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Journal articles on the topic 'Penetrating Thoracic Trauma'

Author: Grafiati

Published: 5 June 2025

Last updated: 8 July 2025

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1

Bastos, Renata, Clinton E. Baisden, Lori Harker, and John H. Calhoon. "Penetrating Thoracic Trauma." Seminars in Thoracic and Cardiovascular Surgery 20, no. 1 (2008): 19–25. http://dx.doi.org/10.1053/j.semtcvs.2008.01.003.

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2

McGonigle, Niall, and Kieran McManus. "Penetrating thoracic trauma." Surgery (Oxford) 29, no. 5 (2011): 227–30. http://dx.doi.org/10.1016/j.mpsur.2011.02.001.

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Beattie, Rory, Peter C. E. Mhandu, and Kieran McManus. "Penetrating thoracic trauma." Surgery (Oxford) 32, no. 5 (2014): 249–53. http://dx.doi.org/10.1016/j.mpsur.2014.02.008.

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Dayananda, KSS, VY Kong, JL Bruce, et al. "A selective non-operative approach to thoracic stab wounds is safe and cost effective – a South African experience." Annals of The Royal College of Surgeons of England 100, no. 8 (2018): 641–49. http://dx.doi.org/10.1308/rcsann.2018.0118.

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Introduction Penetrating thoracic trauma is common and costly. Injuries are frequently and selectively amenable to non-operative management. Our selective approach to penetrating thoracic trauma is reviewed and the effectiveness of our clinical algorithms confirmed. Additionally, a basic cost analysis was undertaken to evaluate the financial impact of a selective nonoperative management approach to penetrating thoracic trauma. Materials and methods The Pietermaritzburg Metropolitan Trauma Services electronic regional trauma registry hybrid electronic medical records were reviewed, highlighted all penetrating thoracic traumas. A micro-cost analysis estimated expenses for active observation, tube thoracostomy for isolated pneumothorax greater than 2 cm and tube thoracostomy for haemothorax. Routine thoracic computed tomography does not form part of these algorithms. Results Isolated thoracic stab wounds occurred in 589 patients. Eighty per cent (472 cases) were successfully managed nonoperatively. Micro-costing shows that active observation costs 4,370 ZAR (£270), tube thoracostomy for isolated pneumothorax costs 6,630 ZAR (£400) and tube thoracostomy for haemothorax costs 21,850 ZAR (£1,310). Discussion Penetrating thoracic trauma places a striking financial burden on our limited resources. Diligent and serial clinical assessments, alongside basic radiology and stringent management criteria, can accurately stratify patients to correct clinical algorithms. Conclusion Selective nonoperative management for penetrating thoracic trauma is safe and effective. Routine thoracic computed tomography is unnecessary in all patients with isolated thoracic stab wounds, which can be reserved for a select group who are identifiable clinically. Routine thoracic computed tomography would not be financially prudent across Pietermaritzburg Metropolitan Trauma Services. Government action is required to reduce the overall incidence of such trauma to save resources and patients.

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Díaz-Rosales, Juan de Dios, Lenin Enríquez-Domínguez, Balthazar Aguayo-Muñoz, and Beatriz Díaz-Torres. "Leucocytosis in penetrating trauma (abdominal and thoracic/osseous): a transversal study in Juarez, México." Archivos de Medicina (Manizales) 15, no. 2 (2015): 220–25. http://dx.doi.org/10.30554/archmed.15.2.771.2015.

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Introduction: The abdominal trauma is an important cause of morbility and mortality, abdomen is the 3th zone of human anatomy more affected by traumatism that require surgery and hospitalization. Evaluation of penetrating abdominal trauma aims to identify patients that requires surgical treatment. Objective: The objective of this study was to compare white blood cells levels in patients with penetrating abdominal trauma isolated and associated with osseous and/or thoracic injury. Patients and methods: A transversal study comparing two groups of abdominal penetrating trauma patients; penetrating abdominal trauma isolated versus penetrating abdominal trauma associated with osseous and or thoracic injury. We examined the level of white blood cells as a factor associated with major injury. Results: Our study showed a difference in mean of white blood cells count between the two groups that was statistically significant (p=0.01). A positive relationship between penetrating abdominal trauma associated with osseous and or thoracic injury was found. Conclusion: A significant elevation in white blood cells count in penetrating abdominal trauma associated with osseous and or thoracic injury is observed in comparison with penetrating abdominal trauma isolated.

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Dalia, Esam Nasser, Salah Abu Arab Walid, Refaat Allam Akram, and Saad Eldin Karara Khaled. "Penetrating cardiac injury: factors affecting outcomes in a developing country." Biolife 3, no. 1 (2022): 61–67. https://doi.org/10.5281/zenodo.7263020.

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<strong>ABSTRACT</strong> The purpose of this investigation was to evaluate factors affecting the outcome following penetrating cardiac trauma in a developing country and to compare our results with others in developed countries. Analysis of the cause of trauma, age, sex, different tools of investigations used, concomitant organ injuries, SBP, GCS, ISS, RTS, TRISS and mortality were performed. This study included 35 patients; all were males. Mortality rate was 22.8%. It was significant with low SBP (p =0.021), GCS ˂ 9 (p =0.02), non-presentation with tamponade (p = 0.023), low ISS (p =0.02), low RTS (p =0.007), low TRISS (p = 0.003), less blood transfusion (p =0.001) and longer time before entrance to OR (p= 0.019). Meanwhile, mortality were not significant with age (p =0.33), mechanism of injury (p =0.16), other associated injuries (p =0.16) or associated intra-abdominal injuries (p= 0.16). Rapid assessment and prompt surgical intervention may reduce mortality. Even in a developing country, mortality rates could reach those in developed countries depending on clinical skills and accessible technology tools. <strong>Key words</strong>: Thoracic injuries, penetrating cardiac injuries, thoracic trauma <strong>REFERENCES</strong> Alexander, B., Dan, H. (2012). Negative FAST and echocardiography in penetrating cardiac injuries decompressing to the chest and peritoneal cavities. Injury Extra, 43: 139-141. Bruno, M.T.P., Vitor , B.N.,  Thiago,  R.A.C.,  Marcelo,  P.V.¸ Orlando,  P., Gustavo,  P.F. (2013).  Penetrating cardiac trauma: 20-y experience from a university teaching hospital. Journal of Surgical Research, 30: e1-e6. Ceviker, K., Tulay, C., Sahinalp, S., Atlı, H.F. (2014). Factors affecting mortality in cardiac injury of penetrating thorax trauma: a retrospective study. Gaziantep Med J, 20: 35-41. Clarke, D.L., Muhammed, A., Reddy, K., Thomson, S.R. (2011). Emergency operation for penetrating thoracic trauma in a metropolitan surgical service in South Africa. J Thorac Cardiovasc Surg, 142: 563-568. Cury, F., Baitello, A.L., Echeverria, R.F., Espada, P.C., Pereira, de Godoy J.M. (2009). Rates of thoracic trauma and mortality due to accidents in Brazil. Ann Thorac Med, 4: 25-26. Niall, M., Kieran. M. (2011). Penetrating thoracic trauma. Surgery, 29: 227-230. O’Connor, J., Ditillo, M., Scalea, T.  (2009). Penetrating cardiac injury. J R Army Med Corps, 155: 185-189. Onan, B., Demirhan R., Öz, K., Onan, İ.S. (2011). Cardiac and great vessel injuries after chest trauma: our 10-year experience. Turkish Journal of Trauma & Emergency Surgery, 17:423-429. Serdar, O., Refik U., Alper, A., Gungor, A., Cemal, O. (2011). Urgent thoracotomy for penetrating chest trauma: Analysis of 158 patients of a single center. Injury, Int J Care Injured, 42: 900-904. Tariq, U.M., Faruque, A. Ansari, H., Ahmad, M., Rashid, U., Perveen, S. (2011). Changes in the patterns, presentation and management of penetrating chest trauma patients at a level II trauma center in Southern Pakistan over the last two decades. Interact Cardio vascThoracSurg, 12: 24-27.  

