ABSTRACT
Objective: To determine the frequency of tube thoracostomy in penetrating thoracic injuries at a tertiary care hospital
Study design: Cross sectional study
Place and Duration of study: Department of Surgery Unit III, Civil Hospital / Dow University of Health Sciences Karachi, from March 2012 to March 2014
Methodology: All patients who presented with penetrating chest injuries due to firearm, stabs etc were treated according to ATLS protocol. Tube thoracostomy was performed when indicated. Chest tube was passed under local anesthesia
Results: A total of 100 patients included in this study. There were 92 males and 8 females. Mean age of the patients was 30+7.29 year. Mechanism of injuries included gunshot injury [n=62], stabs [n=24] and shrapnel injury [n=14]. Pneumothorax was diagnosed in 39 patients, haemothorax in 35, sucking wound of the chest in 20 patients and major vascular injury in 4 patients. Associated extra thoracic injuries were present in 26 patients. Tube thoracostomy was performed in 78 patients. Twenty-two patients underwent thoracotomy
Conclusions: Majority of patients with penetrating chest injuries were managed by tube thoracostomy. No mortality occurred in this series
ABSTRACT
OBJECTIVE OF STUDY: To observe various indications and complications of tube Thoracostomy
DESIGN: Prospective, descriptive study
PLACE and DURATION OF STUDY: Public and private sector hospitals of Nawabshah and Hyderabad from 1[st] Jan 2005 to Dec 2008
METHODOLOGY: All patients of either sex above the age of 13 years having pathology related to chest cavity and underwent chest intubation were included in the study. Patients below the age of 13 years, having serious co morbid illness like Ischemic heart disease [ASA-3], severe chronic obstructive airway disease requiring ventilator support, and complicated chronic liver disease and patients who lost to follow-up were excluded. Data was collected for age, sex, indications of chest intubations, cause of the disease, procedural and post procedural complications and hospital stay. Descriptive analysis was performed using SPSS version 10 for continuous and frequency variables
RESULTS: Total 200 patients of different pathologies related to chest cavity underwent chest intubations. Mean age was 43.57 years SD+/- 12.68 with 60.5% male and 39.5% female. Indications were: pleural effusion 86[43%] patients, pneumothorax 36[18%] patients, empyema thoracis 33[16.5%] patients, hydropneumothorax 24[12%] patients and haemothorax 18[9%] patients
Etiology for intubations includes 118[59%] patients of complicated pulmonary tuberculosis, 27[13.5%] patients of blunt trauma chest and 21[10.5%] patients of post pneumonic empyema
Procedural complications were found in 24[12%] patients and postoperative complications in 25 [12.5%] patients. Mean hospital stay was 5.5 days
CONCLUSION: We found chest tube insertion as the first line of treatment for variety of life threatening chest diseases. It is safe and effective procedure associated with procedural [12%] and post procedural complications [12.5%] which are comparable to international literature