Background: Chest trauma is common and its pattern varies in different places. Majority of
patients are managed mainly conservatively. Tube thoracostomy is a simple procedure but it is
associated with significant number of complications. The aim of this study was to evaluate the
clinical pattern and its management at Muhimbili National Hospital.
Methods: A hospital based prospective study of all consecutive patients admitted with chest
trauma at Muhimbili National Hospital between November 2007 and September 2008. Clinical
assessment and chest x-ray findings were used to diagnose and to evaluate any complications
associated with chest tubes using a structured questionnaire.
Results: The majority (95/119) of patients were males. Their age ranged from 12 to 72 years
with the mode of 32 years. Motor traffic injury (MTI) was the commonest cause of chest trauma
accounting for 72.3% of the cases. Rib fractures were the most clinical type of chest injury and
accounted for about 42.9% of cases. Blunt chest injuries were more common (75.6%) than
penetrating injuries. Seventy three (61.3%) patients had other associated injuries, in which
fracture of extremities (25.2%) and head injury (21.8%) were the commonest. Sixty seven
(56.3%) patients were treated with closed tube thoracostomy only. The overall complication
rate of the chest tubes was 32.9% of which infection (24.7%) and nonfunctional tubes (17.4%)
were the commonest. High mortality rate of 24.2% was recorded.
Conclusion: The clinical pattern and the management of chest injuries in this study was similar
with many other series of study, however, the rate of closed tube thoracostomy remained high
with many and avoidable complications.
