Patterns and Outcomes of Surgically Treated Non-traumatic Acute Abdomen in a Teaching Hospital in Nigeria: A 10-Year Retrospective Study

Aim/objective: This study aimed to investigate the epidemiology, clinical patterns, and outcomes of surgically treated non-traumatic acute abdomen in a Nigerian teaching hospital, identifying key predictors of morbidity and mortality. Materials and methods: This retrospective study, conducted from 2014 to 2024 at Federal Teaching Hospital, Ido-Ekiti, Nigeria, included 611 patients undergoing surgery for non-traumatic acute abdomen. Obstetric, gynecological, pediatric, traumatic, or conservatively managed cases were excluded. Data on demographics, diagnoses, complications, and outcomes were collected from medical records and analyzed using IBM SPSS Statistics for Windows, version 21.0. Logistic regression identified predictors of adverse outcomes, with significance set at p < 0.05. Results: Non-traumatic acute abdomen accounted for 16.94% (611/3,605) of surgical operations. The cohort (51.06% male, 312/611; 48.93% female, 299/611; mean age 39.70 years) predominantly comprised younger patients (18-27 years, 35.19%, 215/611). Acute appendicitis (51.06%, 312/611), intestinal obstruction (30.61%, 187/611), and perforation (13.75%, 84/611) were the leading diagnoses. Complications occurred in 21.77% (133/611) of cases, primarily wound infection (29.29%, 39/133), sepsis (13.74%, 18/133), and chest infection (9.00%, 12/133). Mortality was 9.98% (61/611), mainly due to septic shock (52.46%, 32/61) and fecal fistula (19.67%, 12/61). Fever, comorbidities, delayed presentation (>7 days), and referred status were significant predictors of adverse outcomes, as detailed in the multivariate analysis. Conclusion: Non-traumatic acute abdomen carries a high burden in Nigeria, driven largely by appendicitis, bowel obstruction, and visceral perforation. Outcomes are worsened by delays at several points along the care pathway, from late recognition of symptoms and delayed decisions to seek care, to prolonged transit to facilities and protracted waits for diagnosis and surgery once patients arrive. These cumulative delays, compounded by systemic infection and coexisting comorbidities, escalate morbidity and mortality, underscoring the need for earlier presentation, faster diagnostic access, and timely surgical intervention.