Management of surgical emergencies in Nigeria is characterised by mismatch between supply of facilities and
demand for care. This study aimed to evaluate the waiting time between presentation at hospital with acute abdominal
disease and operative intervention.
Patients and Method:
We prospectively studied adult patients with abdominal diseases requiring emergency operation.
The interval between presentation and first contact with emergency room doctors was defined as T1; time from contact to
decision to operate as T2; time taken to resuscitate patient T3 and to commencement of operation T4. Causes of delay and
its impact on outcome of treatment were noted.
There were 488 patients, mean age 32 ± 1.7SD years. TT ranged between 0.8 and 79.0 hours, mean 22.3 ± 10.0
hours. In 81.6% operative intervention was delayed beyond 6 hours of which financial constraints accounted for 53.8%. T3
accounted for the longest delay (0.5 -53.0hours). Patients of lower socio-economic class had longer T3 (p<0.005). Waiting
for complementary investigations caused delay in 22.1%. Post-operative complications (p=0.0001) and their severity were
higher in patients with longer TT. Prolonged TT (p<0.001), ASA grade (0.005) and time from onset of symptoms to
admission (p=0.009) were associated with mortality. Patients whose operations were delayed beyond 24 hours had a longer
Emergency abdominal operations were delayed in our patients mainly because of scarce financial resources.
Delayed interventions were associated with higher morbidity and mortality.