Penetrating Chest Trauma in Nigeria

Thomas, Martins Oluwafemi; Ogunleye, Ezekiel O.

doi:10.1177/021849230501300202

Cited by 25 publications

(23 citation statements)

References 6 publications

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“…This agrees with the earlier findings on penetrating chest trauma in Nigeria. 9 The contributory effect of associated injuries in mortality due to blunt chest trauma was clearly established in this study. The finding that 72.7% of deaths occurred in patients who had associated injuries, especially musculoskeletal injuries, leads to the conclusion that associated injuries constitute a major prognostic factor in blunt chest trauma in Nigeria.…”

Section: Discussionmentioning

confidence: 57%

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Etiopathology and Management Challenges of Blunt Chest Trauma in Nigeria

Thomas

Ogunleye

2009

Asian Cardiovasc Thorac Ann

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Blunt chest trauma had not been roundly studied in Nigeria. This study was conducted to determine the etiopathological and management challenges of chest trauma in a developing country. In a prospective multicenter hospital-based study of 10-years duration in the city of Lagos, the data of 896 patients were recorded. The male-to-female ratio was 8 : 1, and the mean age was 27.1 years. The majority of patients (76.9%) were aged 20-39 years. Road traffic accidents caused 98.1% of the injuries. Lung parenchymal injuries occurred in 66% of patients, and cardiac trauma in 0.1%. Isolated chest trauma was found in 85% of patients, and 134 had associated injuries. The incidence of blunt chest trauma could be reduced if the number of road traffic accidents in Nigeria is reduced.

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Section: Discussionmentioning

confidence: 57%

“…9 The conclusion here is that males are generally more affected by chest trauma, whether penetrating or blunt. In this series, we found a platykurtic distribution of ages, with patients in the age range of 20-39 years constituting 76.9% of the total.…”

Section: Discussionmentioning

confidence: 76%

Etiopathology and Management Challenges of Blunt Chest Trauma in Nigeria

Thomas

Ogunleye

2009

Asian Cardiovasc Thorac Ann

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“…Die Primärtherapie besteht in der Einlage einer Thoraxdrainage zur Evakuation der Pleurahöhle und Vorbeugung eines Spannungszustandes [70]. Bei der penetrierenden Verletzung ist die Genese durch Messerstich, Schussverletzung oder Pfählung zu erklären, die Behandlung besteht auch hier in einer Drainageneinlage sowie der eventuellen Entfernung des Fremdkörpers [71]. Weisen Patienten nach thorakalen Stichverletzungen eine hämodynamische Instabilität auf, ist die Thorakotomie als lebensrettende Maßnahme indiziert [72].…”

Section: Typische Verletzungen Und Ihre Therapieunclassified

Strategien in Diagnostik und Therapie des Thoraxtraumas

Müller¹,

Hatz²

2005

Viszeralchirurgie

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Chest injury is encountered in 20 % of all traumatized patients. 25-35 % have an isolated trauma to the chest. 65-75 % are seen as accompanying injuries in polytraumatized patients. Blunt trauma occurs in 90-95 % and penetrating injury in 5-10 %. Fractures to the thoracic bone structure are the most common type of injury, followed by contusions to the lung, hemothorax and pneumothorax. Injuries to the mediastinum and diaphragm are less frequent. Primary diagnosis is best established by computer tomography and sonography. If airway, oesophageal or cardiac injury are suspected special diagnostics such as bronchoscopy, esophageal endoscopy, echocardiography and coronary angiography should be employed. 90 % of all thoracic injuries can be treated conservatively with analgesics, oxygen, chest tube drainage and secretolysis. Primary surgical therapy is indicated in 10 %. Mortality is higher following blunt trauma than after penetrating injuries. Key wordsChest injury · polytrauma · blunt trauma · lung contusion · surgery ZusammenfassungIn bis zu 20 % aller Unfallverletzungen findet sich eine Beteiligung des Brustkorbes, die entweder als isoliertes Thoraxtrauma (25-35 %) oder als Mitverletzung des Thorax (65-75 %) bei Polytraumata beobachtet werden. Zu 90-95 % handelt es sich um stumpfe Thoraxtraumen, in 5-10 % um penetrierende Verletzungen. Führend sind Frakturen des knöchernen Thorax, Lungenkontusion und Hämato-/Pneumothorax. Seltener werden Verletzungen der Mediastinalorgane und des Zwerchfells beobachtet. Die apparative Primärdiagnostik erfolgt durch Computertomographie und Ultraschall, sie wird bei speziellen Organverletzungen durch Bronchoskopie und Ösophagoskopie, Echokardiographie und Koronarangiographie ergänzt. Zu 90 % ist eine konservative Therapie durch Gabe von Analgetika, Sauerstoff, Einlage einer Thoraxdrainage und Sekretolyse ausreichend. Eine primär operative Therapie ist in 10 % indiziert. Die Letalität ist höher nach stumpfem als nach penetrierendem Thoraxtrauma. SchlüsselwörterThoraxtrauma · Polytrauma · stumpfes Trauma · Lungenkontusion · chirurgische Therapie Originalarbeit 368 Heruntergeladen von: Universite Laval. Urheberrechtlich geschützt. Einleitung

