West African journal of medicine
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The leading cause of morbidity and mortality from the end of the first year of life to the forty fifth is trauma. This is true worldwide but especially so in our environment. In no other situation are the complexities of the management of trauma more manifest than in the context of polytrauma. For this we undertake to study the problem of polytrauma in Jos. ⋯ Polytrauma occurs with sufficient frequency to warrant serious attention. As majority follow RTA, there is a need to intensify measures aimed at improving road safety. There is also a need to establish pre-hospital care\ambulance services. It is suggested that improved orthopaedic and neurosurgical care will lead to improved polytrauma care and most importantly, the establishment of dedicated trauma teams in tertiary institutions is proposed as a prelude to the establishment of regional trauma centers.
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The outcome of head trauma as a result of road accident rests with increased use of CT scan and other radiological imaging modalities for prompt diagnosis is important. ⋯ CT scan is an effective imaging modality of patient with road traffic accident and should be promptly requested in symptomatic patients who sustain trauma to the head toward identification of lesions that are amenable to surgical treatment.
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Cases of discrete subaortic stenosis are rare in adults. To our knowledge, no case has been reported in Nigerian literature. Cases are thus likely to be missed or wrongly managed. ⋯ Discrete membranous subaortic stenosis though rare in adults should be suspected in patients with clinical features of valvular aortic stenosis. Doppler echocardiography is thus mandatory in the evaluation of these patients.
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Tube thoracostomy (TT) is central in the management of chest trauma sufficing in over 80% of cases. As a result the procedure is commonly performed in most emergency departments. ⋯ Tube thoracostomy in the emergency department using advanced trauma life support principles is effective in chest trauma and associated with few complications.
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After several years of lagging behind due to several constraints, many general surgeons across Nigeria are now performing laparoscopic surgery. An audit of the procedure in our setting is required. ⋯ Our results show the feasibility of laparoscopic surgery in Nigeria. We advocate local adaptation and improvisations to increase the use of laparoscopic surgery in Nigerian hospitals.