Stab wounds in The Gambia.

Over a 24-month period (January 1990 to December 1991) 337 cases of stab wounds were managed at the Royal Victoria Hospital, Banjul, The Gambia. All stabbing occurred in and around Banjul and victims were predominantly male (99.1%). Stabbed subjects were mostly involved in fights (98.2%). The mean age of the subjects was 27.6 +/- 10.5 years. 155 subjects (46%) required emergency room treatment only while 182 (54%) needed hospitalisation. Superficial lacerations predominated (94.3%) while other major complications included haemothorax/pneumothorax (2.4%), haemopericardium/pneumopericadium (0.3%), cardiac lacerations (0.6%), and haemoperitoneum (2.4%). Visceral injuries managed were: Heart lacerations (2%), Liver lacerations (1.2%), lung lacerations (2.4%), peritoneal lacerations (0.6%), gut perforation (0.6%) and pericardial complications of inadequate initial management. Anaesthetic techniques used for major procedures including Thoracotomies and Laparotomies were simple to ensure safety and assure quick post anaesthetic recovery. All patients had an uneventful recovery. In a situation of restricted medical facilities, we have recorded successful management outcomes without resorting to mandatory exploratory celiotomy and expensive diagnostic procedures.