[Lung lesions in penetrating war injuries of the chest].
Presentation is made of 157 patients with lung parenchymal lesions due to penetrating war injuries of the chest, 50.3% civilians and 49.3% soldiers. The wounds were mostly inflicted by cluster projectiles (71.4%), followed by firearms (25.5%) and sharp instruments (3.1%). The injuries were characterized as a combination of laceration and lung contusion. In case of lung laceration, a moderate to massive hemopneumothorax develops. Clinically, the manifestation of lung contusion may range from hardly observable dyspnea and hemophthisis through tachypnea, tachycardia and cyanosis. Most lesions of pulmonary parenchyma can be managed by thoracic drainage, whereas in case of massive bleeding and air loss thoracotomy and appropriate operative procedures are recommended. We used anterolateral thoracotomy as a sparing procedure, which involves minimal thoracic wall disintegration. When deciding on the choice of surgical procedures for the lesions of pulmonary parenchyma, care was taken to ensure to maximally spare the intact parenchyma. Minor resections (sutures, atypical resection, segmentectomies) were performed in 92%, whereas major resection (lobectomy, pulmectomy) had to be performed in 8% of thoracotomized patients. Rethoracotomy was done in two patients due to postoperative hemorrhage. The patient submitted to pulmectomy because of the hilus vasculature lesion died after the surgery. Early resuscitation, volume and blood replacement, rapid diagnosis, and early surgical intervention are the crucial factors that influence survival in patients with lung lesions due to penetrating injuries of the thorax.
Kristek
Jozo
J
Klinika za kirurgiju Klinicke bolnice Osijek, Osijek, Hrvatska.
Krajinović
Zlatko
Z
Horvat
Vlado
V
Fijacko
Vladimir
V
D000328:Adult; D017523:Croatia; D005260:Female; D006801:Humans; D055370:Lung Injury; D008297:Male; D013898:Thoracic Injuries / Q000473:pathology / Q000628:therapy; D014857:Warfare; D014950:Wounds, Penetrating / Q000473:pathology / Q000628:therapy