Which Management for Gunshot Chest Wounds in a War Zone Hospital?
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Keywords

War surgery
Thoracic trauma
Penetrating wound
Gunshot wound
Thoracic drainage

How to Cite

1.
Abdoulaye MB, Ousseini A, SANI R, SANI R. Which Management for Gunshot Chest Wounds in a War Zone Hospital?. ATD [Internet]. 2021 Jan. 11 [cited 2021 Oct. 26];2021. Available from: https://mbmj.org/index.php/atd/article/view/243

Abstract

Introduction:  Gunshot chest wounds are a life-threatening surgical emergency without immediate management. Method: The study period is two years, covering cases admitted from June 2017 to May 2019. The surgical service of the regional hospital center (CHR) of Diffa in Niger is one of the main second-level referral structures where victims of the armed conflict that started in 2014 in the Lake Chad basin are referred and treated. Through this study, we report the preliminary results of the hospital management gunshot chest. Results: Firearm-related chest wounds accounted for 9.22% of firearm injury admissions, interesting especially young man subjects. Penetrating thoracic lesions involved 14 patients, 12 of whom had high and medium-abundant effusion treated by thoracic drainage. Two patients had a pulmonary contusion and a fatal tamponade pattern respectively. Conclusion: Emergency chest drainage is a first-line saving procedure in the treatment of thoracic wounds with firearms in armed conflict.

https://doi.org/10.15342/atd.2021.243
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References

- MacKenzie EJ. Epidemiology of injuries: current trends and future challenges. Epidemiol Rev 2000; 2 2:112–119.

- LoCicero J 3rd, Mattox KL. Epidemiology of chest trauma. Surg Clin North Am 1989; 69: 15–19.

- Von Oppell UO, Bautz P, de Groot M. Penetrating thoracic injuries: what have learnt. Thorac Cardiovasc Surg 2000; 4 8:55–61.

- Boddaert G, Mordant P, Le Pimpec-Barthes F, Martinod E, Aguir S, Leprince P et al. Surgical management of penetrating thoracic injuries during the Paris attacks on 13 November 2015. Eur J Cardiothorac Surg 2017;51:1195–202.

- . Lerer LB, Knottenbelt JD (1994) Preventable mortality following sharp penetrating chest trauma. J Trauma 37(1):9–12

- Hardcastle TC, Finlayson M, van HM, Johnson B, Samuel C, Muckart DJ (2013) The prehospital burden of disease due to trauma in KwaZulu-Natal: the need for Afrocentric trauma systems. World J Surg 37(7):1513–1525.

- James Didier L. et al. Résultats de la prise en charge des plaies thoraciques à l’hôpital National de Niamey, Niger.RECAC 2017; 2(12): 19-24.

- Andrew John N., Sorin E., Pradeep N. Selective operative management of penetrating chest Injuries. Curr Surg Rep (2019) 7:13.

- Van Waes O. et al. Selective nonoperative management of penetrating thoracic injury. European Journal of Emergency Medicine 2016, Vol 00 No 00.

- Lesquen H. et al. Challenges in war-related thoracic injury faced by French military surgeons in Afghanistan (2009–2013). Injury, Int. J. Care Injured 47 (2016) 1939–1944.

- Oparah SS, Mandal AK. Penetrating gunshot wounds of the chest in civilian practice: experience with 250 consecutive cases. Br J Surg 1978;65(January (1)):45–8.

- Borja AR, Ransdell HT. Treatment of penetrating gunshot wounds of the chest. Experience with one hundred forty-five cases. Am J Surg 1971;122(July (1)):81–4.

- Muckart DJ, Meumann C, Botha JB. The changing pattern of penetrating torso trauma in KwaZulu/Natal – a clinical and pathological review. S Afr Med J 1995;85(November (11)):1172–4.

- Kong V. Y., Sartorius B., Clarke D. L. The selective conservative management of penetrating thoracic trauma is still appropriate in the current era. Injury, Int. J. Care Injured 46 (2015) 49–53

- Dietrich D. et al. Penetrating thoracic trauma patients with gross physiological derangement: A responsibility for the general surgeon in the absence of trauma or cardiothoracic surgeon? World J Surg. Société Internationale de Chirurgie 2016. DOI 10.1007/s00268-016-3703-y.

- Siemens R. et al. Indications for thoracotomy following penetrating thoracic injury. The journal of trauma. Vol 17, N°7, July 1977 : 493-500.

- Boyd AD, Glassman LR. Trauma to the lung. Chest Surg Clin N Am 1997; 7:263-84.

- Keneally R, Szpisjak D. Thoracic trauma in Iraq and Afghanistan. J Trauma Acute Care Surg 2013; 74(5):1292-7.

- Durso A.M., Caban K., Munera F. Penetrating thoracic injury. Radiol Clin N Am 53 (2015) 675–693.

- Cerf C. Pulmonary contusions: physiopathology and management. Réanimation 16 (2007) 82–87.

- Michelet P, Couret D, Brégeon F, Perrin G, D'Journo XB, Pequignot V, Vig V, Auffray JP. Early onset pneumonia in severe chest trauma: a risk factor analysis. J Trauma. 2010; 68 (2) : 395-400.

- Raghavendran K, Notter RH, Davidson BA, Helinski JD, Kunkel SL, Knight PR. Lung contusion: inflammatory mechanisms and interaction with other injuries. Shock 2009; 32:122-30.

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