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LeBlang, Suzanne D., and Matthew O. Dolich. "Imaging of Penetrating Thoracic Trauma." Journal of Thoracic Imaging 15, no. 2 (2000): 128–35. http://dx.doi.org/10.1097/00005382-200004000-00008.

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8

Katlan, Banu, Mesut Topdemir, Arman Api, and Nuri imsek. "Experiences with Penetrating Trauma in the Pediatric Intensive Care Unit." Annals of Medical Research 31, no. 1 (2024): 47. http://dx.doi.org/10.5455/annalsmedres.2023.11.309.

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Aim:Penetrating traumas in children, caused by firearms or sharp instruments, are relatively rare, accounting for 10-20% of pediatric traumas. These traumas are serious and can lead to significant consequences, hence the need for prompt and multidisciplinary management. Materials and Methods:The study is a retrospective analysis of pediatric patients treated for PT in the intensive care unit. Patients were divided into two groups based on the cause of injury: sharp instrument wounds and firearm wounds. Data collected included age, gender, diagnosis at ICU admission, type of trauma, cause of trauma (assault, suicide), vital signs, nature of trauma (thoracic, abdominal, cranial, extremity), associated organ failures, surgical needs, performed surgeries or procedures, need for respiratory and cardiovascular support, transfusion requirements, lab parameters (blood gases and organ functions), ICU stay duration, and outcomes. Results:Between April 2022 and November 2023, a total of 425 pediatric cases were treated for trauma in the ICU, with a 6% frequency of PT. The majority of PT cases were in the adolescent age group and were male (76%). The cause of PT was violence in 88% (22/25) cases and attempted suicide in 12% (3/25) cases. 72% were caused by sharp objects and 28% were caused by gunshot wounds. The location of trauma was thoracic in 48% (12/25), abdominal in 44% (11/25), thoraco-abdominal in 4% (1/25), and lower extremity in 4% (1/25). There was no cranial penetrating trauma. In most cases (80%), thoracic and/or abdominal surgery, including tube thoracostomy, was required to treat hemopneumothorax. Blood transfusion was performed in 52% of the cases (13/25). Two cases required non-invasive mechanical ventilation, and one case required mechanical ventilation. The cases were hospitalized in the PICU for a mean period of 3,7 days. All cases were discharged. There were no deaths. Conclusion: Penetrating traumas are rare in children but can lead to serious consequences. Therefore, a rapid and multidisciplinary approach is vital in the management of PT cases in children.

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Shevchenko, O. S., V. V. Makarov, R. S. Shevchenko, et al. "Penetrating combat-related thoracic trauma (review)." Tuberculosis, Lung Diseases, HIV Infection, no. 2 (June 22, 2023): 68–78. http://dx.doi.org/10.30978/tb2023-2-68.

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Objective — to study in detail the mechanisms and to investigate the imaging manifestations of combat-related penetrating thoracic injuries. Materials and methods. To perform the work, a literature search was provided according to the criterion «Thoracic penetrating combat-related trauma». 32 literary sources were selected for this request. Fragments of the clinical experience described in the literature according to the selected sources were illustrated by our own clinical cases of patients who were treated in Kharkiv medical institutions in 2022 for penetrating combat-related thoracic injuries. Results and discussion. Among victims who received chest injuries, polytrauma was most often diagnosed, complicated by several mechanisms of injury associated with penetrating, blunt, and explosive injuries. Pneumothorax and pulmonary contusion were the most common chest injuries. Thoracic injuries, thoracic vascular injuries, and lung ruptures were associated with the highest mortality rates, whereas pulmonary contusions, pneumothorax, and chest wall injuries were associated with relatively lower mortality rates. Chest X-ray is the first-line imaging method during the initial assessment of thoracic trauma in combat and non-combat situations. Such an examination is particularly important in polytrauma situations where multiple fatal injuries can be rapidly diagnosed in order to rapidly triage and include such an injury in the initial evaluation. Tension pneumothorax, large hemothorax, chest fragmentation, and some other lesions can be quickly diagnosed with a portable chest X-ray. Computed tomography (CT) of the chest is an important component of the comprehensive trauma evaluation, which allows to diagnose life-threatening injuries in hemodynamically stable patients with suspected multiple injuries not identified on chest X-ray. Chest CT detects 20 % more pathologies compared to chest X-ray. Conclusions. Combat-related thoracic trauma continues to be a significant contributor to the mortality rates of those injured in military operations. A clear injury pattern and atypical imaging manifestations of thoracic trauma are important to recognize at an early stage because of the acuteness of this category of patients and the impact of an accurate diagnosis on clinical management. Chest X-ray remains the main diagnostic tool. However, in modern and well-equipped institutions, chest CT, video-assisted thoracoscopy, and ultrasound scanning of the abdominal and chest cavity play an important role in the diagnosis of thoracic trauma. Quick and high-quality diagnosis and treatment are possible only in direct cooperation between surgeons and radiologists.

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Shevchenko, O. S., V. V. Makarov, R. S. Shevchenko, L. D. Todoriko, K. M. Smolianyk, and О. О. Pohorielova. "Non-penetrating combat-related thoracic trauma (review)." Tuberculosis, Lung Diseases, HIV Infection, no. 1 (March 15, 2023): 73–80. http://dx.doi.org/10.30978/tb-2023-1-73.

