title: Left thoracotomy utilizing splenectomy in blunt thoracic injury: An alternative surgical approach.
abstract: BACKGROUND
  Posterolateral thoracotomy could be an alternative surgical approach in selected cases coexistence of abdominal injuries with ipsilateral thoracic injury.
  
  
  METHODS
  A 65-year-old male with left sided chest injury was initially admitted to a regional health center after a crawler overthrow accident. He underwent chest tube drainage of left hemithorax and he was transferred immediately to our hospital. A CT scan showed a large spleen which was injured by a wedged splint of the 10th rib into its parenchyma. Lung parenchyma was also lacerated by chest tube misplacement with associated hemothorax. He underwent a lower left lateral thoracotomy. Splenectomy was performed via a phrenotomy and subsequently the injured lung was repaired. His postoperative course was uneventful.
  
  
  CONCLUSIONS
  Incisions in the diaphragm are commonly made to provide adequate exposure during a variety of thoracic and abdominal operations. Thoracic approach could potentially be advantageous for thoracic and abdominal injuries.
  
  
  CONCLUSIONS
  Thoracic approach is a safe alternative, providing excellent exposure of upper abdominal organs, and should be considered in selected cases of abdominal trauma, especially when an ipsilateral thoracic injury coexists.
authors.affiliation: Department of Thoracic Surgery, Sismanoglio General Hospital of Athens, Greece. Electronic address: meletis_kanakis@yahoo.gr.
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Kanakis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Misthos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Alexiou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Karanikas
authors.forename: Achilleas
authors.initials: A
authors.lastname: Lioulias