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BACKGROUND: Pediatric surgical emergency condition is abroad spectrum of surgical pathologies/disorders occurring inpediatric age group requiring proper emergency surgical care asthe only option of management to salvage life, avoid/minimizedisability or palliation. The objective of this study is to analyze thepattern and outcome of pediatric surgical emergencies managed atTikur Anbesa Hospital and the factors associated with outcome.METHODS: Retrospective analysis of medical records of patientswas conducted to assess the pattern, outcome and factorsassociated with outcome of pediatric surgical emergenciesadmitted and managed at Tikur Anbesa Specialized Hospital, fromJanuary 1, 2015 to December 31, 2015. Data was checked forcompleteness and entered into SPSS version 20 for statisticalanalysis.RESULTS: A total of 454 patients’ medical records were analyzed.The presentation was after 5 days of illness in 182(40%), and >3days in 243(53.4%), while only 89(19.6%) of them come within 24hoursoftheillness.Theetiologieswereabdominal/gastrointestinal emergencies 210(46.3%), foreign bodyin aero digestive system in 133(29.3%), urogenital surgicalemergencies in 27(5.9%). The other causes include superficial anddeep tissue abscess collections in 22(4.8%), trauma /injury relatedcases in 24(5.3%) and others in 38(8.4%) respectively whilecongenital malformations were only 57(12.6%) of the cases.Finally, 439(96.7%) were discharged cured or improved withoutmajor disabilities documented, while 9(2%) died.CONCLUSIONS: Delayed presentation, unstable condition onarrival, younger age group and the nature of underlying pathologycould have contributed for the death, but this needs further study.