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“…Firstly, the incidence of blunt chest injuries could be reduced if measures are taken to reduce the number of RTAs and to improve ambulance services, educate the public and to establishing trauma centers. Secondly, the tribal disputes, armed conflicts, the political events, the low level of the strict judicial and security procedures that have been linked to a high incidence of violence chest trauma in other communities (6,7,11,16) are similar to those in our country. Therefore, violent activities and social problems should be solved.…”

Section: Discussionmentioning

confidence: 55%

“…Thoracic surgeons (3,6) generally agree that most patients with penetrating chest injuries could be managed adequately by closed thoracostomy tube drainage alone. Demirhan et al (18) reported 46% tube thoracostomy with favorable outcomes.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Chest Injuries among Yemeni Patients: a Retrospective Analysis

Aldahmashi¹

2015

YEM J SCI

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Objective: To investigate the patterns of thoracic injuries and the methods used for their management. Methods: A retrospective descriptive analysis of 275 chest trauma cases managed at the University of Science and Technology Hospital over the period 2010-2013. Results: Of 275 consecutive patients with chest trauma, 72.7% were males and 7.27% were females with a mean age of 33.6 years old. Blunt injuries represented 51% (125 males and 15 females) while penetrating injuries represented 49% (130 males and five females) of the cases. Among the penetrating injury group, three patients (1.1%) were with direct sustaining cardiac injuries. The most common presenting features associated with injuries were pain (100%), dyspnea (78.6%) and hemorrhagic shock (17%). Concurrent extrathoracic injuries were found in 22.2% (61/275) of the total chest injuries; spinal cord injuries (3.3%; 9/275), brain injuries (6.2%; 17/275) and intraperitoneal injuries (4.4%; 12/275) and bone fractures (7.3%; 23/275). The first three types of extrathoracic injuries were mostly due to penetrating injuries that necessitated a thoracoabdominal approach or chest tube drainage (CTD) and laparotomy. Computerized tomography scan, chest X-ray, ultrasound and echocardiography were the main diagnostic tools, being used for the diagnosis of 95.27%, 96.72%, 9.73% and 9.33% of cases, respectively. Intercostal tube thoracostomy was required for the management of 96.3% (130/135) of patients with penetrating injuries; early thoracotomy was performed in 25.9% (35/135) of patients to control over bleeding while late thoracotomy was performed in 16.3% (22/135) of patients for removal of retained foreign body and empyema. The CTD was performed in 76.4% (107/140) of patients with blunt injuries, whereas 23.6% (33/140) patients had conservative management and only 2.9% (4/140) of patients underwent thoracotomy. The average hospital length of stay was 6 days for penetrating trauma group and about 7 days for blunt trauma group. Out of all admitted cases, 94.5% (260/275) were cured while 5.5% (15/275) died. It is concluded that CTD is the most appropriate method of treating complicated chest injuries; however, the penetrating trauma has a higher rate of internal damage that requires early intervention to save life, especially for severe or progressive intrathoracic bleeding and cardiac injury. Pulmonary contusion and rib fracture were the most common complications of chest traumas, for which strong painkillers, anti-infective therapy, respiratory care measures and mechanical ventilation are the components of an effective treatment strategy. The associated extrathoracic injuries constitute a major prognostic factor in chest traumas, which were higher in blunt traumas.

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Penetrating Chest Trauma in Nigeria

Cited by 25 publications

References 6 publications

Etiopathology and Management Challenges of Blunt Chest Trauma in Nigeria

Etiopathology and Management Challenges of Blunt Chest Trauma in Nigeria

Strategien in Diagnostik und Therapie des Thoraxtraumas

Patterns of Chest Injuries among Yemeni Patients: a Retrospective Analysis

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