Gynaecological Conditions Presenting to General Surgeon as Acute Abdomen

Abstract

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Objectives:  To study the pattern of gynaecological emergencies presenting to general surgeons and to highlight problems in their management and to suggest solutions.

Study Design:  It is a descriptive cross sectional survey.

Setting:  Surgical Unit-II of Ghurki Trust Teaching Hospital of Lahore Medical & Dental College Lahore.

Period:  From 1^st January 2007 to 31^st December 2007 (one year)

Materials & Methods:  All female patients (107) presenting in surgical emergency with acute abdomen were included. However those women with any pervious gynaecological or obstetric operation who presented to surgical emergency with acute abdomen were excluded from the study. Clinical workup including a detailed physical examination and relevant investigations were carried out in all patients. These patients were managed in the surgical ward. The operative treatment, where required, was performed at the earliest possible time. The surgical procedures were employed according to the circumstances.

Results:  The total number of female patients in this study was 107. Nineteen (17.75%) of the patients presented with gynaecological emergencies acute abdomen. Age of the patient in this study ranged from 15 years to 35 years. The commonest gynaecological condition encountered was haemorrhagic functional ovarian cysts. Difficulty and errors in diagnosis occurred in these cases and erroneous diagnosis of acute appendicitis was made in seven out of nineteen patients (36.08%). Conclusion:  Gynaecological emergencies constitute a significant problem encountered by the general surgeons. The problems of difficulty in diagnosis can be resolved by use of ultrasonography and laparoscopy. The general surgeons can contribute by enhancing knowledge of gynaecological emergencies and their clinical and therapeutic skills.

Keywords:  Gynaecological conditions. General surgeon, Acute abdomen.