Management of Chest Injuries: A prospective study

Objective: Chest injuries constitute a continuing challenge, relating to the trauma team or general surgeon, who practicing in a developing country. This study reviews the pattern and management of these injuries mainly by general surgeons. Methods: A prospective review of 112 patients admitted into the surgical wards of the the AL-Gumhouri-Teaching Hospital Sana'a between March 2006 and August 2009. Results: 112 patients with various forms of chest injuries were managed in the AL-Gumhouri Teaching Hospital Sana'a between March 2006 and August 2009. There were 100 (89.3%) males and 12 (10.7%) females.. The age ranged between 16-45 years, with a mean of 26.4 years. Most of the injuries, 68 (60.7%) were penetrating, 42 (37.5%) were due to gun shots and 26 (23.2%) from stab wounds. Blunt injuries constituted the remaining 44 (39.3%), 36 (32.1%) were due to road traffic accident and 8 (7.2%) fall from height. All patients had chest radiographs.The commonest abnormal findings were rib fractures 38 (33.9%), pneumothorax 36 (32.14%), haemothorax 30 (26.8%), haemopneumothorax 24 (21.43%). Most patients 80 (71.4%) required tube thoracostomy as definitive treatment. Ten patients (8.9%) required thoracotomy. The commonest extra-thoracic associated injuries were abdominal injuries in 12 (10.7%), head injuries 6 (5.4%), limb fractures 4 (3.6%), one (0.9%) vertebral bodies fracture. and eight (8.04%) had multiple injuries involving thorax with more than two body systems .The most encountered complications were posttraumatic infection. The overall mortality rate was (8.9%). Conclusion: Penetrating injury of chest is the most common causes of chest injuries in adults in this study although blunt trauma is still common.The majority of the chest trauma are successfully managed by tube thoracostomy and supportive measures.