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Indications of laparotomy in the rural hospital in the low and middle income countries: our 3 years experience in the Ruhengeri referral hospital


MOJ Surgery
Eugene Niyirera,1 Ahmed Kiswezi,2 David Ntirushwa3

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Abstract

Background: Laparotomy is a major, high risk intervention commonly done with therapeutic and for diagnostic purpose. Most of patients with abdominal surgical conditions do not get timely access to that intervention because of paucity of skilled physicians at district hospital for diagnosis and subsequently to intervention in the LMICs, which lead to high mortality and morbidity rate at high level hospitals. The aim of our study was retrospectively to identify the commonest surgical conditions which need laparotomy and their management in the rural areas at district hospital in the LIMCs.
 
Methods: This is a 3 years retrospective study done in the Ruhengeri referral hospital on the patients who underwent laparotomy in the department of surgery from September 2016 to August 2019. The age, sex, diagnosis and initial management have been analyzed.
 
Results and discussion: In this study 232 patients underwent laparotomy for various reasons. The highest incidence was between 21 and 30 years and above 65 years, most of them were men. Globally, the common diagnosis was small bowel obstruction and sigmoid volvulus followed by hollow viscus perforation.
 
Conclusion: This study depicts the burden of surgical abdominal conditions in the remote areas laparotomy can be done at district hospital level if Infrastructures and qualified human resources are available.

Keywords

surgical abdomen, laparotomy, bowel obstruction, hollow viscus perforation, rural hospitals

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