Pattern and Management of Chest Injuries in Maiduguri, Nigeria

Background: Chest injuries constitute a continuing challenge to the trauma or general surgeon practicing in a developing country. This study reviews the pattern and management of these injuries mainly by general surgeons. Methods: A retrospective review of 78 patients admitted into the surgical wards of the University of Maiduguri Teaching Hospital (UMTH) with chest injuries between January 1997 and December 1999. Results: Over the three-year period, 78 patients with various forms of chest injuries were managed in the UMTH. There were 62(79.5%) males and 16 (20.5%) females, giving a male to female ratio of 3.8:1. The age ranged between 5 - 67 years with a mean of 32.28 years. Most of the injuries 48(61.53%) were penetrating; 24(30.76%) were due to low velocity guns, 10(12.8%) from arrow shots and 6(10.34%) from stab wounds. Blunt injuries constituted the remaining 30(38.46%) and were all as a result of road traffic accidents (RTA). All patients had chest radiographs from which the commonest lesions; simple rib fractures, haemopneumothorax, haemothorax and pneumothorax were diagnosed. There were none with major vascular or oesophageal injuries. The commonest extra-thoracic associated injuries were limb fractures and abdominal injuries. Most patients 44(56.4%) required tube thoracostomy as definitive treatment. Four patients (5.12%) required thoracotomy. The commonest complications were infective in nature. The overall mortality was 2.56%. Conclusion: There was a high incidence of chest injuries following gun shuts and arrow shots from armed bandits. The management of seemingly serious chest injuries were well within the competence of general surgeons