|
|
||||||||
The Annals of Thoracic Surgery, Vol 22, 23-28, Copyright © 1976 by The Society of Thoracic Surgeons
G Kish, L Kozloff, WL Joseph and PC Adkins
Trauma to the thorax represents a significant portion of injuries seen in
an inner-city emergency room. Although most of these patients may be
successfully managed without thoracotomy, a certain percentage require
operative intervention either immediately or within several hours. The
records of more than 380 patients with major chest trauma seen in recent
years have been reviewed. Three hundred twenty-one of these patients (84%)
required only good supportive measures such as correction of hypovolemia,
temporary ventilatory support, tube thoracostomy, and careful observation.
Forty-four additional patients (12%) required immediate operation following
preliminary resuscitative treatment. Indications included hemorrhage,
cardiac tamponade, injury to a great vessel, and rupture of the diaphragm.
There were 10 deaths in this group. In 15 other individuals (4%) delayed
operation was undertaken following careful reappraisal of initial injuries
by continued examination, monitoring of vital signs, and appropriate
roentgenographic and laboratory studies. Indications for delayed operation
included continued or recurrent bleeding, widening of the mediastinum,
hemoptysis, and recurrent hemothorax. There was only 1 death in this group.
Thus, although it may be clear which patients require immediate operation,
only careful and continuous monitoring can identify those who initially
appear to be in stable condition but eventually will require exploration.
ARTICLES
Indications for early thoracotomy in the management of chest trauma
This article has been cited by other articles:
![]() |
H. Gasparovic, R. Stern-Padovan, S. Batinica, D. Saric, and I. Jelic Intracardiac shrapnel in a polytraumatized child Ann. Thorac. Surg., March 1, 2004; 77(3): 1083 - 1085. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. Karmy-Jones, G. J. Jurkovich, A. B. Nathens, D. V. Shatz, S. Brundage, M. J. Wall Jr, S. Engelhardt, D. B. Hoyt, J. Holcroft, and M. M. Knudson Timing of Urgent Thoracotomy for Hemorrhage After Trauma: A Multicenter Study Arch Surg, May 1, 2001; 136(5): 513 - 518. [Abstract] [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |