title: Penetrating thoracic trauma.
abstract: The initial approach to penetrating thoracic trauma is directed towards the pathophysiologic syndrome upon presentation. Most patients are successfully treated with drainage tubes. The unstable patient may necessitate thoracotomy at the emergency room to drain cardiac tamponade, provide cardiac massage and control bleeding. The guidelines for this procedure are reviewed. Need for further work-up of potential injuries to other mediastinal organs is frequently screened by computerized tomography. Surgery might still be needed, on a less emergent basis, in order to repair injuries to the trachea/esophagus, retained hemothorax, or to rule out diaphragmatic injury. Laparoscopic and thoracoscopic procedures may be used in specific situations.
authors.affiliation: Division of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA. bastos@uthscsa.edu
authors.forename: Renata
authors.initials: R
authors.lastname: Bastos
authors.forename: Clinton E
authors.initials: CE
authors.lastname: Baisden
authors.forename: Lori
authors.initials: L
authors.lastname: Harker
authors.forename: John H
authors.initials: JH
authors.lastname: Calhoon
mesh_terms: D002305:Cardiac Tamponade / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D004636:Emergency Service, Hospital; D004638:Emergency Treatment / Q000592:standards*; D006491:Hemothorax / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D017410:Practice Guidelines as Topic; D011379:Prognosis; D013898:Thoracic Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000601:surgery*