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Combat-related thoracic trauma is a significant cause of morbidity and mortality in all military operations. Penetrating, blunt, and explosive wounds are the most common mechanisms of injury. Visualization diagnosis plays a key role in the treatment. This review discusses the visualization signs of chest injuries from blunt trauma and blast trauma. Objective was to study in detail the mechanisms and visualization signs of non-penetrating combat-related thoracic trauma. 235 literature sources were found in the PubMed system by the query Thoracic AND Trauma AND Combat, 34 of which were selected for further detailed study. In modern warfare, thoracic trauma accounts for 8.6—16.0 % of casualties. Chest X-ray and CT are the visualization methods most commonly used in the evaluation of polytrauma patients from combat and peacetime. Chest X-ray can be quickly obtained in a patient with blunt trauma and emergency conditions that include tension pneumothorax, large hemothorax, chest compression, and others. Chest CT is an important component of trauma visualization. Compared to chest X-ray, chest CT identifies 20 % more pathology, and occult chest trauma due to blunt force trauma can be identified in 71 % of patients. CT provides 38—81 % additional diagnoses compared to chest X-ray.Thoracic trauma is often diagnosed in places of combat. As medical imaging technology moves closer to combat areas, this tool is becoming increasingly available to aid in the diagnosis and rapid treatment of combat-related thoracic trauma. Clinical and surgical management of the traumatized patient relies on skills learned in modern civilian training and honed in war. However, imaging of blunt and explosive injuries may be different in civilian and military settings. The distinct injury pattern and atypical imaging findings of blunt trauma and blast lung injury are important to recognize at an early stage because of the severity of this pathology and the impact of an accurate diagnosis on clinical management.We present our own observations of patients who were treated at the Military Medical Clinical Center of the Northern Region (Kharkiv) in 2022 for nonpenetrating combatrelated thoracic trauma.

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Pal, Naresh, Vineet Mishra, Udit Jain, and Poonam . "Pattern and management of penetrating and nonpenetrating thoracic injuries." International Journal of Research in Medical Sciences 7, no. 8 (2019): 3133. http://dx.doi.org/10.18203/2320-6012.ijrms20193407.

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Background: Chest trauma constitutes a major public health problem which includes the injuries to chest wall, pleura, tracheobronchial tree, lungs, diaphragm, oesophagus, heart and great vessels. It consist of more than ten percent of all traumas and twenty five percent of death due to trauma occurs because of chest injury. Chest trauma is increasing in frequency in urban hospitals. Penetrating and nonpenetrating thoracic injuries the most serious injuries leading to significant morbidity and mortality.Methods: This study was prospective observational study of 220 patients of thoracic trauma both penetrating and non-penetrating. These patients admitted in general surgical units from August 2017 to May 2018 of Pandit Bhagwat Dayal Sharma, PGIMS Rohtak Haryana India. The study was pertaining to both penetrating and non-penetrating chest trauma.Results: Out of 220 chest injury patients who were studied during the said period, Males were 203 and females 17 by a ratio of 12:1 and age ranged from lowest 18 years to 85 years of age. Majority of the patients (90.45%) sustained blunt injuries. RTA was the common mechanism of blunt injury affecting (50.45%) of patients. Multiple Rib fractures was the commonest type of chest injury (21.36%) followed by head injury (17.27%). Head injury was the commonest associated injury seen in our patients. Conclusions: Chest trauma resulting from road traffic accident remains a major mechanism of chest injury. The measures to decrease the trauma are, educating people about traffic rules and regulations and strictly implementing them is necessary to reduce incidence of chest injuries.

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Chandra, David, and Pesta Parulian Maurid Edwar. "A 20-year-old man with hemopneumothorax caused by penetrating thoracic trauma: a case report." Bali Medical Journal 13, no. 1 (2024): 577–80. https://doi.org/10.15562/bmj.v13i1.5103.

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Link of Video Abstract: https://youtu.be/IgxLxMUB4Xk Background: 20–25% of trauma-related deaths are caused by thoracic injuries, which also contribute to 25–50% of patient deaths. An increasing number of critically injured but potentially salvageable patients are reporting to trauma centers as a result of the rising occurrence of penetrating chest injuries and the advancements in prehospital and perioperative care. Up to 80% of patients with penetrating chest injuries can be treated conservatively; in other situations, a sternotomy/thoracotomy (3%) or tube thoracostomy (18%) may be required. This case report aims to present a case of hemopneumothorax as a consequence of penetrating thoracic trauma. Case presentation: A 20-year-old male patient referred to Dr. Soetomo General Hospital a tertiary referral hospital massive hemopneumothorax dextra post water seal drainage to be underwent surgical resuscitation by open thoracotomy procedure then right internal mammary ligation and pericardial repair surgery. Patient’s condition steadily improved after the operation. Chest penetrating thoracic trauma caused by applying a mechanical force directly and abruptly to a focused location can cause penetrating injuries. By stretching and crushing tissue, a knife or projectile causes damage, which is often limited to the tissues in the route of penetration. The Patient with significant chest injuries needs to be managed with adequate analgesics and chest physiotherapy. Conclusion: Clear treatment algorithms and uniform assessment in chest penetrating trauma are essential for effective management. A substantial number of patients can be saved by conducting the primary survey and beginning with interventions that can save patient lives.

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Peloponissios, Nicolas, Nermin Halkic, Olivier Moeschler, Pierre Schnyder, and Henri Vuilleumier. "Penetrating thoracic trauma in arrow injuries." Annals of Thoracic Surgery 71, no. 3 (2001): 1019–21. http://dx.doi.org/10.1016/s0003-4975(00)02179-2.

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Howell, Antonio, Randall Brown, Dennis W. Ashley, John Williams, and Joshua E. Lane. "Aortopulmonary Fistula from Penetrating Thoracic Trauma." Journal of Trauma: Injury, Infection, and Critical Care 57, no. 6 (2004): 1374. http://dx.doi.org/10.1097/01.ta.0000133839.86049.ee.

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KESIEME, E. B., E. F. OCHELI, C. N. KESIEME, and C. P. Kaduru. "THORACIC TRAUMA." Professional Medical Journal 18, no. 03 (2011): 373–79. http://dx.doi.org/10.29309/tpmj/2011.18.03.2317.

