Retrospective study on presentation,management of post pelvic abscesses A study of patients admitted to the University Teaching Hospital Lusaka,Zambia

Abstract

A pelvic abscess is a pus filled cavity in the pelvis due to infection. It is typically the result of acute Pelvic Inflammably Disease (PID). Pelvic abscesses are a major gynaecological problem in contemporary gynaecological practice. This research paper made a retrospective study into a 3 levelled process of presentation, management and post-treatment of 113 sampled patient files at the Obstetrics and Gynaecological department at the University Teaching Hospital (UTH) in Lusaka, Zambia. Included in the sources of information were 8 doctors and 5 observations of laparotomy by the principal investigator. The study reviewed the medical practitioners’ awareness, knowledge, attitude and practice in assessing the presentation, determining the efficiency and effectiveness of management and evaluation of post-treatment periods of pelvic abscess at UTH. The study revealed that medical practitioners are well aware and have good knowledge and practice protocol in the 3 levelled processes. Nevertheless serious lapses were noted which included delay in administering surgical treatment due mainly to a lack of space in operating theatres. This delay compounded complications for patients resulting in morbidity and mortality. Another serious lapse in protocol was the number of attending surgeons during laparotomy. Lone surgeons pose a threat to the healthcare of patients as challenges during operations may go unreported and these challenges may not be addressed by authorities. The study also revealed that there was a high frequency of pelvic abscess among the age range of 16 - 35 years, a prime reproductive period for women. This was in contrast with the threshold of 40 that Western literature state. The cause of this young age for Zambia could reside in extraneous factors such as abortions and STIs. It was discovered that the majority of patients resided in high density areas where literacy levels are low and thus health education is a great challenge.