Source: Annual Congress 2002 - Chest trauma, airways and miscellaneous
Disease area: Thoracic oncology

Abstract

Penetrating injuries are usually due to missile or stab wounds. In this study we reviewed the consequences of various types of penetrating thoracic traumas and treatment modalities employed for these.We examined 117 patients with major penetrating thoracic injuries, which were hospitalised in our clinic between 1994-2000. The patients had not any trauma of mediastinal great vessels and/or cardiac trauma. Patients with penetrating trauma caused by 77 gunshot wounds and 40 stab wounds. It was included 113 males and 4 females. Average age of all patients was 30.6 (18-54).Among patients with gunshot wounds, there were 25 hemothoraces, 5 pneumothoraces, 28 hemopneumothoraces and 18 lung injuries, while 19 patients only sustained chest wall injuries. All 58 patients with thorax-penetrated gunshot injuries underwent closed tube thoracostomy, 15 out of whom later required thoracotomy or video-assisted thoracic surgery (1 lobectomy, 1 segmentectomy, 1 wedge resection, 7 only pneumoraphy). Laparotomy was performed for abdominal organ injuries in 8 cases with thoraco-abdominal gunshot wound. Among the stab wounds, there were 13 hemothoraces, 13 pneumothoraces and 8 hemopneumothoraces. Nineteen patients underwent tube thoracostomy, 2 thoracotomy. Also in 6 patients intraabdominal organ injuries were observed so laparotomy was performed.According to our suggestion closed tube thoracostomy is very valuable in the management of patients with pneumothorax and/or hemothorax except for some thoracic trauma cases with uncontrolled intrathoracic bleeding or visceral organ injury. But urgent thoracotomy is indicated in patients with large or persistent hemothorax, or with air leak that preclude adequate ventilation.

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T. Isitmangil, S. Sebit, H. Tunc, R. Gorur, O. Erdik, K. Balkanli, O. Y. Ozturk (Istanbul, Turkey). Evaluation of penetrating thoracic traumas over a 7-year period. Eur Respir J 2002; 20: Suppl. 38, 974

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