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Objective: To assess the pattern of thoracic trauma in two semi urban university hospitals in Nigeria, to determine the injuries associated with thoracic trauma, its management and outcome in a setting of small thoracic units and limited intensive care unit facilities. Study Design: Observational Method: The hospital records of 142 patients who sustained thoracic trauma between September 2007 and September 2010 were reviewed. The mode of injury, specific intrathoracic trauma, associated injuries, management and outcome were analyzed. Results: Eighty-two percent (82%) of patients were males and 73% of patients were above 40 years. Blunt thoracic trauma accounted for 77% of thoracic injuries. Road Traffic Accident (RTA) was the commonest cause of Blunt Chest Trauma (90%) while Gunshot injuries constituted the commonest cause of Penetrating Chest Trauma (73%). The commonest specific thoracic injuries were Rib fractures and Haemopneumothorax. Extremity injuries were the commonest associated extrathoracic injuries. Mechanical ventilatory assistance was indicated in 8.5% of patients. Only 1.4% of patients had delayed thoracotomy on account of clotted haemothorax and Empyema Thoracis. 2.8% of patients had Laparotomy for repair of Traumatic Diaphragmatic hernia. Others were managed conservatively. The mortality rate was 9.9%. Mortality was mainly among patients who required mechanical ventilatory support and those with associated severe extra thoracic injuries. Most of the patients were discharged before 20 days on admission. Conclusions: The incidence of chest trauma can be reduced by minimizing the frequency of road traffic accidents, abating violence and improving security. Most patients that sustain thoracic trauma can be managed conservatively. Mortality usually occurs in patients with associated severe extrathoracic trauma and those who require ventilatory support. Improving Intensive care unit facilities and training more trauma/thoracic surgeons and intensivists in the developing countries will help to reduce the mortality rate of chest trauma.

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R, Jain. "A Case of Penetrating Thoracic Injury- A Diagnostic Dilemma and Subsequent Management." Anaesthesia & Critical Care Medicine Journal 8, no. 2 (2023): 1–4. http://dx.doi.org/10.23880/accmj-16000222.

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Trauma is the leading cause of death worldwide. Mortality from thoracic trauma is second highest after head injury. Penetrating thoracic injury poses a challenge in predicting the extent of injury, structures involved and severity of intraoperative adverse events. Diagnostic imaging plays an important part in the evaluation of these patients. We will be doing the detailed discussion on above aspects in this article

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Dr., Muhammad Amjad Nisar Dr. Muhammad Usman Safdar Dr. Zubair Ahmad Dr. Waleed Manzoor. "MANAGEMENT OF CHEST TRAUMA IN GENERAL SURGICAL DEPARTMENT OF SERVICES HOSPITAL LAHORE AND ITS OUTCOME." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 05, no. 09 (2018): 8974–78. https://doi.org/10.5281/zenodo.1432763.

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<strong>Objective:</strong> To determine the dominant pattern of lesions after thoracic trauma and evaluate the appropriateness of treatment strategies used in the general surgery unit of a trauma care hospital. <strong>Study Design: </strong>In the Surgery Department of Services Hospital, Lahore for one year duration from March 2016 to March 2017. <strong>Place and Duration:  </strong>A Case Series with prospective data collection study. <strong>Methodology:</strong> A total of 100 consecutive patients with thoracic trauma who were referred to emergency services were evaluated. Patients older than 12 years were included, either alone or with multiple traumas with chest trauma. <strong>Findings:</strong> 103 total patients were studied over a period of 18 months in different chest injuries. In general, blunt thoracic lesions occur in 58% of patients with penetrating injuries comparison occurs in 42%. 30 patients (29%) were treated conservatively for lesions on the chest wall (mild pulmonary contusion, rib fracture) without pneumothorax or hemothorax. In 64 patients (62%) Thorax intubation was necessary with pneumothorax/ hemothorax. 9 patients (8.8%) required thoracotomy and emergency thoracotomy was done in 2 patients and seven were elective. 8% was the total mortality rate. <strong>Conclusion:</strong> Penetrating chest injury increases because of gunshot wounds with the passage of time, but most common is blunt trauma. Most patients with chest injury can be treated satisfactorily in the general surgery unit and fewer patients require vast surgical treatment. <strong>Key words:</strong> Penetrating trauma, thoracic trauma, pneumothorax, tube thoracostomy, closed traumatism, hemothorax.

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Cabon, Q., C. Deroy, F. X. Ferrand, et al. "Thoracic bite trauma in dogs and cats: a retrospective study of 65 cases." Veterinary and Comparative Orthopaedics and Traumatology 28, no. 06 (2015): 448–54. http://dx.doi.org/10.3415/vcot-15-01-0001.

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SummaryObjectives: To report a case series of thoracic bite trauma in dogs and cats and to evaluate risk factors for mortality.Methods: A retrospective study concerning thoracic bite wounds in dogs and cats was performed. Lesions were categorized by depth of penetration: no wound, superficial, deep or penetrating. Thoracic radiographic reports were reviewed. Lesion management was classified as non-surgical, wound exploration, or explorative thoracotomy.Results: Sixty-five cases were collected. Twenty-two percent of patients with normal respiratory patterns showed thoracic radio-graphic lesions. Respiratory distress was not correlated with mortality. Twenty-eight patients were presented with superficial wounds and 13 with deep wounds. Eight patients exhibited penetrating wounds. Radio-graphic lesions were observed in 77% of dogs and 100% of cats. Explorative thoracotomy was performed in 28% of patients, and surgical wound exploration in 17.2%. With the exception of skin wounds, thoracic wall discontinuity was the most frequent lesion. Thoracotomy was associated with increased length of hospitalisation but was not correlated with mortality. The mortality rate was 15.4%. No studied factor correlated with mortality, and the long-term outcomes were excellent.Clinical significance: A penetrating injury, more than three radiographic lesions, or both together seemed to be indicative of the need for a thoracotomy. In the absence of these criteria, systematic bite wound explorative surgery is recommended, with extension to thoracotomy if thoracic body wall disruption is observed.

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Cabrera Vargas, Luis Felipe, and Ivan David Lozada Martinez. "Endovascular approach for penetrating thoracic aorta trauma." Revista Argentina de Cirugía Cardiovascular 20, no. 2 (2022): 43–45. http://dx.doi.org/10.55200/raccv.es.v20.n2.0014.

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Yoon, R. Y., M. Harling, J. A. Feldman, et al. "Penetrating Thoracic Trauma: Prehospital Resuscitation For All?" Prehospital and Disaster Medicine 8, S2 (1993): S74. http://dx.doi.org/10.1017/s1049023x00049979.

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Rendón, Felipe, Luis H. Gómez Danés, and Mario Castro. "Delayed Cardiac Tamponade after Penetrating Thoracic Trauma." Asian Cardiovascular and Thoracic Annals 12, no. 2 (2004): 139–42. http://dx.doi.org/10.1177/021849230401200212.

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Reinhorn, Michael, Howard L. Kaufman, Erwin F. Hirsch, and Frederick H. Millham. "Penetrating thoracic trauma in a pediatric population." Annals of Thoracic Surgery 61, no. 5 (1996): 1501–5. http://dx.doi.org/10.1016/0003-4975(96)00110-5.

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Scapolan, Maíra Benito, Nathália Lins Pontes Vieira, Silvia Stiefano Nitrini, et al. "Thoracic trauma: analysis of 100 consecutive cases." Einstein (São Paulo) 8, no. 3 (2010): 339–42. http://dx.doi.org/10.1590/s1679-45082010ao1532.

