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 | 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 | 35 | 4 | ||
9.- | 33 | 4 | ||
10.-Hydroceles | 23 | 3 | ||
11.-Tiroid Gland diseases | 21 | 2 | ||
12.-Miscellaneous diseases | 89 | 9 | ||
T O T A L | 970 | 100 | ||
MORBIDITY IN SW 2008 ADI CAIEH
HOSPITAL
DIAGNOSTICS | PATIENTS | % | |
1.- Traumas and | 123 | 30 | |
2.- Skin infections and wall | 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 | 10 | 3 | |
10.-Perinea and anus | 7 | 2 | |
11.-Miscellaneous | 63 | 16 | |
T O T A L | 407 | 100 | |
DIAGNOSTICS IN OR 2008/2007. ADI CAIEH
HOSPITAL.
DIAGNOSTICS | 2008 | 2007 | ||
1.- Soft tissue tumors and | 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 | 4 | 0 | ||
8.- Breast tumors | 3 | 0 | ||
9.- Hand finger | 3 | 1 | ||
10.-Phymosis and | 2 | 21 | ||
11.-Acute appendicitis | 1 | 3 | ||
12. Miscellaneous | 21 | 10 | ||
T O T A L | 149 | 55 | ||
PATIENTS ATENDED IN OR 2007/2008 ADI
CAIEH
HOSPITAL. RELATION MAJOR VS
MINOR
OPERATIONS.
. 
PATIENTS ATENDED IN OR 2007/2008 ADI CAIEH
HOSPITAL. RELATION ELECTIVE VS URGENT
OPERATIONS
OPERATIONS MADE IN 2008. ADI CAIEH
HOSPITAL
OPERATIONS | PROCEDURES No. % | ||
1.- Excisions | 50 31 | ||
2.- Sutures and | 21 13 | ||
3.- Herniorraphys | 19 12 | ||
4.- Incisions and | 15 9 | ||
5.- Laparotomys and several | 11 7 | ||
6.- Hydrocelectomys | 7 4 | ||
7.- Cesareans | 6 4 | ||
8.- Orchidopexias | 4 3 | ||
9.- Fractures and dislocations | 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.