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Selective Operative Management of Penetrating Chest Injuries

  • Trauma Surgery (J. Diaz, Section Editor)
  • Published:
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Abstract

Purpose of Review

The aim of this review was to review the recent literature with respect to penetrating chest injuries so as to provide an update on the current/changing management of these injuries.

Recent Findings

The management of a stable patient following penetrating chest trauma with a hemopericardium on ultrasound has changed from routine sternotomy to a pericardial window and drainage, with a sternotomy reserved for those patients who have active bleeding at the time of the pericardial window. It is imperative to diagnose and repair an occult left-sided diaphragm injury and this can be achieved laparoscopically once a hollow organ injury has been excluded. Small pneumothoraces less than 2 cm may be observed in asymptomatic patients provided the patient is not on positive pressure ventilation, and hemothoraces of less than 300 mL may be managed with observation alone.

Summary

There are new management strategies evolving in the patient presenting with penetrating thoracic trauma and it is important that surgeons managing these patients are aware of these changes.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Trauma Centre, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa

    Andrew John Nicol, Sorin Edu & Pradeep Navsaria

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  1. Andrew John Nicol
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  2. Sorin Edu
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  3. Pradeep Navsaria
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Correspondence to Andrew John Nicol.

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Andrew John Nicol, Sorin Edu, and Pradeep Navsaria declare that they have no conflict of interest.

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Nicol, A.J., Edu, S. & Navsaria, P. Selective Operative Management of Penetrating Chest Injuries. Curr Surg Rep 7, 13 (2019). https://doi.org/10.1007/s40137-019-0233-1

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