East and Central African Journal of Surgery Volume 15 Number 1. March/April 2010. 124 The Pattern and Management of Chest trauma at Muhimbili National Hospital, Dar es Salaam. F.A. Massaga, M. Mchembe Department of Surgery, Muhimbili National Hospital, Dar es Salaam – Tanzania. Correspondence to: Dr. Massaga F.A, University of Dodoma, P.O.Box 259 Dodoma – Tanzania. Email: Massaga2000yahoo.com Source of funding: Ministry of Health of Tanzania. 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 32years. 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. Introduction Chest injuries cause high morbidities and mortalities because they involve vital organs. They affect mainly the young school age and productive members of the societies 1. Motor traffic injury is the known worldwide commonest cause of chest injuries in developing and developed countries due to different risk factors 2, 3, 4. Locally, it has been observed in a pilot study that chest injuries constitute significant number of surgical patients admissions, however little has been documented on its pattern in clinical practice. The pattern here refers to the causes, type of injuries, clinical diagnosis and their associated injuries in relation to the age and sex of the patients. Two different studies in Nigeria, showed different pattern in terms of type of injury one said blunt injury was common due to motor traffic injuries and the other said penetrating injury was common because of penetrating injury following civil war 2, 5. Most of studies in both developing and developed countries showed that blunt chest injuries are common due to motor traffic injuries 6. Chest injuries were noted to be common in young and middle age groups where males were commonly affected as compared to females. This was seen in most of the series 6,7,8,9. Clinical types of chest injuries varied in different studies depending on the causes; however most of them were associated with other injuries. Majority of patient in almost all of the studies were treated conservatively by no more than a chest tube. Although most of these patients managed to arrive at hospital for treatment, more deaths occurred within the hospital 10. Closed tube thoracostomy is a simple and a life saving procedure but still is associated with many complications 11, 12,13,14,15. This has been a challenge to many surgeons on this preventable cause of deaths.