The Presentation and Management of Thoracic Trauma in a General Surgical Ward

Abstract

Objective: To evaluate the various modes of presentation of thoracic trauma and to assess the adequacy of management in a surgical ward of a tertiary care hospital.

Study Design: A retrospective study

Place and Duration of Study: This study was conducted at the Surgical Department Khalifa Gul Nawaz Teaching Hospital Bannu from July, 2016 to April, 2018.

Materials and Methods: A total of 220 patients with thoracic trauma, including both blunt and penetrating thoracic trauma presented to the emergency unit of KGN hospital were included in this study.

Results: Out of the 220 patients, 48% (105) were with blunt thoracic trauma and 52% (115) with penetrating thoracic trauma. Rib fracture was detected in 70% (154) cases, haemopneumothorax in 40% (88) of patients, pneumothorax in 28% (61), haemothorax in 18% (40), flail chest in 6% (13) of the cases, traumatic rupture of diaphragm in 7% (15) of the cases. Pure thoracic trauma was present in 62% (136) patients, thoracic trauma with associated injuries presented in 38% (84) patients and out of these 84 cases, 15.5% (13) cases had polytrauma. During treatment, 77.7% (171) of the patients were treated either non operatively or with chest tube thoracostomy. 16.5% (36) developed complications. 8.18% required thoracotomy. The overall mortality was 8.18% (18).

Conclusion: Penetrating chest trauma is increasing with time due to gunshot injuries although blunt trauma is commoner worldwide. Most of the chest trauma patients can be managed in the general surgical wards satisfactorily and only a few patients need surgical intervention in their management.