Traumatic gastric injuries are relatively uncommon, occurring in 7-24% of abdominal trauma [3,4]. This is because of the relative mobility of the stomach and gastric mural thickness amongst other factors. In this study we found 55 out of a total of 735 abdominal trauma patients requiring hospital admission over a 10 year period, representing 7.5% of abdominal trauma. This shows an average of 5.5 patients per year, which is lower than 14.1% rate reported from Durban [5], and higher than the 6% from Uzbekistan [6].

The male preponderance of 87.3% is in keeping with the male pattern of predominance in trauma generally and was in line with the findings of other studies [7-9]. There were 44 (80%) patients between the ages of 20 -39 years. This supports the assertion that trauma is a disease of predominantly young adult males [10-12].

Penetrating abdominal injury was the predominant mechanism in this study, as gastric injury following blunt abdominal injury is rare [1, 13].  Gunshot injuries accounted for 56.4% of the patients, which is rather worrying in a civilian population during peace time. We opine that this may be due to increasing proliferation of light arms in circulation in our city [14, 15]. However, the finding is in keeping with studies from South Africa and Spain [5, 16].

Isolated gastric injury occurred in 37.7%, the majority having injuries to other abdominal viscera as well. This is not unexpected as the stomach; especially the non distended one enjoys some protection by the lower ribs, and its relatively small size [2].

Complications occurred in 31(56.4%) of the patients, the commonest being wound infection in 21(38.2%). This can be explained by the fact that perforation of the stomach will necessarily cause peritonitis, and the mechanisms of the injuries makes all the wounds untidy by Rank and Wakefield classification, with a high infection rate [17]. Diaphragmatic hernia occurred in one of the 12 patients with associated diaphragmatic injury, which was repaired via the abdominal route. Another patient with diaphragmatic and lung parenchymal injury developed empyema thoraces, and had thoracotomy with decortication of the empyema. Eighteen of those that developed complications presented more than 6 hours post trauma.

The mortality is 5.5%, in keeping with findings from studies in Spain [16].  All mortalities occurred from septic complications. It is worthy to note that all the mortalities were recorded in patients who presented more than 24hours post trauma. Thus, we can infer from this study that delay in presentation is a major predictor of mortality in traumatic gastric injury.