Diagonal Thoraco-abdominal Arrow and Gunshot Injuries as Seen at Juba Teaching Hospital, South Sudan .

Background: Civil wars and inner city violence in Africa and worldwide are associated with multiple severe injuries to various anatomical sites or combined. The thoraco-abdominal variety tends to cause high mortality or significant morbidity and they warrant an auditing study to guide practice and reduce mortality.
Methods: At Juba Teaching Hospital, South Sudan we receive numerous victims of gunshot or arrow shot injuries to most parts, head, neck, chest abdomen, pelvis, and limbs or combined. Between Dec.2012-Jan.2014, we managed a significant number of casualties, and out of this number we selected to study prospectively the outcome of management of patients with thoraco-abdominal arrow and gunshot injuries.
Results: We managed 23 patients. 22 adult males and one female child aged 7years, mean age (29) and range 7-59years. 11 patients (47.8%) survived and discharged and 12/23 died (52.2%). *Two patients died on table before operative intervention.
Conclusion: Diagonal thoraco-abdominal gunshot and arrowshot injuries are associated with high mortality in African setting with limited resources that do not include specialist and intensive therapies units.