Acute non-traumatic abdominal pain presenting to emergency unit of a university teaching hospital in Rwanda

Abstract

Background: Emergency Department consultation for non-traumatic abdominal pain is one of the common reasons for presentation; accounting for 5.76–20 % of all Emergency Department consultations. Research about non-traumatic abdominal pain is limited in Rwanda and East Africa. This study aims to understand the clinical profile and outcomes of non-traumatic abdominal pain at the largest tertiary hospital in Rwanda. Methodology: A prospective cohort study of patients presenting with non-traumatic abdominal pain was undertaken. Results: During the 5-month study, two hundred sixty-one patients were enrolled in the study. The mean age was 39.7 years and male patients accounted for 57.5 % of the cohort. Nearly half of the cohort were triaged as a high priority (11.1 % red, 31.8 % orange), and 42.9 % were hemodynamically unstable at or shortly after presentation. More than half of the patients (57 %) had surgical conditions, including 40.2 % who underwent surgery and 17.6 % who were treated conservatively. The most common diagnoses were intestinal obstruction (25.7 % of all cases) and hollow viscus perforation (18.8 %). Mortality was 11.1 %, and the mean hospital length of stay was 9.1 days. Predicting factors for death outcome (p-value<0.05) were advanced age, altered mental status, jaundice at presentation, peritonitis, known malignancy, and acute kidney injury Conclusion: Abdominal pain is a common presenting problem, accounting for approximately 1 in 10 patients presenting to a tertiary care centre in Rwanda, with 2 in 5 patients requiring operative interventions. Identification of potential risk factors for mortality requires a multidisciplinary approach to decrease mortality and morbidity.

Keywords

• Abdominal pain
• Non-traumatic abdominal pain
• Acute abdomen
• Outcome
• Triage
• Rwanda