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traumatic rupture of the diaphragm: Retrospective Study of 27 Cases Operated in Three Hospitals in Yaoundé (Cameroon)

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Surgical Science 2022年第4期13卷 207-215页

作者： 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

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 Yaoundé (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

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