Missed injuries in casualties from the Iraqi-Iranian war: a study of 35 cases

Thirty-six injuries were missed in 35 casualties admitted to Basrah University Teaching Hospital from the Iraqi-Iranian war. The errors were made particularly in patients with severe multiple injuries. The incidence of missed injuries and the reasons for the diagnostic failures are discussed. The injuries that were overlooked mostly involved the peripheral nerves, and the factors leading to inadequate initial assessment were poor clinical routine, failure to interpret correctly the physical signs and poor use of X-ray facilities. Casualties with head injury, and those who presented with traumatic amputations, need particular care. Such patients are costly both in staff time and in investigations.