Experience Of Thoracic Surgery Performed Under Difficult Conditions in Somalia

Authors: M. Y. Hassan, A. M. Elmi, Marco Baldan
2004, East and Central African Journal of Surgery


To review the outcome of thoracic surgery performed at Medina Hospital over last two years under situations of constraints and to assess its feasibility in such conditions.

Design And Settings

Case series study in Medina Hospital, Mogadishu - Somalia.

Subject and Methods

Thoracotomies were performed in thirty-two patients with traumatic and nontraumatic conditions. No proper pre-operative investigations were available such as spirometry, haemogasanalysis, bronchoscopy and CT scan. We relied only on clinical evaluation and plain x-rays. Operations were performed under general anaesthesia with no inhalation substance; no anaesthetic machine was used. We simply used ketamine, Suxamethonium, Diazepam and Atropine. We did not use post-operative suction drainage but simple "under water seal" bottle drainage.


Thoracic surgery was performed in 32 patients in Medina Hospital. Most of these cases underwent pleural decortications for chronic empyema (18 patients), 7 patients had removal of bronchial foreign bodies, 4 patients had resection of oesophageal cancer, 2 patients had pericardiectomy for constrictive pericarditis and 1 had lobectomy for lobar consolidation. We had two post-operative complications and 2 patients died after having surgery for carcinoma of the oesophagus.


Thoracic surgery can be performed under constrains with good results in skilled and experienced hands.

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