Tomographic aspects of penetrating thoracic trauma: injuries from firearms and other weapons

Abstract

ObjectiveThe aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions.Material and MethodsWe studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon.ResultsPulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2.5%) and hematomas in 1 (2.5%). Hemothorax was seen in 31 cases (77.5%), and pneumothorax was seen in 22 cases (55%). Mediastinal lesions were observed in 8 cases (20%), including mediastinal hematoma in 3 cases (7.5%), hemopericardium in 3 (7.5%), and pneumomediastinum in 2 (5%). Diaphragmatic rupture was seen in 2 cases (5%).ConclusionIn patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach.

Traumatismo Torácico Por Arma De Fuego

“…Los hallazgos y/o lesiones torácicas más frecuentes fueron el hemotórax no masivo, neumo-tórax, contusión pulmonar y enfisema subcutáneo. Esto se condice con la literatura donde las lesiones pulmonares son las más frecuentes 3,17,26 . Cabe mencionar que los TPC corresponden a un 10,2% de los TTAF y que estos forman parte de una entidad distinta, con características propias y mayor mortalidad 25 .…”

“…Se requirió de tratamiento invasivo en la mayoría de los pacientes (77,6%), correspondiendo en su mayoría a pleurotomía (42,9%). Series europeas describen tratamiento suficiente con pleurotomía en el 76,3% de los casos [22][23][24][25][26][27] . La necesidad de cirugía torácica descrita en distintas revisiones oscila entre 5,8%-71,0% 17,28 , esto se puede deber a las diferencias epidemiológicas en las distintas poblaciones, además, la mayoría de los estudios incluyen grupos heterogéneos de lesiones como las toracoabdominales.…”

Solving the impossible. Penetrating cardiac injuries, a case series of diagnostic workup and management

“…(Nummela et al, 2019) SW are the most prevalent cause of surgical intervention of PCI (39-81.4%) (Uchimura et al, 2010;Karigyo Toshiyuki et al, 2013;Besir, Gokalp and Eygi, 2015;Khorsandi et al, 2015), even though GSW has been reported as the main etiology of PCI, it often presents higher mortality rate prior to the arrival into the OR. (Albadani and Alabsi, 2013;Kaljusto et al, 2015;Melo et al, 2017;de Araújo et al, 2018)…”

A Review of “Reevaluation of Diagnostic Procedures for Transmediastinal Gunshot Wounds” (2002)

“…8 The impact of the study has been seen on the management of both civilian and military populations in the United States and abroad. [9][10][11] The ripple effect of this article extends well past the management of the TMGSW patient. With the success of CT scanning as a screening tool for hemodynamically stable patients with a TMGSW, CT scan use for penetrating injury was expanded sequentially to other truncal locations including the flank, pelvis, and thoracoabdominal region.…”

“…8 The impact of the study has been seen on the management of both civilian and military populations in the United States and abroad. 9-11…”