• Alain Chichom Mefire, Jean Jaques Pagbe, Marcus Fokou, Jean Francois Nguimbous, Marc Leroy Guifo, and Jean Bahebeck.
• University of Buéa, Cameroon. alainchichom@yahoo.com
• S Afr J Surg. 2010 Aug 1;48(3):90-3.

BackgroundThe proportion of death and disability related to trauma is increasing in Third-World countries. Thoracic trauma is significantly involved, but few data are available on this issue in African countries with specific local conditions.MethodsThe aim of the study is to analyse the diagnosis and management procedures in thoracic trauma in a typical African country. The records of 354 patients admitted to an emergency unit for chest trauma over a 13-year period were retrospectively analysed.ResultsThe sample included patients with 231 cases of blunt and 123 of penetrating trauma to the chest; their mean age was 41.86 years, and the male:female ratio was 4.2:1. The majority (N=226) of the injuries were sustained in road traffic accidents, and the most common lesions were rib fractures (50.3%) and haemothorax (38.7%). The diagnosis was based on physical examination and standard chest radiographs in most cases. At least one associated lesion was found in 260 (73.45%) patients. The mean injury severity score (ISS) for our patients was 16.39. Most patients were managed conservatively (N=303); thoracotomy was performed mostly on penetrating trauma patients. Morbidity occurred in 49 patients, mainly affecting those treated with thoracic drainage, and 27 patients (7.6%) died. Factors related to mortality were ISS score and association with neurotrauma.ConclusionsChest trauma can be managed in our Cameroonian environment, with morbidity and mortality comparable with that of Western countries. Diagnosis must still rely on physical examination, chest radiographs and thoracic echography, which are affordable tools.

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