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ABSTRACT Objective: To analyze thoracic trauma assisted by the Emergency Service of Hospital da Irmandade da Santa Casa de Misericórdia de São Paulo. Methods: One hundred patients with thoracic trauma were assisted throughout six months in 2006. Data from their records were collected and a protocol of thoracic trauma was fulfilled. The Revised Trauma Score was used to evaluate gravity of injury and to calculate the survival index. Results: Prevalence of trauma injury in male from 20 to 29 years old was observed. Out of all patients, 44 had blunt trauma and 56 penetrating trauma (78.6% presented stab wounds and 21.4% gun shots). Up to the settings of injuries, 23% were in the thoracoabdominal transition, 7% in the precordium and 70% in the remainder thoracic area. In those with the thoracoabdominal transition injury, 22.7% were hemodynamically unstable and 77.3% stable. Thoracoabdominal injury patients presented 40.9% of diaphragm wound and all were stable. Of those with precordium wound, 37.5% presented cardiac injury. In cardiac onset, 66.7% presented stable and 33.3% unstable. Thoracic drainage was the most accomplished surgical procedure (71%). Conclusions: The thoracic trauma patient is most prevalently young male with stab wound penetrating injury, without associated injuries, hemodynamically stable, presenting hemothorax, with high probability of survival.

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Okyere, I., S. Singh, E. Ameyaw, et al. "Emergency Thoracic Surgery in Chest Trauma at the Komfo Anokye Teaching Hospital in Ghana: The Role of Sternotomy and Thoracotomy." Postgraduate Medical Journal of Ghana 11, no. 1 (2022): 42–49. http://dx.doi.org/10.60014/pmjg.v11i1.277.

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Objective: Chest trauma, as blunt or penetrating injury, account for significant amount of all traumatic injuries. They are associated with high mortality of about 75% of all trauma-related deaths, either from direct or indirect consequence of the injury. Nearly 80-85 % of chest trauma is managed conservatively with only about 10-15 % needing emergency surgery.Methodology: A retrospective cohort study of patients presenting with chest trauma and undergoing emergency thoracic surgery at the Komfo Anokye Teaching Hospital from January 2015 to June 2020 was carried out.Results: There were 29 patients, with 82.8% (24) being males. The mean age was 33.8 ± 15.0 years with range of 5-65 years. The leading mechanism of chest trauma was penetrating chest injury, which accounted for 51.7% (15). Eighteen (86%) patients underwent exploratory thoracotomy with 5 (10%) having exploratory sternotomy and the remaining 4% undergoing other procedures. Fourteen (82.1%) patients out of the eighteen who underwent the thoracotomy had a left thoracotomy with four (24.1%) patients having right thoracotomy. The major indication for surgery in acute thoracic trauma was traumatic diaphragmatic rupture (62.1%) followed byimpalement injury (17.2%), traumatic thoracotomy (6.9%), cardiac tamponade (6.9%), massive haemothorax (3.5%), and vascular injury (3.5%). There were no mortality over the 5-year period.Conclusion: The leading indication for emergency thoracic surgery in chest trauma was traumatic diaphragmatic rupture caused mostly by penetrating thoracic injury. Thoracotomy was the major emergency thoracic surgical approach performed.

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Chou, Elizabeth L., Eric H. Twerdahl, and Matthew J. Eagleton. "Endovascular management of penetrating and non-penetrating aortic injury." Vasa 48, no. 1 (2019): 23–33. http://dx.doi.org/10.1024/0301-1526/a000740.

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Abstract. Aortic trauma is a devastating injury often associated with significant polytrauma. Penetrating injury of the aorta is highly lethal and therefore rarely encountered in the hospital setting. The management of blunt trauma of the aorta has changed significantly over the past decade, principally due to improved imaging technology and the development of endovascular therapy. The most common site of injury is the proximal descending thoracic aorta. The degree of aortic wall injury guides the indication for therapy, while a combination of the degree of injury and the extent of co-morbid injuries drives the timing of repair. Lower grade injuries frequently do not require any surgical intervention. Thoracic aortic endograft repair can be performed in a safe, expeditious fashion. Short-term and mid-term outcomes appear excellent, with patient survival based mainly on concomitant traumatic injuries. Long-term outcomes are less well known. Future endeavors will be guided toward gaining a better understanding of the indications for repair and the long-term outcomes for endograft devices designed for this purpose.

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Lichtenberger, John P., Andrew M. Kim, Dane Fisher, et al. "Imaging of Combat-Related Thoracic Trauma – Review of Penetrating Trauma." Military Medicine 183, no. 3-4 (2017): e81-e88. http://dx.doi.org/10.1093/milmed/usx034.

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Shinde, Nandkishor Dhanvantrao, Basvanth Patil, Ahmed Khan, Manjunath Jyothinaikar, and Kakoli Paul Choudhary. "Audit of thoracic trauma in children at tertiary care center." Muller Journal of Medical Sciences and Research 15, no. 1 (2024): 12–16. http://dx.doi.org/10.4103/mjmsr.mjmsr_22_23.

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ABSTRACT Background and Objectives: Thoracic trauma in children is increasing due to rising population, industrialization, modernization, increase in vehicular traffic, terrorist activities, and riots. It requires more caution because of its associated morbidity and mortality. This study is done to know the prognostic factors and outcome of thoracic trauma in children, which helps in decreasing morbidity and mortality. Materials and Methods: This retrospective observational study was conducted from November 2016 to October 2022. Retrospectively, records of all the pediatric patients <18 years of age with a history of thoracic trauma were analyzed. Demographic details, mechanism of injury, nature of the injury, hemodynamic stability, investigations, definitive treatment, and outcome of patients were analyzed. Results: There were 66 children with thoracic trauma. Road traffic accidents were the most common mode of trauma seen in 74.2% of cases, followed by falls in 18.2% of cases. Fifteen (22.7%) cases were hemodynamically unstable. Thirty-two (48.5%) cases required transfusion of blood or blood products. Penetrating trauma was seen in 10 (15.2%) cases. In children with thoracic trauma, up to 29 (43.9%) children had pneumothorax and 21 (31.8%) children had hemothorax. Among the injuries, lung contusions were more commonly seen in 31 (46.9%) cases, followed by rib fractures seen in 24 (36.4%) cases. About 83.3% of cases were managed nonoperatively and 16.7% of cases required surgical intervention. Ten (15.5%) children with thoracic trauma were succumbed to the death. Among the factors leading to mortality delayed presentation and management (50%), hemodynamic instability (100%) patients, requirement of transfusion (100%), penetrating trauma (80%), higher grade of injury (80%), and surgical intervention (80%) were identified to had poor outcome increasing mortality. Site and mechanism of injury are the other factors contributing to and deciding outcomes in pediatric thoracic trauma. Conclusion: Factors such as delayed presentation, hemodynamic instability, penetrating trauma, mediastinal structure injury, higher grade of injury, and surgical intervention had poor outcomes.

