Gunshot injuries in the Niger Delta region of Nigeria

Abstract

Background: Violent trauma especially by gunshot injuries appears to be on the increase worldwide. There is inadequate data from many centres in Nigeria to support this observation. Aim: To determine the pattern of gunshot injuries in the University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a prospective study covering a period of three years (January 2002-December 2004). A standard proforma was used to record all cases of gunshot injuries reporting to the UPTH. Details sought were age, gender, occupation, gun type, anatomic region of the body involved and treatment given. Other information recorded were time of injury, duration of hospital stay, injury time before presentation, assailant and outcome. Information was obtained directly from victims, relations, the police or those accompanying the victim. Where surgical operations were done or patients were admitted to the wards, relevant information or findings were then retrieved from theatre and ward records. Results: There were 135 patients (120 males and 15 females) between the ages of 1½ -67 years. Students and civil servants constituted the largest number. Seventy-one injuries were due to high velocity missiles while 64 were low velocity. Armed robbery and attacks by “unknown assailants” were the commonest modes of attack with 47 and 41 victims respectively. The lower limbs, abdomen and chest were the most frequent anatomic regions involved recording 38, 28 and 27 cases respectively. There were 9 cases in which multiple anatomic sites were affected. The majority of patients (56) presented within 12-18 hours after injury; only 9 cases presented within 6 hours. Twenty-nine patients underwent laparotomy while 14 had thoracostomies. Forty-nine patients were treated and discharged. Minor surgery (like wound debridement) was the commonest treatment in 43 patients. All cases of fracture among these were subsequently referred to the trauma unit for appropriate treatment. Thirty patients died giving a mortality rate of 22.2%. Conclusion: Gunshot injuries constitute a major cause of violent trauma in the Niger Delta Region of Nigeria with a high and disturbing level of morbidity and mortality. Port Harcourt Medical Journal Vol. 1(1) September 2006: 34-38