PAEDIATRIC SURGICAL EMERGENCIES: TRENDS, OUTCOMES, AND CHALLENGES
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Keywords
Paediatric surgical emergencies, appendicitis, trauma, postoperative complications, socioeconomic factors
Abstract
Background: Paediatric surgical emergencies are a critical component of healthcare delivery, requiring timely diagnosis and intervention to prevent complications and improve outcomes.
Objectives: This study was aimed to analyze the trends, outcomes, and challenges associated with paediatric surgical emergencies.
Methods: This prospective descriptive study was carried out for about 6 months from Nov, 2009 to April, 2010 in the Department of Paediatric Surgery, Khalifa Gulnawaz Teaching Hospital, Bannu Medical College, Bannu, Pakistan. Paediatric patients aged 0–18 years presenting with surgical emergencies were included. Data on demographics, clinical features, surgical details, outcomes, and referral patterns were collected using a structured proforma. Statistical analysis was performed to identify significant trends and associations.
Results: Seventy-seven paediatric surgical emergencies were included in the study. These were Appendicitis 32%, Trauma 26% followed by Pyloric stenosis 16 and intussusception 13%. The majority of patients (58%) had open surgeries; of which, 78% were done on an emergent basis. Local complications were reported in 26% of patients, and the overall mortality was 6%. The anterior presentation and decreased availability of appropriate surgical intervention were real issues. Another factor that came up and which related to health care included the socioeconomic status of the population.
Conclusion: In this population and context, surgical emergencies for children comprise mainly appendicitis and trauma, which result in frequent use of open surgical procedures due to limitations in resources. It is therefore important to work towards early diagnosis of cases, and health care systems that will make efficient referrals and provision of money for minimally invasive procedures. Socioeconomic determinants play a major role in narrowing the gap in access to quality healthcare services.
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Muhammad Jehangir Khan
Assistant Professor, Department of Paediatric Surgery, Khalifa Gulnawaz Teaching Hospital, Bannu Medical College, Bannu, Pakistan