Diagnosis and Treatment of Deep Pulmonary Laceration With Intrathoracic Hemorrhage From Blunt Trauma

Urgent pulmonary lobectomy for blunt chest trauma: report of three cases without mortality

“…Hypovolemic shock, massive hemothorax with chest tube output greater than 1,500 mL and not controlled airway leak are the standard indications for urgent thoracotomy in blunt chest trauma (3,(6)(7)(8). For reducing mortality, some authors suggest to perform urgent thoracotomy when the output of thoracostomy tube reaches 1,000 mL (8).…”

“…The delay of the surgical treatment is one of the most important factors influencing negatively the outcome of these patients (3,8). Hypovolemic shock, massive hemothorax with chest tube output greater than 1,500 mL and not controlled airway leak are the standard indications for urgent thoracotomy in blunt chest trauma (3,(6)(7)(8).…”

“…Pulmonary resections are needed in 17% of patients that underwent urgent thoracotomy for blunt chest trauma and range from wedge resection to pneumonectomy (5). In case of extensive injuries involving major hilar vessels or bronchi, an anatomic pulmonary resection is necessary (6,8).…”

“…Hypovolemic shock, massive hemothorax with chest tube output greater than 1,500 mL and not controlled airway leak are the standard indications for urgent thoracotomy in blunt chest trauma (3,(6)(7)(8). For reducing mortality, some authors suggest to perform urgent thoracotomy when the output of thoracostomy tube reaches 1,000 mL (8). In patients with massive hemothorax for blunt chest trauma, the surgical hemostasis must to be achieved quickly: pneumonorrhaphies and wedge resections are preferred but if more conservative interventions do not control hemorrhage, anatomical lobectomy must be performed without delay (6,8).…”

“…The majority of patients with blunt chest trauma are managed non-operatively by supportive measures and tube thoracostomy; thoracotomy is required in only 7-10% of cases (5)(6)(7)(8).…”