Management of Warfare Chest Injuries

Mohan, Pvr; Mohan, Rajesh

doi:10.1016/s0377-1237(10)80010-3

Cited by 8 publications

(13 citation statements)

References 10 publications

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“…The chest, forming such a large and exposed part of the body and containing such vital structures as the heart and lungs, is particularly vulnerable to trauma. While in civil practice grave thoracic injuries are relatively infrequent, in military practice chest wounds assume serious and significant importance [5] . Previous accounts of war injury have limited reporting on civilians (noncombatants) [6] .…”

Section: Discussionmentioning

confidence: 99%

“…The lungs are particularly vulnerable to this form of injury; because of their air-filled alveoli and delicate vascular structure [12] . This effect can be explained by the mechanism of sudden rise in intrathoracic pressure causes alveolar disruption and parenchymal bleeding [5] . The therapeutic goal in the war scenario is to restore normal physiology and thereby to restore cardiac and pulmonary function [5] .…”

Section: Discussionmentioning

confidence: 99%

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War Thoracic Wounds Among Civilians Casualties in Aden During the 2015

Salem

Bux

Hudeel

2020

Electron. J. Univ. Aden Basic Appl. Sci.

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Thoracic injury during warfare was associated with a high incidence of morbidity and mortality. In wartime, civilians have became a direct target and accounted for one-half to two-thirds of the casualties. We aimed to highlight the incidence and pattern of thoracic injury and its outcomes management among civilians during the war in Aden. This retrospective study was based on the data were prospectively recorded in Medical Registry. There were 84 civilian casualties identified during the study period. Of those, 97.6% of casualties were males and 2.4% were females. The overall mean age was 30.8 ± 9.8 years (range: 10 – 65 years). Of those, 73.8% of casualties were produced by rifle bullets, while 26.2% of casualties were due to fragmentation weapons. Hemopneumothorax was the most common injury patterns. Abdomen injury was the most common associated injuries. Of those, 91.7% of casualties were treated with chest tube insertion alone. Thoracotomy was performed for 7.1% of casualties. The overall complications were 54.8%. Wound infection was the most frequent complications. The overall mortality rate was 3.6%. The overall mean hospital stay was 8.3 ± 5.9 days. We concluded that chest drain is best option for treatment the majority penetrating chest wounds.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

War Thoracic Wounds Among Civilians Casualties in Aden During the 2015

Salem

Bux

Hudeel

2020

Electron. J. Univ. Aden Basic Appl. Sci.

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confidence: 99%

“…There are more cases of vital pulmonary parenchymal damage in high-speed gunshot wounds used in wartime, and this situation is related to increased incidence of empyema [1]. Most penetrating chest wounds in both wartime and in civilian life are caused by gunshot wounds, and the factors determining mortality are hemorrhage, respiratory failure, and sepsis [6].…”

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confidence: 99%

“…Another indication of thoracotomy is the wide air leakages caused by serious damage in the pulmonary parenchyma [1,8]. While in cases of pneumothorax in small air leakages a simple thoracic tube and closed underwater drainage would be sufficient, this mode of treatment could be insufficient in serious air leakages, and non-anatomical pulmonary resection performed by a stapler could be called for [9].…”

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confidence: 99%

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The neglected face of war surgery: sepsis redo thoracotomy following inadequate first responder management in the Libyan civil war

Gülmez¹,

Senger²,

Gündeş³

et al. 2017

Arch Med Sci Civil Dis

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Chest injuries account for about 15% of war injuries [1], and the main cause of wartime mortality and morbidity is chest injuries [2]. The consequences of penetrating thoracic injuries can be serious, and mortality can occur at the scene especially if this situation is a result of a gunshot wound. Mortality can sometimes occur, specifically as a result of sepsis, in the late period. Noting this can make prudent intervention possible during the first response and enable a solution to the problem even before it happens. There might not be enough time, however, for a second intervention for complications related to existing injuries in extraordinary situations like war, and the picture may easily result in mortality.The 23-year-old male patient had initially received left anterolateral thoracotomy, pneumorrhaphy, and tube drainage procedures in Libya because of a penetrating gunshot wound in the left lung during the civil war. The patient was referred to our clinic with a picture of sepsis on the 17 th post-operative day for advanced treatment. The patient's presenting general condition was bad, his consciousness was somnolent, he was hypotensive, tachycardic, and tachypneic with axillary fever of 38.9°C. He also had bilaterally extensive subcutaneous emphysema which was more pronounced in the left thorax. Respiratory sounds could not be heard in the left lung through auscultation. The thoracic tube placed in the middle of the current thoracotomy line of the patient was not oscillating at the time of presentation. There was pus at the entry point of the tube into the skin and in the inner wall of the tube. The results of the thoracic x-ray and the thoracic computed tomography (CT) performed by us on the day of the patient's presentation at our clinic revealed left pneumothorax, pneumomediastinum, atelectasis, multilocular 6 × 4.5 cm intraparenchymal upper left lobe, infected hematoma with air value, segmental fracture in the posterior left 5 th rib (Figures 1 A, B), and extensive pleural effusion. Moreover, metal parts belonging to the gunshot wound were observed in the upper abdominal wall's left lateral part. His laboratory infection parameters were high (C-reactive protein (CRP): 26 mg/dl, leukocytes: 21500/mm 3 ). His drawn arterial blood gas showed signs of hypoxemia (pO 2 : 58 mm Hg) and hypercarbia (pCO 2 : 43 mm Hg), which suggested pulmonary organ failure. Furthermore, the patient was receiving totally parenteral nutrition (TPN) from the central venous pressure (CVP) catheter. Reoperation was planned from the pa-

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