Background: Emergency thoracotomies often challenge surgical logistics and they tend to produce inferior outcomes when compared with elective surgery. Aims: We sought to identify the specific indications and therapeut...Background: Emergency thoracotomies often challenge surgical logistics and they tend to produce inferior outcomes when compared with elective surgery. Aims: We sought to identify the specific indications and therapeutic challenges that go with patients who undergo thoracotomy within 24 hours of admission and the re-thoracotomies. Methodology: Spanning a 7-year period, the bio-data of patients who met our criteria for emergency thoracotomies were collated. We noted their indications for surgery, therapeutic challenges and outcome of care. Results: In all, 36 patients (28 males and 8 females) met the inclusion criteria. Majority, (66.7%) fell into the 20 - 39 year age range. Diaphragmatic rupture was the commonest indication, followed by massive intra-thoracic haemorrhage. Postoperative mortality occurred in 11.1% of patients. Postoperative ventilation was absolutely indicated in 6 patients. Discussion and Conclusion: Diaphragmatic rupture is the commonest indication for emergency thoracotomy. We noted the need for improvement in pre hospital care for trauma patients as a way to improve the management outcome of emergency thoracotomies.展开更多
Background: Fluids collect in the pleural space under different conditions and they are of different types. Detailed study of demographic attributes and aetiology of pleural collections has not been well reported in A...Background: Fluids collect in the pleural space under different conditions and they are of different types. Detailed study of demographic attributes and aetiology of pleural collections has not been well reported in Africa. Aims and Objectives: This study was conducted to determine the demographic attributes and aetiology of common pleural space fluid collections. Methods: The sample population consisted of referrals received via clinics, admission through the emergency centre and wards. We noted their biodata, hospital identification numbers, ages and gender and other relevant parameters. Data analysis was done with special interest in gender-based diseases like ovarian carcinoma prostatic carcinoma and the like. Results: There were 372 patients over a 55-month period. The M:F ratio was 1:1 approximately. The combined mean age was 37.8 ± 0.92 years at 95% confidence interval. Their distribution was negatively skewed and it was leptokurtic. The age bracket of 20 - 49 had 65.6% of cases. There was gender based disparity in ages. Discussion: Malignant effusions constituted majority of sample size and the right side was consistently affected more often than the left side. Conclusion: Advanced malignancies are the commonest causes of pleural effusion. There is ongoing epidemiologic transition of diseases as the burden of non-communicable diseases is now juxtaposed with that of communicable diseases in Africa.展开更多
文摘Background: Emergency thoracotomies often challenge surgical logistics and they tend to produce inferior outcomes when compared with elective surgery. Aims: We sought to identify the specific indications and therapeutic challenges that go with patients who undergo thoracotomy within 24 hours of admission and the re-thoracotomies. Methodology: Spanning a 7-year period, the bio-data of patients who met our criteria for emergency thoracotomies were collated. We noted their indications for surgery, therapeutic challenges and outcome of care. Results: In all, 36 patients (28 males and 8 females) met the inclusion criteria. Majority, (66.7%) fell into the 20 - 39 year age range. Diaphragmatic rupture was the commonest indication, followed by massive intra-thoracic haemorrhage. Postoperative mortality occurred in 11.1% of patients. Postoperative ventilation was absolutely indicated in 6 patients. Discussion and Conclusion: Diaphragmatic rupture is the commonest indication for emergency thoracotomy. We noted the need for improvement in pre hospital care for trauma patients as a way to improve the management outcome of emergency thoracotomies.
文摘Background: Fluids collect in the pleural space under different conditions and they are of different types. Detailed study of demographic attributes and aetiology of pleural collections has not been well reported in Africa. Aims and Objectives: This study was conducted to determine the demographic attributes and aetiology of common pleural space fluid collections. Methods: The sample population consisted of referrals received via clinics, admission through the emergency centre and wards. We noted their biodata, hospital identification numbers, ages and gender and other relevant parameters. Data analysis was done with special interest in gender-based diseases like ovarian carcinoma prostatic carcinoma and the like. Results: There were 372 patients over a 55-month period. The M:F ratio was 1:1 approximately. The combined mean age was 37.8 ± 0.92 years at 95% confidence interval. Their distribution was negatively skewed and it was leptokurtic. The age bracket of 20 - 49 had 65.6% of cases. There was gender based disparity in ages. Discussion: Malignant effusions constituted majority of sample size and the right side was consistently affected more often than the left side. Conclusion: Advanced malignancies are the commonest causes of pleural effusion. There is ongoing epidemiologic transition of diseases as the burden of non-communicable diseases is now juxtaposed with that of communicable diseases in Africa.