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Dinc, Tolga, Selami Ilgaz Kayilioglu, and Faruk Coskun. "Late Onset Traumatic Diaphragmatic Herniation Leading to Intestinal Obstruction and Pancreatitis: Two Separate Cases." Case Reports in Emergency Medicine 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/549013.

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Although diaphragmatic injuries caused by blunt or penetrating trauma are rare entities, they are the most commonly misdiagnosed injuries in trauma patients and occur in approximately 3–7% of all abdominal or thoracic traumas. Acute pancreatitis secondary to late presenting diaphragmatic hernia is very rare. Here we present two separate cases: one with acute bowel obstruction and the other with acute pancreatitis secondary to late onset traumatic diaphragmatic hernia (three and twenty-eight years after chest trauma, resp.).

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Goel, Tushar, and Sameer Bhate. "Case report of isolated impaling lung injury with successful outcome." International Surgery Journal 4, no. 10 (2017): 3548. http://dx.doi.org/10.18203/2349-2902.isj20174537.

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Impalement thoracic injuries are rare of great importance due to severity and high chances of mortality. It is essential to prevent possible vascular injury by the object avoiding major haemorrhage. This study’s primary objective is to discuss 22-year-old male patient admitted in emergency with impaling thoracic trauma by metallic sharp object post battery blast at home. X-ray reveals linear foreign body: penetrating thorax and lung. CT Chest was done and assessment was made for further management with cardiothoracic department. Patient details were collected by patient’s IPD file. Complete detailed history, patient vitals, hemogram, ABO, ABG, CXR along with USG chest and abdomen and CECT chest was done. Post op daily chest X-ray and hemogram along with chest physiotherapy and spirometry was done. Treatment diagnosis was impaled linear foreign body penetrating thorax and lung, patient was shifted to OT, under GA sternotomy was performed. Foreign object passing just lateral to subclavian penetrating upper pole of lung was identified and under specific vision pulled out carefully through entry wound keeping in mind vascular trauma. Necrosed lung part was stapled and wedge resected, on POD 8 patient was discharged with satisfactory condition. Impalement thoracic traumas are rare and have high mortality. Selection of line of treatment is necessary. Indication of surgery under high risk is performed for further trauma. In our case sternotomy was planned and under specific vision impaled object which was passing just by subclavian penetrating through lung was removed safely and patient went home in good condition.

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Fernandes, Abigail. "461 Follow up of penetrating thoracic trauma patients." Resuscitation 203 (November 2024): S214. http://dx.doi.org/10.1016/s0300-9572(24)00744-5.

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Blanié, Antonia, Elie Fadel, and Jacques Duranteau. "Left Pulmonary Artery Transection After Penetrating Thoracic Trauma." Journal of Trauma: Injury, Infection, and Critical Care 71, no. 5 (2011): 1479. http://dx.doi.org/10.1097/ta.0b013e31822b57f5.

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Loogna, Peter, Fabrizio Bonanno, Douglas M. Bowley, et al. "EMERGENCY THORACIC SURGERY FOR PENETRATING, NON-MEDIASTINAL TRAUMA." ANZ Journal of Surgery 77, no. 3 (2007): 142–45. http://dx.doi.org/10.1111/j.1445-2197.2006.03994.x.

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Williams, Michael Jon. "Blunt and Penetrating Trauma to the Thoracic Aorta." Seminars in Cardiothoracic and Vascular Anesthesia 6, no. 2 (2002): 77–81. http://dx.doi.org/10.1177/108925320200600204.

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Jin, Jian, Bo Song, Yuechang Lei, and Xuefeng Leng. "Video-assisted thoracoscopic surgery for penetrating thoracic trauma." Chinese Journal of Traumatology 18, no. 1 (2015): 39–40. http://dx.doi.org/10.1016/j.cjtee.2014.07.003.

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Faryar, Kiran, Michael P. Flaherty, and Martin Huecker. "ST-Elevation Myocardial Infarction after Penetrating Thoracic Trauma." Journal of Emergency Medicine 53, no. 1 (2017): e5-e9. http://dx.doi.org/10.1016/j.jemermed.2017.01.048.

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Sersar, Sameh I., Khalid A. Albohiri, and Hysam Abdelmohty. "Impacted thoracic foreign bodies after penetrating chest trauma." Asian Cardiovascular and Thoracic Annals 24, no. 8 (2016): 782–87. http://dx.doi.org/10.1177/0218492316664673.

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PETERSON, RICHARD J., ANURAG D. TIWARY, NIRANJAN KISSOON, JOSEPH J. TEPAS, ERIC L. CEITHAML, and PAM PIEPER. "Pediatric penetrating thoracic trauma: A five-year experience." Pediatric Emergency Care 10, no. 3 (1994): 129–31. http://dx.doi.org/10.1097/00006565-199406000-00002.

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Worthington, Michael G., Mark de Groot, Alfred J. Gunning, and Ulrich O. von Oppell. "Isolated thoracic duct injury after penetrating chest trauma." Annals of Thoracic Surgery 60, no. 2 (1995): 272–74. http://dx.doi.org/10.1016/0003-4975(95)00415-h.

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Jaabouti, Ghizlane, Soumia Bencchakroun, Chafiq Mahraoui, and Naima El Hafidi. "Post-Traumatic Pulmonary Pneumatoceles: A Case Report." Asian Journal of Medicine and Health 21, no. 9 (2023): 95–100. http://dx.doi.org/10.9734/ajmah/2023/v21i9862.

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Road accidents are the main cause of serious injuries worldwide, accounting for over 10% of trauma cases resulting in death or significant physical impairment. Thoracic injuries, on the other hand, are responsible for a quarter of all trauma-related deaths. In such cases, pneumothorax is the most common thoracic injury, affecting 30 to 40% of patients with thoracic trauma. This injury occurs twice as often in closed traumas as in penetrating traumas. However, post-traumatic pulmonary pneumatocele is a very rare condition that occurs mostly in children and young adults. It’s often a sequelae of acute pneumonia or barotrauma resulting from alveolar hyperpressure in the context of closed glottis trauma. Recognizing these injuries quickly can save lives, whether the patient is outside or in a modern intensive care unit. The reported case is an 8-year-old female child with no medical history, no delayed growth or development, who was involved in a public road accident with a thoracic impact. She presented with hemoptysis and chest pain, and a thoracic CT scan revealed bilateral pulmonary parenchymal contusions predominantly on the right, with post-traumatic pneumatoceles on the right side and a right pneumothorax blade, with good progress under surveillance, oxygen therapy, and prophylactic antibiotic treatment.

