Vascular injuries: Aetiology, presentation and management outcomes at a tertiary hospital in Lagos, Nigeria.

Vascular injuries lead to haemorrhagic shock and distal limb ischaemia, especially with an arterial injury. This life-threatening state mandates urgent evaluation and intervention to save life and limbs. The treatment aims to restore blood flow and replace lost blood within the golden hours, stabilising cardiovascular haemodynamics and averting irreversible ischaemic damage. The aim of this study was to analyse the clinical profile of vascular injuries, management and outcomes in our institution. Materials and Methods: This retrospective study covered the period from January 2015 to December 2021. Information of interest were extracted from the medical records of each participant. The results from the data analysis were presented in charts and tables. Results: Seventy-four patients aged 15-78 years (mean 32.30 ± 13.75 years) were included in this study. The male-to-female ratio was 3.6:1. The most common causes were gunshot injury, road traffic accident and iatrogenic injuries. The mean duration from injury to presentation was 9.85 h and mean duration from presentation to restoration of flow was 7.3 h. The most common injured artery was the femoral artery, whereas the most common vein was inferior vena cava. Primary vascular repair was done in majority of the cases. Amputation was performed in 18.9% with loss of viability of the limb. Conclusion: Vascular injury though relatively uncommon remains a challenging and life-threatening disease predominantly in young adult males. Urgent intervention prevents limb loss and mortality. Favourable outcome is accomplished by improving emergency healthcare delivery and well-equipped vascular centres with adequately trained personnel in the nation's hospitals.

Abdominal stab wounds in Lagos: A review of fifty cases.

BACKGROUND: The optimum management of patients with abdominal stab wounds (ASWs) is yet to be fully elucidated. AIMS AND OBJECTIVES: To evaluate the pattern of injury, treatment offered and outcome in patients with ASWs seen at our tertiary hospital. PATIENTS AND METHODS: This was a retrospective descriptive study of patients who sustained ASWs seen from January 2011 to December 2015. Information obtained from case notes were analysed on a personal computer using SPSS version 22 (SPSS Inc., Chicago, IL, USA).P<0.05 was considered statistically significant. RESULTS: Fifty patients who sustained ASWs were included in the study. Forty-four (88%) were males, mean age was 27 years and 50% were between the ages of 21 and 30 years. The wounding weapon in patients was the knife in 26 (52%) and broken bottle in 14 (28%). Our patients presented at the hospital about 3 h after abdominal stabs and surgical intervention time was uniformly prolonged. Forty-eight (96%) patients had emergency laparotomy, whereas two (4%) patients with omental evisceration were treated using the policy of selective non-operative management. The commonly injured organs were stomach (22.9%), small bowel (20.8%), omentum (18.8%), colon (18.8%) and liver (14.6%). The negative laparotomy rate was 31.3%. The knife was a more lethal weapon than broken bottle in our patients (P<0.05). Seven (14%) patients suffered serious post-operative complications and two (4%) died. CONCLUSION: The high therapeutic laparotomy rates observed in our patients who had generalised peritonitis, evisceration and shock, support the fact that these findings should be indications for immediate laparotomy.