TITLE:
Traumatic Rupture of the Diaphragm: Retrospective Study of 27 Cases Operated in Three Hospitals in Yaoundé (Cameroon)
AUTHORS:
Guy Aristide Bang, Georges Bwele Motto, Marie Ange Ngo Yamben, Christel Teddy Chappi, Joseph Cyrille Chopkeng, Daniel Biwole Biwole, Bernadette Ngo Nonga
KEYWORDS:
Traumatic Rupture of the Diaphragm, Morbidity, Mortality, Polytrauma
JOURNAL NAME:
Surgical Science,
Vol.13 No.4,
April
22,
2022
ABSTRACT: 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.