The concept of staged laparotomy can be successfully applied to wounds of the pancreas and duodenum. Debridement of devitalized tissue and drainage can be employed for most cases of pancreatic trauma. Most duodenal injuries can be managed with debridement and primary repair. Temporary exclusion and reoperation should be employed for unstable patients.

The appropriate use of intercostal drains and therapeutic thoracoscopy are important considerations in penetrating non-cardiac thoracic trauma. Rapid transportation, immediate triage, open-minded use of emergency room thoracotomy, and aggressive surgical management with liberal use of sub-xiphisternal pericardial windows are important factors in improving the survival of penetrating cardiac trauma.

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