Review of Postoperative Complications in Emergency Laparotomy at General Hospital Yola, Adamawa State

Emergency laparotomy is associated with significantly higher morbidity and mortality than elective abdominal surgery, largely due to patient acuity, limited preoperative optimization, and resource constraints. This professional practice review examines postoperative complications following emergency laparotomy at General Hospital Yola, Adamawa State, North East Nigeria, from 2020 to 2023. A retrospective review of 150 emergency laparotomy cases was conducted. Complication data were categorized using the Clavien-Dindo classification. Variables analyzed included preoperative risk stratification (ASA classification), intraoperative findings, duration of surgery, and 30-day complication and mortality rates. The most common indications for emergency laparotomy were typhoid intestinal perforation, perforated peptic ulcer disease, and bowel obstruction. Grade III and IV complications occurred in 29% of patients. Postoperative surgical site infection was the most frequent complication (38%), followed by respiratory complications and anastomotic dehiscence. Thirty-day mortality was 16%, predominantly in ASA III and IV patients. Inadequate perioperative resuscitation and absence of high-dependency care facilities were identified as key modifiable system factors. The study recommends structured emergency laparotomy pathways, preoperative resuscitation protocols, and investment in high-dependency surgical units at General Hospital Yola and comparable North East Nigeria facilities. Keywords: emergency laparotomy, postoperative complications, Clavien-Dindo, Yola, Adamawa