Background: Globally, emergency laparotomy is a frequently performed type of surgery with high morbidity and mortality rates, even in the best healthcare systems. There is limited knowledge regarding the outcome of emergency laparotomy performed in Ethiopia. Objective: To assess perioperative mortality and its predictors among patients undergoing emergency laparotomy at selected southern Ethiopian governmental hospitals. Methods: A multicenter prospective cohort study was conducted, and data were collected at selected hospitals after obtaining ethical approval from the Institutional Review Board. Data were analyzed using SPSS version 26. Results: The rate of postoperative complications after emergency laparotomy surgery was 39.3%, with an in-hospital mortality rate of 8.4% and a length of hospital stay of 9±6.5 days. The predictors of postoperative mortality were the age of the patient greater than 65 [adjusted odds ratio (AOR)=8.46, 95% CI=1.3–57.1], presence of intraoperative complications (AOR=7.26, 95% CI=1.3–41.3), and postoperative ICU admission (AOR=8.5, 95% CI=1.5–49.6). Conclusion: Our study revealed a significant level of postoperative complications and in-hospital mortality. The identified predictors should be sorted and applied to the preoperative optimization, risk assessment, and standardization of effective postoperative care following emergency laparotomy.

Introduction and importance: Ascaris Lumbricoides is the most common helminthic infection affecting humans worldwide and causing serious medical and social problems, especially in the developing countries where unhygienic disposal of human excreta is common. Even though a lot of complications were reported from Ascaris Lumbricoides infestations worldwide, there were only a few reports from the Ethiopian context where the socio-economic condition put a high vulnerability to such infection. Hence reporting such findings with its intervention will help the policymakers to mitigate the challenges in the health care system and also help as a piece of baseline evidence for future researchers on the issue of interest. Case presentation: A six years old girl from a rural locality of southern Ethiopia was brought to the surgical emergency department with a chief complaint of abdominal pain of 4 days duration which was an intermittent colicky type of periumbilical region associated with vomiting of ingested matter of 3–4 episodes per day. Slight abdominal distension which moves with respiration and diffuse abdominal tenderness was observed for which acute abdomen secondary to small bowel obstruction secondary to intussusception was suspected. Clinical discussion: The physicians treating patients with ascariasis should be aware of the abdominal complications, since a delay in its intervention may have a fatal outcome. The intestinal obstruction caused by Ascaris Lumbricoides infestation is a rare and underestimated problem that may lead to death or irreversible complications. Early surgical intervention in those with worm bolus obstruction, peritonitis, and volvulus may salvage the bowel and reduce the mortality rate. Conclusion: Ascaris is one of the health challenges worldwide. Prevention and control methods like health education for the community should be implemented in endemic areas. Early diagnosis and periodic deworming should be encouraged to avoid complications. Highlights