 |
Research Article
Comparative outcomes of blunt and penetrating abdominal trauma in a low-resource setting: A two year retrospective study
1 Department of Surgery, Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), PMB 102, Abakaliki, Ebonyi State, Southeast Nigeria; Department of Surgery, Ebonyi State University, Abakaliki (EBSU), PMB 053, Ebonyi State; Department of Surgery, Alex Ekwueme Federal University, Ndufu-Alike, Ikwo (AEFUNAI), PMB 102, Abakaliki, Ebonyi State, Southeast Nigeria
Address correspondence to:
Daniel Umezurike Akuma Howard
(FWACS, FICS), Department of Surgery, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, PMB 102, Ebonyi State,
Nigeria
Message to Corresponding Author
Article ID: 100063S05DH2025
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Howard DU, Eni EU. Comparative outcomes of blunt and penetrating abdominal trauma in a low-resource setting: A two year retrospective study. Edorium J Surg 2025;11(1):12–19.ABSTRACT
Aims: To compare clinical outcomes of blunt abdominal trauma (BAT) and penetrating abdominal trauma (PAT) in a Nigerian tertiary hospital and identify predictors of mortality in a low-resource setting.
Methods: A retrospective cohort study of 136 patients with abdominal trauma (93 BAT, 43 PAT) managed at Alex Ekwueme Federal University Teaching Hospital (January 2022–December 2023). Data included demographics, injury mechanisms, management strategies (operative vs. non-operative), and outcomes. Statistical analysis used SPSS v26, with multivariate logistic regression to identify mortality predictors.
Results: Penetrating abdominal trauma patients had significantly higher mortality than BAT (25.6% vs. 12.9%, p = 0.04). Delayed surgical intervention (>24 hours) occurred in 75.3% of cases, associated with 3.1-fold increased mortality risk (OR: 3.1, 95% CI: 1.4–7.0). Hemorrhagic shock on arrival (44.2% PAT vs. 32.3% BAT) independently predicted mortality (OR: 4.3, 95% CI: 1.9–9.7). Non-operative management (NOM) was attempted in 16.9% of BAT cases, with a 78.3% success rate.
Conclusion: Resource limitations, including delayed surgical access and reliance on clinical triage over imaging, disproportionately worsen outcomes for PAT in low-resource settings. Context-specific trauma protocols emphasizing prehospital care and timely operative intervention are critical to reducing mortality.
Keywords: Blunt abdominal trauma, Hemorrhagic shock, Low-resource setting, Nigeria, Non-operative management, Penetrating trauma, Surgical management, Trauma outcome
SUPPORTING INFORMATION
Author Contributions:
Daniel Umezurike Akuma Howard - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Emmanuel Uche Eni - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Daniel Umezurike Akuma Howard et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
