Pattern of cases and its management in a general surgery unit of a rural teaching institution

Objective: To study the pattern of general surgery cases and their management in a rural teaching institution. Methods: This descriptive case-series was conducted prospectively in Surgical Unit II at Fatima Hospital and Baqai Medical University, from June 16, 2005 to June 15, 2010. There were 1125 patients in the series who were managed either conservatively or operated upon. All patients with symptoms suggesting a surgical disease and managed as a surgical case were included, while cases that were shifted to other departments and those that left against medical advice were excluded. Results: The majority of patients had alimentary tract diseases 327 (29.1%), followed by urinary tract diseases 241 (21.4%), hernia 176 (15.6%), superficial lumps 135 (12%), hepato-biliary-pancreatic diseases 102 (9.1%), breast diseases 47 (4.2%), scrotal diseases 37 (3.3%), thyroid diseases 19 (1.7), salivary gland diseases 10 (0.9%), vascular diseases 4 (0.4%), thoracic diseases 2 (0.2%), and miscellaneous 25 (2.2%). A total of 726 (64.5%) patients were managed as elective cases, while 399 (35.5%) were managed as emergency cases. As many as 834 (74.1%) patients were managed by operations and 244 (21.7%) patients by conservative treatment, while 47 (4.2%) patients were referred. Seven patients expired, giving a mortality rate of 0.62%. Conclusion: The commonest cause of seeking surgical care was alimentary tract diseases, followed by urinary tract diseases, hernias, superficial lumps, hepato-biliary-pancreatic diseases, breast diseases, scrotal diseases and thyroid diseases. Baqai Medical University is catering to the needs of rural population by providing essential surgical care to a broad spectrum of surgical diseases.