THORACIC TRAUMA EPIDEMIOLOGICAL, CLINICAL, RADIOLOGICAL AND EVOLUTIONARY ASPECTS ABOUT 84 CASES

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Introduction: Thoracic trauma is common and remains a health problem. Objectives: to analyse the epidemiological, clinical, radiological and evolutionary aspects of thoracic trauma in the intensive care unit of the National hospital centre in Nouakchott. Patients and methods: this is a retrospective, single-centre, descriptive study with analytical aims covering 84 cases of thoracic trauma over a period of 2 years between September 2015 and August 2017. Results: There were 49 cases of closed thoracic trauma and 35 cases of open thoracic trauma. The average age of the patients was 34.83±17.16 years (5.5 to 86 years) with a male predominance of 94%. Stroke was the leading cause (45.23%). The clinical picture on admission was dominated by respiratory distress (64 cases). Systematic chest X-rays and CT scans (61 cases) revealed: rib fractures in 35 cases, rib flaps in 5 cases, pneumothorax in 20 cases, haemothorax in 15 cases, haemopneumothorax in 52 cases and pulmonary contusion in 28 cases. CT was able to demonstrate its superiority by identifying lesions that had gone unnoticed on standard radiography. All patients had received general analgesia (84 cases). Thoracic drainage was performed in 79 cases. Emergency surgery was used in 3 patients. The outcome was favourable in 78 cases, apart from 1 case of pneumonia and 1 case of atelectasis. Four patients died, 3 of them had associated severe head injuries. Conclusion: Thoracic trauma is common, and remains serious in the context of polytrauma. Close collaboration between the intensive care unit, the surgeon and radiologist is necessary for rapid and effective patient management.

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