traumatic acute abdomen.

Abstract

Key words Non-traumatic acute abdomen, causes, associated factors, sonographic patterns BACKGROUND OF THE STUDY: Non-traumatic acute abdomen (NTAA) is a common abdominal emergency at Mulago Hospital and it is accomplished by high morbidity and mortality. Despite the previous studies done at Mulago Hospital, the sonographic patterns of the majority of causes of NTAA which would enhance diagnosis and management have not yet been documented. OBJECTIVES: This study was intended to determine the causes, the associated sociodemographic factors and describe the sonographic of NTAA at mulago hospital. METHODS: This was a descriptive cross sectional study in which 272 patients presenting with symptoms and signs of NTAA at mulago hospital from the 1st of February to the 30th april 2009 were recruited. Ultrasound examination of the patients was done by the principal investigator and data collection was done by the principal investigator with the help of two research assistants who were both radiographers. Parameters recorded were socio-demographic variables, sonographic, X-ray and CT patterns. Analysis of the data was done with the help of a statistician. RESULTS: A Total of 272 patients within the age range of 12 to 86 years were recruited. The mean age was 35.4 years and female to male ratio was 1.7:1. The female gender, low socio economic status and low levels of education were the common factors associated with NTAA. The most commonly associated symptoms were fever, vomiting and loss of appetite. The genitourinary system was the most affected with cystitis as the leading cause. The most common sonographic pattern was a thickened urinary bladder wall and ascites. Other sonographic patterns included enlarged intra-abdominal lymph nodes, increased echoenicity and heterogenous echo pattern of the abdominal organs. CONCLUSION: The common causes of NTAA in A & E of mulago hospital were due to infections. The most affected age group was 26-40 years and women were more affected than men. Ultrasound palyed a significant role in aiding diagnosis and differentiating surgical from non-surgical causes of NTAA. RECOMMENDATION: Abdominal ultrasound examination is recommended for all patients presenting in A & E department of mulago hospital with symptoms and signs of NTAA.