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Thomas, Martins O., and Ezekiel O. Ogunleye. "Penetrating Chest Trauma in Nigeria." Asian Cardiovascular and Thoracic Annals 13, no. 2 (2005): 103–6. http://dx.doi.org/10.1177/021849230501300202.

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Penetrating chest trauma occurs worldwide, and various accounts of it have been reported in the literature. 1 – 5 Blunt trauma is not usually associated with military or civilian violence, while penetrating chest trauma often is. Penetrating chest trauma is frequently caused by gunshots and non gunshot-related incidents such as stabs, traffic accidents, and impalements. This prospective study was conducted to determine a pattern of penetrating thoracic injuries, including their causes, the role of surgery, and intervention outcomes. In this study, we treated 168 patients (142 males and 26 females, giving a male-to-female ratio of 5.5:1). Gunshots caused 60.1% of the injuries while traffic accidents caused 27.3% of the injuries. Chest tube insertion alone was the main treatment initiated. This technique was used on 73.8% of the patients. To reduce the occurrence of penetrating chest trauma in Lagos, Nigeria, study results suggest that the Nigerian people and their property need greater security, and that pre-hospital level of care for trauma victims must improve.

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Bayuadi, Imam Suseno, and Aulia Chaya Kusuma. "029. Management of Injury to The Right Lung Due to Penetrating Trauma to The Chest: A Case Report." JBN (Jurnal Bedah Nasional) 8, no. 2 (2024): 29. http://dx.doi.org/10.24843/jbn.2024.v08.is02.p029.

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Background: Thoracic trauma is a significant cause of mortality, in fact, many patients with thoracic trauma die after reaching the hospital. However, many of these deaths can prevented with prompt diagnosis and treatment. Less than 10% of blunt chest injuries and only 15 to 30% of penetrating chest injuries require operative intervention. Most patients who sustain thoracic trauma can be treated by technical procedures within the capabilities of trained clinicians. Case: We reported a case of 44-year-old female having a penetrating wound in her left chest because of her ex-husband stabbed her with a knife. The patient felt pain and the vital signs were stable, from the physical examination there were no abnormalities found. The surgeons did anterior thoracotomy and evacuated the knife within 2 hours since the patient arrived in the ER, and turned out the knife injured the right lung and there was bronchopleural fistula appeared. The surgeons did repair of the fistula and debridement of the wound and primary suturing carried out. The patient discharged 3 days after hospitalized with good clinical condition. Conclusion: This case report presents a successful management of a stable patient with penetrating chest trauma.

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Degiannis, Elias, Agneta Geldenhuis, Konstantinos Degiannis, Jason Degiannis, Matthias Maak, and Dietrich Dietrich Doll. "How we do it Emergency Department Thoracotomy for Penetrating Pulmonary Trauma." Albanian Journal of Trauma and Emergency Surgery 6, no. 1 (2022): 1007–9. http://dx.doi.org/10.32391/ajtes.v6i1.256.

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Abstract The manuscript specifically concentrates on patients with penetrating thoracic trauma, who having undergone Emergency Department Thoracotomy (EDT) have been diagnosed with injury to the lung. Its purpose is to describe a practical / heuristic approach, enabling the inexperienced in thoracic surgery doctor, to perform a successful EDT and if need arises, a definitive operation in the absence of a Cardiothoracic or appropriately trained Trauma Surgeon.

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Nummela, Mari T., Sigurveig Thorisdottir, Gudrun L. Oladottir, and Seppo K. Koskinen. "Imaging of penetrating thoracic trauma in a large Nordic trauma center." Acta Radiologica Open 8, no. 12 (2019): 205846011989548. http://dx.doi.org/10.1177/2058460119895485.

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Dar, Parvez Mohi Ud Din, Shivanand Gamanagatti, Pratyusha Priyadarshini, and Subodh Kumar. "Traumatic chylothorax: a dilemma to surgeons and interventionists." BMJ Case Reports 14, no. 5 (2021): e238961. http://dx.doi.org/10.1136/bcr-2020-238961.

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Chylothorax is generally seen due to iatrogenic injury to the thoracic duct during thoracic or neck surgery. It can also be encountered secondary to chest trauma either blunt or penetrating. Percutaneous thoracic duct embolisation is an alternative to surgical treatment and is considered an effective and safe minimally invasive treatment option for chylothorax with a success rate of about 80%. We present a case of blunt trauma to the chest with chylothorax, which was successfully managed with transvenous retrograde thoracic duct embolisation.

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Refaely, Yael, Leonid Koyfman, Michael Friger, et al. "Clinical Outcome of Urgent Thoracotomy in Patients with Penetrating and Blunt Chest Trauma: A Retrospective Survey." Thoracic and Cardiovascular Surgeon 66, no. 08 (2017): 686–92. http://dx.doi.org/10.1055/s-0037-1608899.

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Introduction In contrast to an emergency department of thoracotomy (EDT), an urgent thoracotomy (UT) is defined as a surgical thoracic intervention performed in the operating room within the first 48 hours of the patient's intensive care unit (ICU) stay. The factors affecting survival after UT are not fully understood. In this study, we retrospectively analyzed the clinical data and outcome of patients with blunt and penetrating chest injuries who underwent UT. Methods All adult patients who had blunt or penetrating chest trauma and who underwent UT, were included in the study. All data were collected from the patients' hospital and ICU records. Forty-five patients with thoracic injuries who underwent UT during the first 48 hours of ICU stay were analyzed. Of these, 25 had penetrating chest injuries, and 20 had blunt thoracic injuries. Of the penetrating injuries, 16 were stab wounds, and 9 were gunshot wounds. Results Overall ICU mortality was 29% (n = 13) and was significantly higher in the blunt chest trauma group than in the penetrating trauma group (45% vs 16%; p = 0.04). Lung parenchyma injuries (lacerations and contusions) were the most common intraoperative findings in both groups. The following independent predictors of in-hospital mortality were found: an Injury Severity Score (ISS) of >40; an Acute Physiology and Chronic Evaluation II (APACHE II) score of >30; prolonged duration of UT; low body temperature on admission to the ED; abnormal arterial blood lactate, bicarbonate, and pH at the end of UT; and use of vasopressors during the first 24 hours of ICU stay. Conclusion Mortality after UT was higher in patients with blunt chest trauma. The UT should be performed in both penetrating and blunt chest trauma as quickly as possible and should be limited to damage control. It also emerges that acidosis and hypothermia in chest trauma patients need to be treated extremely aggressively before, during, and after UT.

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Sathish Kumar, Venkatesh N. "A Delayed Presentation of Traumatic Diaphragmatic Hernia with Large Bowel Obstruction." Journal of Medical Science and clinical Research 13, no. 02 (2025): 11–14. https://doi.org/10.18535/jmscr/v13i02.03.

