Traumatic Rupture of the Diaphragm: Retrospective Study of 27 Cases Operated in Three Hospitals in Yaoundé (Cameroon)  

Traumatic Rupture of the Diaphragm: Retrospective Study of 27 Cases Operated in Three Hospitals in Yaoundé (Cameroon)

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作  者:Guy Aristide Bang Georges Bwele Motto Marie Ange Ngo Yamben Christel Teddy Chappi Joseph Cyrille Chopkeng Daniel Biwole Biwole Bernadette Ngo Nonga Guy Aristide Bang;Georges Bwele Motto;Marie Ange Ngo Yamben;Christel Teddy Chappi;Joseph Cyrille Chopkeng;Daniel Biwole Biwole;Bernadette Ngo Nonga(Departement of Surgery, Yaoundé University Teaching Hospital, Yaoundé, Cameroon;Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon;Department of Digestive, Central Hospital of Yaoundé, Yaoundé, Cameroon;Department of Orthopaedic, Surgery and Traumatology, Yaoundé Emergency Centre, Yaoundé, Cameroon)

机构地区:[1]Departement of Surgery, Yaoundé University Teaching Hospital, Yaoundé, Cameroon [2]Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon [3]Department of Digestive, Central Hospital of Yaoundé, Yaoundé, Cameroon [4]Department of Orthopaedic, Surgery and Traumatology, Yaoundé Emergency Centre, Yaoundé, Cameroon

出  处:《Surgical Science》2022年第4期207-215,共9页外科学(英文)

摘  要: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 Yaound&#233 (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.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 Yaound&#233 (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.

关 键 词:Traumatic Rupture of the Diaphragm MORBIDITY MORTALITY POLYTRAUMA 

分 类 号:R65[医药卫生—外科学]

 

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