Bowel perforation secondary to illegally induced abortion: a tertiary hospital experience in Tanzania
<p>Abstract</p> <p>Background</p> <p>Bowel perforation though rarely reported is a serious complication of induced abortion, which is often performed illegally by persons without any medical training in developing countries. A sudden increase in the number of patients i...
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| Format: | Article |
| Language: | English |
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BMC
2012-09-01
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| Series: | World Journal of Emergency Surgery |
| Subjects: | |
| Online Access: | http://www.wjes.org/content/7/1/29 |
| _version_ | 1818113779508969472 |
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| author | Mabula Joseph B Chalya Phillipo L Mchembe Mabula D Kihunrwa Albert Massinde Anthony Chandika Alphonce B Gilyoma Japhet M |
| author_facet | Mabula Joseph B Chalya Phillipo L Mchembe Mabula D Kihunrwa Albert Massinde Anthony Chandika Alphonce B Gilyoma Japhet M |
| author_sort | Mabula Joseph B |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Bowel perforation though rarely reported is a serious complication of induced abortion, which is often performed illegally by persons without any medical training in developing countries. A sudden increase in the number of patients in our centre in recent years prompted the authors to analyze this problem. The study was conducted to describe our own experiences in the surgical management of these patients.</p> <p>Methods</p> <p>This was a retrospective study involving patients who were jointly managed by the surgical and gynecological teams at Bugando Medical Centre (BMC) for bowel perforation secondary to illegally induced abortion from January 2002 to December 2011. The statistical analysis was performed using SPSS version 17.0.</p> <p>Results</p> <p>A total of 68 patients (representing 4.2% of cases) were enrolled in the study. Their ages ranged from 14 to 45 years with a median age of 21 years. Majority of patients were, secondary school students/leavers (70.6%), unmarried (88.2%), nulliparous (80.9%), unemployed (82.4%) and most of them were dependent member of the family. Previous history of contraceptive use was reported in only 14.7% of cases. The majority of patients (79.4%) had procured the abortion in the 2<sup>nd</sup> trimester. Dilatation and curettage (82.4%) was the most common reported method used in procuring abortion. The interval from termination of pregnancy to presentation in hospital ranged from 1 to 14 days (median 6 days ). The ileum (51.5%) and sigmoid colon (22.1%) was the most common portions of the bowel affected. Resection and anastomosis with uterine repair was the most common (86.8%) surgical procedure performed. Complication and mortality rates were 47.1% and 10.3% respectively. According to multivariate logistic regression analysis, gestational age at termination of pregnancy, delayed presentation, delayed surgical treatment and presence of complications were significantly associated with mortality (P<0.001). The overall median length of hospital stay (LOS) was 18 days (1day to 128 days ). Patients who developed complications stayed longer in the hospital, and this was statistically significant (P=0.012).</p> <p>Conclusion</p> <p>Bowel perforation following illegally induced abortion is still rampant in our environment and constitutes significantly to high maternal morbidity and mortality. Early recognition of the diagnosis, aggressive resuscitation and early institution of surgical management is of paramount importance if morbidity and mortality associated with bowel perforation are to be avoided.</p> |
| first_indexed | 2024-12-11T03:40:15Z |
| format | Article |
| id | doaj.art-2d9851a27cad459c90785d48ec28f30d |
| institution | Directory Open Access Journal |
| issn | 1749-7922 |
| language | English |
| last_indexed | 2024-12-11T03:40:15Z |
| publishDate | 2012-09-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Emergency Surgery |
| spelling | doaj.art-2d9851a27cad459c90785d48ec28f30d2022-12-22T01:22:10ZengBMCWorld Journal of Emergency Surgery1749-79222012-09-01712910.1186/1749-7922-7-29Bowel perforation secondary to illegally induced abortion: a tertiary hospital experience in TanzaniaMabula Joseph BChalya Phillipo LMchembe Mabula DKihunrwa AlbertMassinde AnthonyChandika Alphonce BGilyoma Japhet M<p>Abstract</p> <p>Background</p> <p>Bowel perforation though rarely reported is a serious complication of induced abortion, which is often performed illegally by persons without any medical training in developing countries. A sudden increase in the number of patients in our centre in recent years prompted the authors to analyze this problem. The study was conducted to describe our own experiences in the surgical management of these patients.</p> <p>Methods</p> <p>This was a retrospective study involving patients who were jointly managed by the surgical and gynecological teams at Bugando Medical Centre (BMC) for bowel perforation secondary to illegally induced abortion from January 2002 to December 2011. The statistical analysis was performed using SPSS version 17.0.</p> <p>Results</p> <p>A total of 68 patients (representing 4.2% of cases) were enrolled in the study. Their ages ranged from 14 to 45 years with a median age of 21 years. Majority of patients were, secondary school students/leavers (70.6%), unmarried (88.2%), nulliparous (80.9%), unemployed (82.4%) and most of them were dependent member of the family. Previous history of contraceptive use was reported in only 14.7% of cases. The majority of patients (79.4%) had procured the abortion in the 2<sup>nd</sup> trimester. Dilatation and curettage (82.4%) was the most common reported method used in procuring abortion. The interval from termination of pregnancy to presentation in hospital ranged from 1 to 14 days (median 6 days ). The ileum (51.5%) and sigmoid colon (22.1%) was the most common portions of the bowel affected. Resection and anastomosis with uterine repair was the most common (86.8%) surgical procedure performed. Complication and mortality rates were 47.1% and 10.3% respectively. According to multivariate logistic regression analysis, gestational age at termination of pregnancy, delayed presentation, delayed surgical treatment and presence of complications were significantly associated with mortality (P<0.001). The overall median length of hospital stay (LOS) was 18 days (1day to 128 days ). Patients who developed complications stayed longer in the hospital, and this was statistically significant (P=0.012).</p> <p>Conclusion</p> <p>Bowel perforation following illegally induced abortion is still rampant in our environment and constitutes significantly to high maternal morbidity and mortality. Early recognition of the diagnosis, aggressive resuscitation and early institution of surgical management is of paramount importance if morbidity and mortality associated with bowel perforation are to be avoided.</p>http://www.wjes.org/content/7/1/29Bowel perforationIllegally induced abortionSurgical managementTanzania |
| spellingShingle | Mabula Joseph B Chalya Phillipo L Mchembe Mabula D Kihunrwa Albert Massinde Anthony Chandika Alphonce B Gilyoma Japhet M Bowel perforation secondary to illegally induced abortion: a tertiary hospital experience in Tanzania World Journal of Emergency Surgery Bowel perforation Illegally induced abortion Surgical management Tanzania |
| title | Bowel perforation secondary to illegally induced abortion: a tertiary hospital experience in Tanzania |
| title_full | Bowel perforation secondary to illegally induced abortion: a tertiary hospital experience in Tanzania |
| title_fullStr | Bowel perforation secondary to illegally induced abortion: a tertiary hospital experience in Tanzania |
| title_full_unstemmed | Bowel perforation secondary to illegally induced abortion: a tertiary hospital experience in Tanzania |
| title_short | Bowel perforation secondary to illegally induced abortion: a tertiary hospital experience in Tanzania |
| title_sort | bowel perforation secondary to illegally induced abortion a tertiary hospital experience in tanzania |
| topic | Bowel perforation Illegally induced abortion Surgical management Tanzania |
| url | http://www.wjes.org/content/7/1/29 |
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