Peripheral vascular injuries and their management in Accra
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Date
2008
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Publisher
Ghana Medical Journal 41(4): 186-189
Abstract
Ghana is not known on account of low reporting.
Objective: We performed a study aimed at reviewing
the pattern of injuries to peripheral vessels, and also the
pattern of referral, presentation and management of
these injuries at the Korle-Bu Teaching Hospital, Accra.
Method: The study covered the period of January 1989
to March 2005 and involved a review of all peripheral
vessel injuries referred for vascular surgical opinion.
Results: Fifty two (52) patients with aged between 13-
50 years were reviewed. Penetrating trauma (82.7%)
and blunt trauma (11.5%) were the commonest modes
of injury. Arterial injuries (63.5%) and combined arterial
and venous injuries (23.1%) were the commonest
forms of injury. Brachial artery injuries were the commonest
injuries seen. Associated nerve injuries occurred
in 25% of patients most of whom also had brachial
artery injuries. Late presentations of false aneurysms
and arteriovenous fistulae were seen in 40.4%
patients. There were delays in referring patients (range
1 hour to 4 years). Vascular investigations like angiograms
and duplex scanning were obtained in only
25.0% of patients. Vascular reconstruction was successful
in 84.6% patients and 7.7% of patients required
major limb amputation and an equal number of patients
died from other injuries.
Conclusion: There is undue delay in referring patients
with vascular injuries for intervention due to the inability
of the initial attending medical personnel to recognize
these injuries. Most of these injuries can be adequately
treated without the use of sophisticated investigations,
which are usually expensive.
Description
Keywords
Arterial injuries, venous injuries, false aneurysms, arteriovenous fistula