Clinicopathological Features of Abdominal Complaints that Require Exploratory Laparotomy: A Five-Year Experience in Aefutha

Background: An exploratory laparotomy, also known as a celiotomy or "ex-lap," is a type of major surgery that involves opening the abdomen with a large incision in order to visualize the entire abdominal cavity. An exploratory laparotomy is done to diagnose and possibly treat related abdominal complaints arising from any of the intra-abdominal contents that cannot otherwise be treated through less-invasive methods. The surgery can be done in adults and children and may be performed as an emergency or an elective. The precise timing of the surgery depends on the indication, and definitive treatment depends on the intra-operative findings. Aim: To analyze the clinicopathological features of abdominal complaints that required exploratory laparotomy and identify the commonest indication for exploratory laparotomy in Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State, Nigeria, from May 2016 to April 2021. Method: This was a 5-year analytical descriptive prospective study. Data were collected using a proforma over a 5-year period from May 2016 to April 2021. The details of the proforma comprised of age, sex, presenting complaints, diagnosis, and definitive procedure performed; all patients aged 16 years and above who gave consent and presented to the institution with abdominal complaints and had exploratory laparotomy were recruited in the study. The results of their diagnosis and definitive procedures performed were analyzed using a Chi-square for categorical values and a T-test for continuous variables. Result: A total of 488 patients had exploratory laparotomy over the study period. Three hundred and six (62.7%) patients were males, while 182 (37.3%) patients were females. Four hundred and sixteen cases (85.2%) were done as emergency surgery, while 72(14.8%) cases were done as elective surgery. Benign pathologies were 413(84.6%) in numbers, while malignant pathologies were 75(15.4%) in numbers. Of all benign pathologies, infective cases outnumbered, recording 195(47.2%) out of 413 cases seen during this period. Out of the yg75 malignant pathologies operated upon during the study period, large bowel malignancy outnumbered others, representing 48(64.0%) of them. Conclusion: In Alex Ekwueme Federal University Teaching Hospital Abakaliki, large volumes of exploratory laparotomy are being performed annually. A greater number of those surgeries are for benign pathologies; however, amongst those that are malignant, colonic origins still dominate.