title: [Current issues in the diagnosis and treatment of penetrating chest trauma].
abstract: BACKGROUND
  Successful treatment of penetrating chest trauma largely depends on the accurate and rapid diagnostic work-up, as well as the adequate surgical management. The authors discuss current issues in the diagnosis and the treatment of penetrating chest injuries based on the analysis of 109 cases.
  
  
  METHODS
  82 men and 27 women with penetrating chest trauma were studied. The average age of the patients was 37.8 years. The injury was caused by stabbing in 104 cases (95.4%), gunshot in 4 patients (3.7%) and explosion in one case (0.9%). 41 patients had cardiac and pericardial injuries. In those, 19 (46.3%) patients had a chest X-ray, echocardiography was done in nine cases (22%), while CT scan and diagnostic VATS were performed in two patients, respectively. All patients underwent surgery except one, who was treated conservatively.In all of the 68 patients, who had no cardiac injuries, a chest X-ray was performed. Echocardiography was done in six (8.8%) cases, diagnostic VATS in four (5.9%) patients, and abdominal ultrasound scan in 3 (4.4%) cases. Chest tube was inserted in 13 patients (19.1%), an open surgery was performed in 51 cases, while in 4 cases VATS was carried out.
  
  
  RESULTS
  In the group of patients with cardiac and pericardial injuries, the sensitivity of the chest X-ray, echocardiography and VATS were 57.9%, 88.9% and 100%, respectively. Further, specificity of the above were 26.3%, 88.9% and 100%, respectively. However, in patients with non-cardiac injuries, the sensitivity of the chest X-ray was 100%, and both the specificity and sensitivity of VATS was 100%. Postoperative complication rate was 12.6% overall (15% in cases with cardiac injury and 10.9% in the non-cardiac subgroup). Mortality rate was 7.3% among the patients with cardiac injury, while there was no mortality detected in the non-cardiac subgroup. The average mortality rate was 2.8%.
  
  
  CONCLUSIONS
  Patients with penetrating chest trauma should undergo a rapid and accurate diagnostic work-up followed by an adequate surgical management in order to keep their prognosis relatively good.
authors.affiliation: DE OEC Sebészeti Intézet, Auguszta Sebészeti Központ, 4004 Debrecen, Móricz Zs. krt. 22. szentkerzs@freemail.hu
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Szentkereszty
authors.forename: Eniko
authors.initials: E
authors.lastname: Trungel
authors.forename: János
authors.initials: J
authors.lastname: Pósán
authors.forename: Péter
authors.initials: P
authors.lastname: Sápy
authors.forename: Tamás
authors.initials: T
authors.lastname: Szerafin
authors.forename: Sándor
authors.initials: S
authors.lastname: Sz Kiss
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005107:Explosions; D005260:Female; D006335:Heart Injuries / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000601:surgery; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted; D019616:Thoracic Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000601:surgery; D014950:Wounds, Penetrating / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D014951:Wounds, Stab / Q000175:diagnosis / Q000601:surgery