Treatment of Penetrating Wounds Of the Chest

Garzon, Antonio A.; Amer, Norman L.; Karlson, Karl E.

doi:10.1001/archsurg.1964.01310210071011

Cited by 9 publications

(3 citation statements)

References 13 publications

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“…The mortality rate of 17 per cent in this series compares with a 14 per cent mortality reported by Gray et al. (1960) and a 12.5 per cent mortality reported by Garzon et al (1964) for civilian penetrating thoracoabdominal injuries. It is noteworthy that all the deaths in this series resulted from the abdominal lesions.…”

Section: Discussionsupporting

confidence: 73%

“…The incidence of diaphragmatic penetration in chest casualties in the Korean War varied from 10 per cent (Valle, 1952) to 22 per cent (Rockey, 1952). The incidence of diaphragmatic injury in civilian penetrating chest injuries is much lower-5-6 per cent (Gray et al, 1960;Garzon et al, 1964;Cordice and Cabezon, 1965). A 23 per cent incidence of diaphragmatic involvement in this series of penetrating chest injuries among civilians appears to be rather high and is attributable to the vulnerability of the diaphragm on the left side, due to the downward directed knife thrusts of a right-handed assailant.…”

Section: Discussionmentioning

confidence: 80%

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Penetrating thoracoabdominal injuries

Sandrasagra

1977

British Journal of Surgery

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Twenty-three cases of penetrating thoracoabdominal injury are reviewed. Abdominal pain, tenderness and rigidity were found to be the most constant indicators of diaphragmatic penetration in these injuries (65 per cent). These features may occur as referred phenomena of purely thoracic injuries and persist as a result of the presence of an intercostal drainage tube used in the treatment of such injuries. There may be no abdominal signs in injuries of the diaphragm unaccompanied by any visceral damage or in injuries confined to the lesser sac. A high index of suspicion in the presence of a wound over the lower half of the chest is necessary to detect these lesions. Negative radiological findings do not exclude a diaphragmatic injury. The thoracic component of a penetrating thoracoabdominal injury can usually be treated conservatively by aspiration or drainage of the pleural space, but laparotomy is advised for the repair of the abdominal

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 80%

Penetrating thoracoabdominal injuries

Sandrasagra

1977

British Journal of Surgery

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“…Therefore patients with thoracoabdominal wounds had nearly two times higher mortality than those with isolated chest wounds. The presence of associated abdominal injuries influenced the outcome/ [12,13,14]/ [12][13][14]/. Chest wounds (n ϭ 351) that required thoracotomy for cardiac or noncardiac wounds comprised 12.8%.…”

Section: Discussionmentioning

confidence: 99%

Penetrating chest wounds: 24 years experience

Mandal

Sanusi

2001

World j. surg.

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Thoracic and thoracoabdominal penetrating wounds are frequently encountered in urban medical centers in the United States. This study was undertaken to determine the clinical characteristics and in hospital outcome of these injuries. This was a longitudinal, nonblinded study using the established standard of care of patients with penetrating chest trauma. It consists of an analysis of a consecutive series of 3049 patients treated at one trauma center between April 1972 and March 1996. There were 1347 stab wounds and 1702 gunshot wounds. Antibiotic prophylaxis was administered to patients who underwent laparotomy or thoracotomy or who had lung contusion with hemoptysis (41.6%, 1296/3049). Of 3049 patients, 196 had cardiac injuries. All of them underwent thoracotomy, and the mortality was 21.9%. In contrast, among 2853 patients without cardiac injuries, only 257 (9%) required thoracotomy; the mortality in this group was 1.5%. Patients with thoracoabdominal injuries (899/3049) had a mortality of 4.3% compared to 2.1% among those who had isolated chest injuries. The overall mortality was 2.8%. Of 1702 patients with gunshot wounds, 85 (5%) sustained transaxial injuries, with an overall mortality of 36.5%. The complication rate among the survivors was 6% with only 2.5% being infectious. We conclude that the mortality for noncardiac penetrating injuries of the chest is low. The presence of associated abdominal injuries increases the mortality twofold. More than one-third of the patients with transaxial wounds die. Gunshot wounds of the heart result in higher mortality than stab wounds to the heart. The infection rate is low.

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Thoracic Emergencies

Fry¹,

Adams²

1967

Arch Surg

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Treatment of Penetrating Wounds Of the Chest

Cited by 9 publications

References 13 publications

Penetrating thoracoabdominal injuries

Penetrating thoracoabdominal injuries

Penetrating chest wounds: 24 years experience

Thoracic Emergencies

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