Emergency Thoracotomy: Indications and Management Challenges in a Developing World

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DOI: 10.4236/wjcs.2012.21001    6,990 Downloads   13,512 Views  Citations

ABSTRACT

Background: Emergency thoracotomies often challenge surgical logistics and they tend to produce inferior outcomes when compared with elective surgery. Aims: We sought to identify the specific indications and therapeutic challenges that go with patients who undergo thoracotomy within 24 hours of admission and the re-thoracotomies. Methodology: Spanning a 7-year period, the bio-data of patients who met our criteria for emergency thoracotomies were collated. We noted their indications for surgery, therapeutic challenges and outcome of care. Results: In all, 36 patients (28 males and 8 females) met the inclusion criteria. Majority, (66.7%) fell into the 20 - 39 year age range. Diaphragmatic rupture was the commonest indication, followed by massive intra-thoracic haemorrhage. Postoperative mortality occurred in 11.1% of patients. Postoperative ventilation was absolutely indicated in 6 patients. Discussion and Conclusion: Diaphragmatic rupture is the commonest indication for emergency thoracotomy. We noted the need for improvement in pre hospital care for trauma patients as a way to improve the management outcome of emergency thoracotomies.

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M. Thomas and E. Ogunleye, "Emergency Thoracotomy: Indications and Management Challenges in a Developing World," World Journal of Cardiovascular Surgery, Vol. 2 No. 1, 2012, pp. 1-4. doi: 10.4236/wjcs.2012.21001.

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