Severe Chest Injury Revisited - An Analysis of The Jos University Teaching Hospital Trauma Registry.

BACKGROUND: Chest injury remains a major source of morbidity and mortality in trauma as approximately two-thirds of all severe traumas involve the chest. OBJECTIVE: To determine the changes in the profile management and outcome of severe chest injury in Jos University Teaching Hospital, Jos, Nigeria. MATERIALS AND METHODS: This is an analysis of the Trauma Registry of Jos University Teaching Hospital-a prospectively gathered database. Patients' entries with severe chest injuries for 7 years, from January 2012 to December 2018, were entered into a database and analyzed using the Epi Info Statistical Software, using simple statistics. RESULTS: In all, 162 patients presented with severe chest injury over a 7-year period, of whom 78 (48.1%) had polytrauma, while 84 (51.9%) had isolated chest injury. There were 139 males and 23 females, giving male: female ratio of 6:1. Over 95 (58.6%) of them were between 20 and 39 years. Blunt injury was predominant, constituting 66.7%. Motor vehicular crash was the most common mechanism of injury constituting 87 (53.7%), while gunshot injuries were responsible for 34 (21%). In managing these severe chest injuries, 146 (90%) of the patients had closed-chest tube thoracostomy as the definitive treatment, while 16 (9.9%) had thoracotomy. The mean and median duration of hospital stay was 13.3 and 10 days, respectively. The commonest complication was wound infection in 8 (4.9%) patients and a mortality of 5.9%. CONCLUSION: Blunt chest injury remains the commonest mechanism of chest injury but with an increasing proportion of penetrating injuries affecting predominantly young males. Most severe chest injury patients survive with simple interventions of resuscitation, and closed-chest tube thoracostomy for definitive treatment.

CERVICAL LIPOSARCOMA IN A 22 YEAR OLD MAN- AN UNCOMMON PRESENTATION.

Liposarcomas are uncommon malignant growths, most of which occur in the retroperitoneum and lower extremities. Liposarcoma arising in the head and neck is an uncommon and a potentially life threatening malignancy. We present a 22 year-old male with a dedifferentiated cervical liposarcoma, who had local excision, with no recurrence at twenty months of follow-up. This patient has drawn our attention to the fact that although liposarcomas are rare in the neck and commonly occur in patients between 40 and 60 years, any neck swelling in the young with atypical features should raise suspicion as to the possibility of malignancy.

COMPLETE OESOPHAGEAL STRICTURE FOLLOWING THYROIDECTOMY FOR BENIGN GOITRE: A CASE REPORT.

Oesophageal injury leading to stricture is a dreaded disease with clinical course and prognosis that are dependent on the etiology, early recognition, and prompt and effective treatment. Commonly, iatrogenic oesophageal injury occurs during endoscopic procedures, and often in a diseased oesophagus. Though uncommon, injury can occur during thyroidectomy. We therefore present the case of a Nigerian woman with complete oesophageal stricture resulting from oesophageal injury sustained during thyroidectomy.

TRAUMATIC DIAPHRAGMATIC HERNIA WITH INTESTINAL OBSTRUCTION IN A CHILD: A CASE REPORT.

Diaphragmatic ruptures caused by blunt or penetrating trauma are relatively uncommon in children, however, they are the most commonly missed or delayed injuries in trauma patients because of its rarity and its coexistence with more obvious and serious injuries. We present a case of acute intestinal obstruction in a 6-year old boy with traumatic diaphragmatic hernia presented four years after trauma, underscoring the fact that clinical scenario in paediatric patients may not always correlate with the degree of severity of the injury and that some of the classical features of intestinal obstruction could be absent.