Background: Traumatic ruptures of the diaphragm (TRD) are serious lesions that are often part of polytrauma. They pose a real diagnostic and therapeutic challenge in a disadvantaged environment such as ours. Methods: ...Background: Traumatic ruptures of the diaphragm (TRD) are serious lesions that are often part of polytrauma. They pose a real diagnostic and therapeutic challenge in a disadvantaged environment such as ours. Methods: We conducted a descriptive observational study covering a period of 11 years in 3 referral hospitals in the city of Yaoundé (Cameroon). All patients who had undergone surgery for a traumatic rupture of the diaphragm between January 1, 2011 and December 31, 2020, and whose outcome within 30 days of surgery was known were included. Results: A total of 27 patients were collected. Their mean age was 36.4 ± 19.7 years. There was a strong male predominance with 22 cases (81.5%). The TRD occurred mainly after an assault (n = 9, 33.3%), was mainly on the left side (n = 25, 92.6%) and was most often part of a polytrauma (n = 17, 62.9%). The lesions associated with TRD were mainly visceral (n = 11) and bony (n = 6). The diagnosis was made preoperatively in only 13 patients (48.1%). The average length of the diaphragmatic breach was 6.4 ± 4.5 cm and a simple suture was most often used for the repair (26 cases or 96.3%). Four osteosynthesis procedures were performed at the same time as the diaphragmatic repair. The morbidity rate was 51.9%, with surgical site infection as the main complication. Six deaths (22.2%) were recorded;septic shock was the main etiology (n = 4). Conclusion: The hospital incidence of TRD remains low in our context. These lesions remain associated with significant morbidity and mortality and require a multidisciplinary approach.展开更多
Traumatic rupture of the ascending aorta is rare. We report the case of a 23-year-old man who suffered a service accident by crushing the thorax between two tanks during army maneuvers that resulted in an adventitial ...Traumatic rupture of the ascending aorta is rare. We report the case of a 23-year-old man who suffered a service accident by crushing the thorax between two tanks during army maneuvers that resulted in an adventitial rupture of the ascending thoracic aorta extending to the Crosse. Treatment consisted of replacement of the ascending aorta with a 24 mm Hemashield straight tube and re-implantation of supra-aortic vessels at the dome of the prosthesis.展开更多
文摘Background: Traumatic ruptures of the diaphragm (TRD) are serious lesions that are often part of polytrauma. They pose a real diagnostic and therapeutic challenge in a disadvantaged environment such as ours. Methods: We conducted a descriptive observational study covering a period of 11 years in 3 referral hospitals in the city of Yaoundé (Cameroon). All patients who had undergone surgery for a traumatic rupture of the diaphragm between January 1, 2011 and December 31, 2020, and whose outcome within 30 days of surgery was known were included. Results: A total of 27 patients were collected. Their mean age was 36.4 ± 19.7 years. There was a strong male predominance with 22 cases (81.5%). The TRD occurred mainly after an assault (n = 9, 33.3%), was mainly on the left side (n = 25, 92.6%) and was most often part of a polytrauma (n = 17, 62.9%). The lesions associated with TRD were mainly visceral (n = 11) and bony (n = 6). The diagnosis was made preoperatively in only 13 patients (48.1%). The average length of the diaphragmatic breach was 6.4 ± 4.5 cm and a simple suture was most often used for the repair (26 cases or 96.3%). Four osteosynthesis procedures were performed at the same time as the diaphragmatic repair. The morbidity rate was 51.9%, with surgical site infection as the main complication. Six deaths (22.2%) were recorded;septic shock was the main etiology (n = 4). Conclusion: The hospital incidence of TRD remains low in our context. These lesions remain associated with significant morbidity and mortality and require a multidisciplinary approach.
文摘Traumatic rupture of the ascending aorta is rare. We report the case of a 23-year-old man who suffered a service accident by crushing the thorax between two tanks during army maneuvers that resulted in an adventitial rupture of the ascending thoracic aorta extending to the Crosse. Treatment consisted of replacement of the ascending aorta with a 24 mm Hemashield straight tube and re-implantation of supra-aortic vessels at the dome of the prosthesis.
