Abstract

Background: Abdominal malignancies as surgical emergencies pose a serious problem for surgeons with respect to choice of curative and palliative treatment management in absence of opportunity for proper evaluation and support for multidisciplinary approach. There is a very high rate of perioperative mortality in oncological abdominal emergencies.

Materials and Methods: A Retrospective analysis of abdominal emergency surgeries done over a period of 1 year, June 2019 to May 2020 at king George Hospital Visakhapatnam andin them abdominal malignancies were studied with respect to the incidence, pattern of clinical presentation, management and outcomes.

Results: Excluding abdominal trauma cases, a total of 150 abdominal emergency surgeries were done in study period. Abdominal malignancies analysedwere 15 of which 70% of cases were presented as obstruction and30% of cases as perforation peritonitis. It was noted that colonic malignancies (47%) were the most common to present as emergency followed by gastric malignancies (20%), ovarian(13%) malignancies, small bowel (6%), Hepatobiliary (14%) Malignancies. Management approach was with palliative intent 73% and with curative intent is 27%. Overall mortality rate in study period is 24% and perioperative period (within 30days) is 19%.

Conclusion: Surgical intervention appears to be unavoidable even knowing the morbidity and mortality rate is very high in abdominal malignancies presenting as surgical emergency. Surgery should both increase the survival and quality of life. This is difficult because these patients are frail, often malnourished and have a poor performance status. Early detection of the disease by screening is the solution for better prognosis of the patient.

Keywords: Abdominal Malignancies, Surgical Emergencies.