Penetrating cardiothoracic war wounds

Biočina, Bojan; Sutlić, Željko; Husedžinović, Ino; Rudež, Igor; Ugljen, Ranko; Letica, Dalibor; Slobodnjak, Z; Karadza, J; Brida,; Vladović-Relja, T; Jelić, Ivan

doi:10.1016/s1010-7940(96)01124-4

Cited by 37 publications

(23 citation statements)

References 12 publications

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“…In a description of Croatian wartime chest injuries, Biocina et al [1] reported that less than 10% of 259 penetrating chest injuries involved the heart. Among these, only one patient sustained coronary artery injury, again confirming that coronary artery injuries are found in less than 5% of injuries to the heart and/or great vessels, whether the result of blunt or penetrating trauma [2,3].…”

Section: Discussionmentioning

confidence: 99%

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Management of Traumatic Coronary Artery Injuries: Advantages of Off-Pump Coronary Artery Bypass

et al. 2009

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Coronary artery injuries are rare but highly lethal. Debate exists as to the best treatment for this complex set of injuries, with historical treatment favoring arterial ligation. Although conventional coronary artery bypass grafting using cardiopulmonary bypass has been used somewhat successfully, enthusiasm for off-pump CABG (OPCAB) has grown more recently. We report two unique cases of left anterior descending coronary arterial injuries managed successfully with OPCAB.

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Section: Discussionmentioning

confidence: 99%

“…Injuries to the heart requiring emergency surgical approach for repair are rare [1][2][3], and coronary artery injuries encompass an even more select subset of traumatic injuries [2,3]. Initial efforts to control hemorrhage from coronary injuries primarily involved coronary artery ligation with high rates of mortality [4].…”

Section: Introductionmentioning

confidence: 99%

Management of Traumatic Coronary Artery Injuries: Advantages of Off-Pump Coronary Artery Bypass

et al. 2009

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“…20 In this case, we thought that unless there were additional forces on the object, it would probably remain lodged indefinitely in the trabeculae and become endothelialized. The proximity to the right coronary artery was a concern.…”

Section: Intrathoracic Foreign Bodymentioning

confidence: 94%

Case 11-2014

et al. 2014

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case records of the massachusetts general hospitalT h e ne w e ngl a nd jou r na l o f m e dicine n engl j med 370;15 nejm.org april 10, 2014 Pr esentation of C a seDr. John T. Nagurney (Emergency Medicine): A 34-year-old man was brought to the emergency department at this hospital because of multiple traumatic injuries that he sustained when a bomb exploded while he was watching the 2013 Boston Marathon. At the scene, the patient reportedly lost consciousness, had a complete amputation of his right leg directly below the knee, and had copious blood loss. A tourniquet had been applied to the right upper leg. He was placed on a backboard, immobilized, and transported to this hospital by ambulance, arriving at 3:20 p.m., 31 minutes after the explosion. He was brought immediately into a trauma bay in the emergency department. No additional history was known.On examination by Dr. Timothy Fallon (Emergency Medicine Resident) in the emergency department, the patient was covered with ash and smelled of smoke; he was somnolent but arousable to verbal stimuli, and he was oriented to date, self, and place (the hospital). The blood pressure was 98/52 mm Hg, the pulse 128 beats per minute, the respiratory rate 28 unlabored breaths per minute, and the oxygen saturation 100% (oxygen supplementation not recorded). He opened his eyes in response to speech. The Glasgow Coma Scale score was 14 on a scale of 3 (indicating coma) to 15 (indicating normal). There was soot and dirt on the face, and the nasal hairs and eyebrows were singed. The pupils were equal and reactive to light. The mucous membranes were dry. The cervical spine was not tender to palpation. The lungs were clear to auscultation, and there was no tenderness, crepitus, or deformity of the chest wall. The heart sounds were normal. The femoral pulses were 2+. The abdomen was soft, nontender, and nondistended, without guarding. The extremities were pale and cool. There was venous bleeding and a large pool of blood at the site of the amputation of the right leg, as well as an open fracture of the left foot. There were burns involving the face, trunk, and extremities; a puncture wound (3 cm in length) in the posterior aspect of the left thigh with some tissue destruction and no active bleeding; and multiple smaller penetrating wounds. Detailed wound and burn examinations were deferred. The patient moved all extremities and had no gross focal neurologic deficits.

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“…In open pneumothorax, which is uncommon in GSW unless massive chest wall loss has occurred secondary to close range shotgun blast, the management is little different with closure of the wound by a three sided flutter dressing followed by large bore chest drainage avoiding the site of injury. Large defects will need formal chest wall reconstruction in due course (Biocina et al, 1997).…”

Section: The Thoraxmentioning

confidence: 99%

The early hospital management of gunshot wounds. Part 1: head, neck and thorax

Garner

2005

Trauma

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The management of gunshot wounds is an increasing problem for UK emergency doctors, but not to an extent where it has become routine or allowed individuals to gain significant experience in their treatment. This article reviews the pathophysiology of gunshot injury in general before examining the evidence available concerning the management of gunshot wounds to the head neck and thorax. Figure 1Typical appearance of a close range shotgun injury. There is an obvious central mass effect with 'peppering' around the periphery

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Penetrating cardiothoracic war wounds

Abstract: Penetrating cardiothoracic wounds are among the most serious injuries in war, either in combat or among civilians. In spite of their nature, they can be treated successfully with relatively low mortality and morbidity.

Cited by 37 publications

References 12 publications

Management of Traumatic Coronary Artery Injuries: Advantages of Off-Pump Coronary Artery Bypass

Management of Traumatic Coronary Artery Injuries: Advantages of Off-Pump Coronary Artery Bypass

Case 11-2014

The early hospital management of gunshot wounds. Part 1: head, neck and thorax

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