Objective: Abdominal surgical emergencies constitute significant disease burden world-wide. An emerging trend due to changing demographics and westernization has been observed in many regions of the developing economy. We present the spectrum, management and outcome measures of emergency abdominal operations in Abakaliki, Southeast Nigeria. Methods: This is a descriptive prospective study of all consecutive teenage and adult patients operated for abdominal emergencies between January 2009 and December 2013 at Federal Teaching Hospital Abakaliki(FETHA). The data were analyzed using Statistical Package for Social Sciences (SPSS) version 22.0. Result: A total of 684 patients operated for abdominal emergencies were enrolled, 398(58.2%) males and 286 (41.8%) females. The ages of the patients ranged from 16-85 years with a mean of 38.89 +/- SD 17.58. The most common diagnoses were appendicitis (264, 38.6%), adhesive bands (77,11.3%) and trauma(66, 9.6%). Nearly a third (85, 32.2%) of the patients with appendicitis had complicated disease pre-operatively and 22.7% of the excised appendices were histopathologically normal. Majority (96.1%) of the 77 patients managed for adhesive bands had previous abdominal surgeries. Approximately three-quarter (50, 75.8%) of abdominal traumas were due to road traffic accidents (RTA). Indeed 80.0% and 48.4% of blunt and penetrating injuries respectively resulted from RTA. Post-operative morbidity and mortality rates were 34.1% and 4.8% respectively. At a median follow up of 10 months, 16 (2.3%) incisional hernias developed and 48.0% of patients with colonic cancer developed extensive intra-peritoneal metastasis. Conclusion Appendicitis, adhesive bands and trauma have taken over from strangulated external hernias as major causes of abdominal emergencies in our environment. Late presentation and advancing age are associated with poor outcomes.
