Pattern of thoracoabdominal injuries in Basrah province: clinical review and management

A Prospective study of Patients with penetrating thoraco-abdominal wounds managed at the Teaching Hospital in Basrah was carried out between January 1987 to June 1987. Patients were resuscitated and assessed on clinical basis, physical examination and radiology of the chest and abdomen peritoneal lavage was not performed in the ovaluation of the patients. One hunderd and twenty patients with pentrating thoraco-abdominal injuries were identified and treated. The patients were treated by laparotomy and treatment of the associated injuries while 110 patients initially underwent aggressive resuscitative measures followed by laparotomy. Haemothorax, pneumothorax accounted for 70% of chest injuries and were treated by closed drainage chest tube. Colon [52%], liver [39%], spleen [33.3%] and small intestine [25.8%] were the most frequently injured abdominal organs. Mortality rate in our series was 5.2%; this rate rises to 58.3% when intracranial injuries were associated with thorco-abdominal injuries. In this study we conclude that thoracic injuries are minor as compared to intra-abdominal injuries and we suggest, based on the patients we treated and review of literatue, that the only safe policy in the management of penetrating wounds of chest and abdomen is by mandatory laparotomy

pattern of pleural effusion in Southern Iraq

The causes of pleural effusions in 394 patients were determined [between December 1984 and November 1987] by physical examination and investigations. Tuberculous [38%], cancerous [20%] and bacterial [20%] effusions were found to be the most common causes. The cause of effusion was not found in 44 patients. Tuberculous effusion was diagnosed by character and culture of the pleural fluid and pleural biopsy, cancerous effusion was diagnosed by cytological examination of pleural fluid and biopsy of the pleura, lung and lymph nodes. Empyema was found to be caused by gram positive and gram negative cocci and a few anaerobes