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Surgical morbidity in Adi Caeih Hospital

Enviado por Rosendo Reyes


  1. Introduction
  2. Material and Methods
  3. Conclusions

Introduction

The ministry of Health faces a tremendous challenge of fulfilling the human, financial and material needs for effectively running the newly constructed and expanded health facilities.

The introduction of a new surgeon in Adi Caih Hospital was necessary and strategic decision to attend the patients in a vast and remote area which is about 120 Km away from Asmara

with its population approximately 60,000, where the majority of them lives sparsely in rural zones, where the accident are frequently taken part and other several surgical diseases occurs.

Moreover, the circumstances have obvious limitations such as:

  • Health workers are not available for the attention to solve the problems and to treat the patients.

  • Electric energy is only 6 hrs daily.

  • The Hospital has only one ambulance.

  • The generator for emergency is out of work frequently.

  • Fuel is not enough.

  • Only one Anesthetist Technician.

  • Lack of full drugs for necessity.

  • Non availability of instruments and miscellaneous for necessary operations.

  • Non availability of blood for emergency.

  • Some patients who are badly sick or complicated get admitted late.

Therefore, this study was done in the following objectives:

  • To know the principals diagnose in Surgical out Patient Department (SOPD), Surgical Ward (SW) and Operating Room (OR).

  • To assess to study the magnitude of the surgical attention.

Material and Methods

A retrospective analysis was done during the months, from April 2008 to November 2008, with the patients who had surgical attention in Adi Ceih Hospital. Clinical patient"s record were attended in SOPD, in OR and admitted in SW were reviewed. Data on personal history, diagnostic or principal symptoms, age and surgical procedure, were systematically collected from the patient"s cards.

The results are presented in graphic and some of there are compared with similar period of previous year.

Patients who came for second or more times with the same symptoms or diagnostic in SOPD were excluded.

In general syndromes, some diagnostic indifferent such as headache, body pain, chest pain, digestive disorder, dysuria and urine infections, etc had been included.

We have also included certain surgical diagnostic like: sigmoid volvulus, intestinal stenosis, intussusceptions, appendicular mass, abdominal tumors, Hirsprung disease, digestive bleeding, rectal stenosis, rectal polyp, burns, breast tumors, foreign body, gynecology disease, osteomyelitis, Perthes disease, cryptorchid testis, hypospadia, bladder stone and polyp, varicocele, testicle atrophy and agenesis, phymosis, prostatitis and epididimus cyst.

In miscellaneous in OR Diagnostic includes: mesenteric thrombosis, intestinal stenosis, ulcer perforation peritonitis, urethra stenosis, testicle agenesis and atrophy, sigmoid volvulus, hemoneumotorax, undescend testicle, hypospadia, perinea fistula, etc.

In miscellaneous procedures certain operations are included such as: uretroplastic, amputation, colostomy, Hartman operation, mastectomy, tracheotomy, Heineken Mickuliz Ileoplasty, etc.

MORBIDITY SOPD 2008 ADI CAIEH HOSPITAL

Diagnostic or principals symptoms

Patients

%

1.- Traumas y Politraumas

179

19

2.- Generals syndromes

173

18

3.- Soft tissue tumors

136

14

4.- Abdominal pain

85

9

5.- Abdominal wall hernias

53

6

6.- Prostatic hypertrophy

52

6

7.- Skin infections

51

6

8.- Perinea and anal diseases

35

4

9.- Malformations/deformations

33

4

10.-Hydroceles

23

3

11.-Tiroid Gland diseases

21

2

12.-Miscellaneous diseases

89

9

T O T A L

970

100

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MORBIDITY IN SW 2008 ADI CAIEH HOSPITAL

DIAGNOSTICS

PATIENTS

%

1.- Traumas and Politraumas

123

30

2.- Skin infections and wall abscess

86

22

3.- Abdominal pain

38

9

4.- Prostatic hypertrophy

18

5

5.- Abdominal wall hernias

15

4

6.- Hydroceles

13

3

7.- Burns

13

3

8.- Soft tissue tumors

12

3

9.- Back and extremity pain

10

3

10.-Perinea and anus disease

7

2

11.-Miscellaneous

63

16

T O T A L

407

100

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DIAGNOSTICS IN OR 2008/2007. ADI CAIEH HOSPITAL.

DIAGNOSTICS

2008

2007

1.- Soft tissue tumors and cysts

46

13

2.- Skin and wall wounds

22

1

3.- Abdominal wall hernias

17

2

4.- Abscess

13

4

5.- Hydroceles

11

0

6.- Cesareans

6

0

7.- Extremity fractures and dislocations

4

0

8.- Breast tumors

3

0

9.- Hand finger malformations

3

1

10.-Phymosis and paraphymosis

2

21

11.-Acute appendicitis

1

3

12. Miscellaneous

21

10

T O T A L

149

55

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PATIENTS ATENDED IN OR 2007/2008 ADI CAIEH

HOSPITAL. RELATION MAJOR VS MINOR

OPERATIONS.

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PATIENTS ATENDED IN OR 2007/2008 ADI CAIEH HOSPITAL. RELATION ELECTIVE VS URGENT

OPERATIONS

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OPERATIONS MADE IN 2008. ADI CAIEH HOSPITAL

OPERATIONS

PROCEDURES

No. %

1.- Excisions

50 31

2.- Sutures and reparations

21 13

3.- Herniorraphys

19 12

4.- Incisions and drainages

15 9

5.- Laparotomys and several procedures

11 7

6.- Hydrocelectomys

7 4

7.- Cesareans

6 4

8.- Orchidopexias

4 3

9.- Fractures and dislocations corrections

4 3

10.- Miscellaneous

23 14

T O T A L

160 100

Conclusions

  • The more frequently diagnostic in SOPD and SW were the traumas and Politraumas, while in OR were the soft tissue tumors and cysts; therefore the excision was the more common procedure.

  • The study reveled that the surgeons for Adi Caieh Hospital should have a vast, enough and more preparation.

 

 

Autor:

Dr: Rosendo Rosel Reyes Rivera.

Surgeon Adi Caieh Hospital.