It has been reported that thoracotomy will be required in as many as 30% of cases presenting following penetrating chest injury and 15% after blunt chest trauma. There are, in general, three indications: shock/arrest with suspected correctable intrathoracic lesion; specific diagnosis’s (e.g. penetrating cardiac or blunt aortic injury) or evidence of ongoing thoracic hemorrhage. Outcome and management strategies depend upon mechanism of injury, degree of hemodynamic instability on presentation and associated extra-thoracic injuries.
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