Clin Surg | Volume 3, Issue 1 | Research Article | Open Access

Seasonal Variation of Gastro - Duodenal Perforation in University of Benin Teaching Hospital (UBTH) - A 5 Years Study

Agbonrofo PI1*, Irowa OO1, Okhakhu AL3, Odigie VI1, Oboh OE2, Eriba LO2, Adeyemi OF2 and Jatto JB2

1Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria
2Department of Radiotherapy, University of Benin Teaching Hospital, Benin City, Nigeria
3Department of Ear, Nose and Throat, University of Benin Teaching Hospital, Benin City, Nigeria

*Correspondance to: Peter I Agbonrofo 

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Abstract

Aim: To highlight the pattern of seasonal variation of gastro-duodenal perforations in University of Benin Teaching Hospital and some associated aetiological factors.Patients and
Methods: Consecutive records of all patients diagnosed and operated from January 2013 to December 2017, were studied using a pro forma, the medical records, operative notes, Pathology and Surgery departmental records of the University of Benin Teaching Hospital, Benin City, Nigeria. Information of all cases of gastro-duodenal perforation, confirmed at laparotomy, were extracted from the pro forma and analyzed considering socio-demography, seasonal pattern, associated aetiological factors and intra - operative findings, using Microsoft Excel 2016. Ethical approval was obtained from the departmental ethical committee, University of Benin Teaching Hospital.Results: There were 112 intra - operatively confirmed cases of gastro - duodenal perforations during the study period, (constituting 64.3% of all gastrointestinal perforations seen during the study period). Records of 108 patients (96.4%) were adequate for analysis. In 4 patients the records were inaccurately entered in the spread sheet and were excluded, from the study. Overall crude incidence of gastroduodenal perforations in UBTH was 21.6 cases per year during the study period. Age range was 18 years - 79 years. Mean age 47 ± 16 years. Bimodal cluster age distribution, 3rd to 4th decade (37%) and 6th to 7th decade (44.4%), Male: Female ratio =2:1. Peasant farmers and Farm produce loaders/haulers (49%) were most common. Clergy (2.1%) was the least. Non - Steroidal Anti - Inflammatory Drugs was the commonest culprit. Ratio of duodenal to gastric perforations is 5:1. There were two peak periods of seasonal perforations: February to May (40%) - crop preplanting/ religious fasting season, and August to October (32%) - crop harvest and farm-produce loading/haulage period. July was the least period of perforation (4%).Conclusion: The study reveals that duodenal perforations were five times more common than gastric perforations in Edo state (South - south region of Nigeria). Gastro - duodenal perforations were related to seasonal and geographic variations; being more common among peasant farmers, farm - produce loaders/haulers and the pre-planting/bush clearing seasons. This season when combined with the religious fasting periods accounted for 72% of perforations. Prognosis was related to time of presentation at hospital which was also directly related to seasons of economic strength (harvest period of farm produce) of the peasant farmer. To reduce incidence of gastro - duodenal perforations in Edo State - (South - south of Nigeria), it is the authors’ opinion that there is a need to educate the Edo state populace (especially peasant farmers and farm-produce loaders/ haulers), on the consequences of non-steroidal anti-inflammatory drugs abuse.

Keywords:

Seasonal variation; Gastro-duodenal perforation; Fasting; Non-steroidal antiinflammatory drugs

Citation:

Agbonrofo PI, Irowa OO, Okhakhu AL, Odigie VI, Oboh OE, Eriba LO, et al. Seasonal Variation of Gastro - Duodenal Perforation in University of Benin Teaching Hospital (UBTH) - A 5 Years Study. Clin Surg. 2018; 3: 2064.

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