Relaparotomy in Children in a Developing Country: A 10-Year Review

Abstract

Background: Complications arising from abdominal surgeries may necessitate a relaparotomy. The purpose of this study was to evaluate the indications, outcome and factors affecting mortality following pediatric relaparotomy in Enugu, Nigeria.

Methods: This was a retrospective study of children that had relaparotomy at the pediatric surgery unit of Enugu State University Teaching Hospital, Enugu over a 10-year period. The parameters assessed included patients’ demographics and other factors that may affect mortality following relaparotomy using a multivariate analysis.

Results: A total of 683 laparotomies were performed during the study period, out of which 31(4.5%) patients had relaparotomy. The ages of the patients ranged from 2 weeks to 15 years, with a median of 10 years. Typhoid intestinal perforation was the most common initial pathology that necessitated the initial laparotomy and right hemicolectomy with ileotransverse anastomosis was the most common initial procedure performed. Anastomotic leak (61.3%) was the most common indication for relaparotomy and surgical site infection (29%) was the most common complication following relaparotomy. Mortality rate was 19.4% and statistical analysis (multivariate analysis) showed post-operative complication as the only factor that affected mortality (p value = 0.04).

Conclusion: Relaparotomy is inevitable in many unsuccessful primary laparotomies. The mortality rate in developing country like Nigeria is high and efforts should be made towards improving outcome.

Keywords: Abdominal, children, complications, developing country, relaparotomy, review.

What is already known about the topic: There is no publication on pediatric relaparotomy from West African. A literature search on pediatric relaparotomy in Africa showed only one paper from Ethiopia which recorded high mortality especially in neonates.

What does this article add: To the best of my knowledge, this is the first article from West Africa that brings up information on pediatric relaparotomy. This article adds information on the unique experience from West Africa.

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Medical Journal: Relaparotomy in Children in a Developing Country: A 10-Year Review

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