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Diaphragmatic injury is a rare occurrence, constituting less than 3 percent of all traumatic injuries. It typically arises from either blunt or penetrating trauma, presenting a notable challenge in clinical settings, with a 2:1 ratio of penetrating to blunt trauma(1). These injuries often elude immediate recognition or face delayed diagnosis, primarily due to their infrequency and the concurrent presence of more overt and severe traumas in patients. The delayed identification of diaphragmatic injuries can contribute to complications such as pulmonary issues, persistent abdominal pain, or acute bowel obstruction, thereby elevating the risk of morbidity and mortality. Here, we report a case of a 30-year-old man who exhibited a diaphragmatic hernia with large bowel obstruction which manifested following blunt abdominal and thoracic trauma that occurred three years prior to the current presentation.

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O, Choua, Rimtebaye K, Adam Adami M, Bekoutou G, and Anour M A. "Les Plaies Penetrantes Par Armes Blanches Et A Feu A N’djamena, Tchad: Une Epidemie Silencieuse ?" European Scientific Journal, ESJ 12, no. 9 (2016): 180. http://dx.doi.org/10.19044/esj.2016.v12n9p180.

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Aim: the aim of this study was to report the experience of the General Hospital of National Reference in N'djamena (Chad) in the management of penetrating wounds. Patients and methods: This was a prospective study ranging from 01/07/2013 to 30/06/2014. Were included all patients undergoing penetrating stab or firearm wound. The studied variables were: age, sex, and type of trauma, prehospital delay, transport, and the treatment. The length of hospital stay, morbidity and mortality were also studied. Results: the series included 129 patients: 120 men (93%) and 9 women (7%). penetrating trauma constituted 22.7% of the 569 surgical emergency admissions. They were caused by a knife and a gun in respectively 112 (77.5%) and 17 (13.2%) patients. Brawls and assaults were the cause of trauma in 78 cases, respectively (60.5%) and 47 cases (36.4%). The cause was accidental in 4 cases (3.1%). The most used wounding agent was the knife in 100 cases (77.5%), followed by firearms in 17 cases (13.2%) and other sharp objects in 12 cases (9.3%). The admission average time was 3,7h. Patients arrived mostly by public transport. Penetrating wounds were respectively 67 cases in thoracic, 50 cases in abdominal and in 2 intracerebral cases. Treating chest wounds included: in 50.7% of cases right thoracic drain, 46.3% of left thoracic drain and 3% of bilateral thoracic drain. For abdominal penetrating wounds laparotomy was the rule. Surgical treatment in these cases: 6 gastric sutures, 25 sutures and 4 resection of the small intestine, and 10 sutures, plus 2 resections of the colon, 3 negative laparotomies. Similarly, the diaphragm, the liver, and spleen injuries had proper treatment. Elsewhere, two intra brain knives were extracted. The average stay was 8.9 days. Morbidity was 6.2% and mortality 3.1%. Conclusion: penetrating trauma is a real public health problem in N'Djamena related to brawls and aggressions. Knife is the most used agent.

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de Rooster, H., O. Taeymans, H. van Bree, and M. Risselada. "Penetrating injuries in dogs and cats." Veterinary and Comparative Orthopaedics and Traumatology 21, no. 05 (2008): 434–39. http://dx.doi.org/10.3415/vcot-07-02-0019.

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SummaryThe objective of this retrospective study was to assess radiographical and surgical findings, surgical management and outcome of penetrating injuries in dogs and cats by evaluating patient records. Sixteen patients were identified (15 dogs and one cat), four with gunshot wounds, and 12 with fight wounds (11 with bite wounds, one struck by a claw). The thoracic cavity was affected in six patients, the abdominal cavity in three cases. Both cavities were affected in five dogs and the trachea in two cases. All of the patients with fight wounds were small breed dogs. Multiple injuries to internal organs that required intervention were found surgically after gunshot wounds and a high amount of soft tissue trauma requiring reconstruction was present after fight wounds. Radiography diagnosed body wall disruption in two cases. All of the affected thoracic body walls in the fight group had intercostal muscle disruptions which was diagnosed surgically. Fourteen patients survived until discharge and had a good outcome. In conclusion, penetrating injuries should be explored as they are usually accompanied by severe damage to either the internal organs or to the body wall. A high level of awareness is required to properly determine the degree of trauma of intercostal muscle disruption in thoracic fight wounds.

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Schicho, Andreas, Lukas Lürken, Ramona Meier, et al. "Non-penetrating traumatic injuries of the aortic arch." Acta Radiologica 59, no. 3 (2017): 275–79. http://dx.doi.org/10.1177/0284185117713352.

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Background In severely injured trauma patients, non-penetrating aortic arch injuries (NAAI) have a remarkable incidence and mortality. Both diagnostics and therapy of NAAI recently underwent significant changes. Purpose To assess mortality, morbidity, and the risk factors associated with NAAI in severely injured patients (Injury Severity Score [ISS] ≥16) under the light of recent technical and procedural advances in trauma care. Material and Methods A total of 230 consecutive trauma patients with ISS ≥16 admitted to our level-I trauma center during a 24-month period, were prospectively included and underwent standardized whole-body computed tomography (CT) in a 2 × 128-detector-row scanner. Incidence, mortality, patient and trauma characteristics, and concomitant injuries were recorded for patients with NAAI. Localization of NAAI was described referring to Mitchell and Ishimaru; severity was graded according to the proposal of Heneghan et al. Results Thirteen of 230 patients had a NAAI, yielding an incidence of 5.6%. Mean age and ISS was not elevated in NAAI (44.4 ± 14.8 years, ISS = 38 ± 12.4). Mortality was 23.1%. One patient had severe neurologic sequelae from a stroke; all surviving patients had to undergo (transient) anticoagulant therapy. Trauma mechanism was of high kinetic energy in all cases. Concomitant injuries were predominantly thoracic (rib fractures = 76.9%, thoracic spine fracture = 38.5%). Conclusion Whenever an individual possibly encountered a deceleration–acceleration trauma mechanism, a high level of suspicion for NAAI should be maintained. It remains to be determined whether recent advances in mortality are due to changes in trauma care or due to improved vehicle and road safety.

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Sheard, Kate. "Thoracic trauma in small animals: road traffic accidents." Veterinary Nurse 12, no. 1 (2021): 15–19. http://dx.doi.org/10.12968/vetn.2021.12.1.15.

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Thoracic trauma is common in small animals and can be caused by a variety of insults from penetrating wounds to blunt force trauma. Patients that have sustained any form of thoracic trauma require immediate attention and intensive nursing care in order to have a positive outcome for the patient. These cases can prove challenging as multiple organ systems can be affected and surgery is often required. However, combined with the appropriate medical care, the outcome can be successful.

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