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Abstract
ABSTRACT
Background. Abdominal trauma occupies an important place within traumatic injuries in prison. No study has been conducted to date on this topic in our country. We aimed to determine the typology of abdominal trauma in Cameroonian inmates and to assess the results of their management in penitentiary hospitals. Methods. This study was conducted in the medical unit of the three biggest Cameroonian penitentiary institutions. Retrospectively, we collected data on inmates admitted for the management of abdominal trauma from November 1st, 2019 to October 30, 2020. Results. We recorded 66 patients with a mean age of 29.45 years; the sex ratio was of 12.2/1 in favour of males. Patients were mainly pre-trial inmates (81.3%, n=54). Abdominal trauma occurred after fight/assault by another detainee in all cases. Forty-three patients (65.1%) had blunt abdominal trauma and 23 (34.9%) abdominal stab wound. On admission, 14 (32.5%) patients with blunt abdominal trauma presented with hemodynamic instability. Stab wounds were penetrating in 17 cases (73.9%) and associated with an evisceration in 5 patients. Fifty-five (83.33%) of patients were totally managed in penitentiary health units, with 4 deaths recorded (7.3%). The mortality rate was higher in patients with stab wounds (21.4%) compared to that of patients with blunt traumas (2.5%). No death was recorded among the eleven patients who were transferred to community hospitals. Conclusion. Abdominal traumas are uncommon among Cameroonian inmates. The mortality is high and more important among patients with abdominal injuries. The penitentiary health system needs to be improved to reduce these outcomes.
RÉSUMÉ
Introduction. Les traumatismes abdominaux font partie des traumatismes les plus fréquents en prison. Aucune étude n'a été menée à ce jour sur ce sujet dans notre pays. Notre objectif était de déterminer la typologie des traumatismes abdominaux chez les détenus camerounais et d'évaluer les résultats de leur prise en charge dans les centres médicaux pénitenciers. Materiels et methodes. Cette étude a été menée dans les centres médicaux des trois plus grands établissements pénitentiaires camerounais. Rétrospectivement, nous avons collecté des données sur les détenus admis pour prise en charge de traumatismes abdominaux du 1er novembre 2019 au 30 octobre 2020. Résultats. Nous avons enregistré 66 patients avec un âge moyen de 29,45 ans ; le sexe ratio était de 12,2/1 en faveur des hommes. Les patients étaient principalement des prévenus (81,3 %, n=54). Le traumatisme abdominal s'était produit après une bagarre/une agression par un autre détenu dans tous les cas. Quarante-trois patients (65,1 %) avaient une contusion abdominale et 23 (34,9 %) une plaie de l'abdomen. A l'admission, 14 (32,5%) patients présentant une contusion abdominale avaient une instabilité hémodynamique. Les plaies abdominales étaient pénétrantes dans 17 cas (73,9%) et associées à une éviscération chez 5 patients. Cinquante-cinq (83,33%) des patients ont été totalement pris en charge dans les unités de santé pénitentiaires, avec 4 décès enregistrés (7,3%). Le taux de mortalité était plus élevé chez les patients avec des plaies abdominales (21,4%) par rapport à celui des patients avec des contusions (2,5%). Aucun décès n'a été enregistré parmi les onze patients qui ont été transférés dans les hôpitaux communautaires. Conclusion. Les traumatismes abdominaux sont relativement rares chez les prisonniers camerounais. La mortalité liée à ces traumatismes est élevée et plus importante en cas de plaie abdominale. Le système de santé pénitentiaire devrait être amélioré pour réduire ces résultats.
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References
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- - Thorburn KM. Injury monitoring in U.S. prison systems. Journal of the American Medical Association 1999;282:430-431.
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- - Ludwig A, Cohen L, Parsons A, Venters H. Injury surveillance in New York City Jails. Am J Public Health 2012;102(6):1108-1111.
- - O’Connor HM, Stringer DG. Review of traumatic injuries in regional federal penitentiaries. Can Med Assoc J 1985;133:204-205.
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- - Zafar SN, Rushing A, Haut ER, Kisat MT, Villegas CV, Chi A et al. Outcome of selective non-operative management of penetrating abdominal injuries from the North American National Trauma Database. Br J Surg 2012;99:155–164.
- - Hope WW, Smith ST, Medieros B, Hughes KM, Kotwall CA, Clancy TV. Non-operative management in penetrating abdominal trauma: is it feasible at a Level II trauma center? J Emerg Med 2012;43:190–195.
References
- Green L, Hutchinson C, Lamb D, Johnson D, Wilcox K. Injury surveillance in correctional facilities-Michigan, April 1994-Marh 1995. Morbidity and mortality weekly report 1996;45:69-72.
- Thorburn KM. Injury monitoring in U.S. prison systems. Journal of the American Medical Association 1999;282:430-431.
- Sung HE. Prevalence and risk factors of violence-related and accident-related injuries among state prisoners. Journal of correctional Health care 2010 ;16(3) :178-187.
- Lacambre M, Courtet P. Violence et prison. La Lettre du Psychiatre. 2012;8(5):124-7.
- EndrassJ, Rosseger A, Urbaniok F, Laubacher A, Vettel S. Predicting violent infractions in a swiss state penitentiary : a replication study of the PCL-R in a population of sex and violent offenders. BMC psychiatry 2008;8:74.
- Bragg WD, Hoover EL, Turner EA, Nelson-Knuckles B, Weaver WL. Profile of trauma due to violence in a statewide prison population. Southern Medical Journal 1992;85(4):365-369.
- Condon L, hek G, Harris FY. A review of prison health and its implications for primary care nursing in England and wales : the research evidence. Journal of clinical nursing 2007 ;1201-1209.
- Youssef N. Surgical digestive emergencies in prisoners, about a prospective study. J Emerg Trauma Shock. 2014;7(1):59-61.
- Smit SJA, Kleinhans F. Surgical practice in a maximum security prison – unique and perplexing problems. S Afr Med J. 2010;100(4):243-246.
- Ludwig A, Cohen L, Parsons A, Venters H. Injury surveillance in New York City Jails. Am J Public Health 2012;102(6):1108-1111.
- O’Connor HM, Stringer DG. Review of traumatic injuries in regional federal penitentiaries. Can Med Assoc J 1985;133:204-205.
- Henning J, Frangos S, Simon R, Pachter L, Bholat OS. Patterns of traumatic injury in New York City prisoners requiring hospital admission. J Correct Health Care 2015;21(1):53-58.
- Bilong Nkoh FR. Eloignement de la justice de ses réalités locales et crise d’effectivité des normes de procédure pénale au Cameroun. RIDC 2017;69(1):211-230.
- Okuş A, Sevinç B, Ay S, Arslan K, Karahan Ö, Eryılmaz MA. Conservative management of abdominal injuries. Ulus Cerrahi Derg 2013;29(4):153-157.
- van der Wilden GM, Velmahos GC, Emhoff T, Brancato S, Adams C, Georgakis G et al. Successful nonoperative management of the most severe blunt liver injuries: a multicenter study of the research consortium of new England centers for trauma. Arch Surg 2012;147:423–428.
- Zafar SN, Rushing A, Haut ER, Kisat MT, Villegas CV, Chi A et al. Outcome of selective non-operative management of penetrating abdominal injuries from the North American National Trauma Database. Br J Surg 2012;99:155–164.
- Hope WW, Smith ST, Medieros B, Hughes KM, Kotwall CA, Clancy TV. Non-operative management in penetrating abdominal trauma: is it feasible at a Level II trauma center? J Emerg Med 2012;43:190–195.