Penetrating Trauma by George C. Velmahos Elias Degiannis & Dietrich Doll

Author:George C. Velmahos, Elias Degiannis & Dietrich Doll
Language: eng
Format: epub
Publisher: Springer Berlin Heidelberg, Berlin, Heidelberg

Dietrich Doll

Email: [email protected]

Thoracoabdominal injuries in penetrating trauma are very important for two reasons. Firstly, they are characterized by a high morbidity and mortality due to the significant physiological impact on the patient. Secondly, it is often difficult to come to a conclusive decision on which cavity needs to be operated on, or, if both cavities have to be opened, which one takes priority. Therefore, it is difficult to give clear-cut guidelines, but certain aspects can render the decision-making process more error proof. Having said that, the surgeon should still have the flexibility to move from one cavity to the other if his initial decision was wrong or if life-threatening developments present intraoperatively from the other cavity.

The following course of action maybe followed for patients presenting with thoracoabdominal injury:Once the patient has arrived at the resuscitation room, place the bullet wound markers on the wounds and proceed with AP and lateral X-rays of the chest and abdomen. This will give you an idea of the trajectory and apart from confirming the thoracoabdominal nature of the injury, this information will also help you to see if the bullet crossed the midline (if there is no obvious entry and exit wound).

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