Gunshot injuries of chest : analysis of 32 patients

Mustafa Noman Sabet; Abdelkarim   Bashir; Ahmad Faraj  Hamad

doi:10.54361/

Authors

Mustafa Noman Sabet Department of Surgery, Omar Al-Mukhtar University , Al Beida Author
Abdelkarim Bashir Department of Surgery, Omar Al-Mukhtar University , Al Beida Author
Ahmad Faraj Hamad Department of Surgery, Omar Al-Mukhtar University , Al Beida Author

DOI:

https://doi.org/10.54361/

Keywords:

Penetrating thoracic trauma, tube thoracostomy, thoracotomy

Abstract

Background: Penetrating injuries to the chest present a frequent and challenging problem. The majority of these injuries can be managed non-operatively. The selection of patients for operation or observation can be made by clinical examination and appropriate investigations. This study is conducted to present our experience in management of the chest gunshot during Libyan revolution and in a situation where the basic diagnostic tool (X-ray) was unavailable. Methods: we retrospectively reviewed 32 patients seen at our hospital over a 6-day period during revolution (16-21 Feb). The data evaluated and analysed. Results: The group comprised 32 male patients, with a mean age of 29 years (17-58). Of these patients,17 (53.2%) had left-sided, 15 (46.8%) had right-sided, 19(59.4%) had isolated chest injury and 13 (40.6%) patients had associated other injuries.. Thorcostomy tube was the only therapy required in 19 patients (59.4%), whereas 13 patients (40.6%) underwent thoracotomy and exploration. Mean hospitalization period for patients with thoracostomy tube was 6 days whereas median hospitalization duration in the exploration group was 9 days. Complications recorded in 2 cases. Conclusion: In this study we emphasize that in the situation where x-ray is not available , the clinical examination, pleural aspiration and the thoracostomy tube are the appropriate methods of managing penetrating chest injuries.

References

Patterson A, Cooper D, Deslauriers J, Lerut AEMR, Luketich JD, Rice TW. Pearson’s thoracic and esophageal surgery, 3rd ed. Philadelphia: Churchill Livingstone; 2008. p.1777-9.

Tariq UM, Faruque A, Ansari H, Ahmad M, Rashid U, Perveen S et al. Changes in the patterns, presentation and management of penetrating chest trauma patients at a level II trauma centre in Southern Pakistan over the last two decades. Interact Cardiovasc Th orac Surg 2011; 12: 24-7.

Cury F, Baitello AL, Echeverria RF, Espada PC, Pereira de Godoy JM. Rates of thoracic trauma and mortality due to accidents in Brazil. Ann Th orac Med 2009; 4: 25-6.

Madiba TE, Thomson SR, Mdlalose N. Penetrating chest injuries in the firearm era. Injury. 2001;32:13–16

Murray JA, Berne J, Asensio JA. Penetrating thoracoabdominal trauma. Emerg Med Clin North Am. 1998;16:107–128.

American College of Surgeons Committee on Trauma. Advanced Trauma Life Support for Doctors, ATLS Student Course Manual. Chicago: American College of Surgeons; 2008.

Asensio JA, Arroyo H Jr, Veloz W. Penetrating thoracoabdominal injuries: ongoing dilemma-which cavity and when? World J Surg. 2002;26:539–543.

Bastos R, Baisden CE, Harker L, Calhoon JH. Penetrating thoracic trauma. Semin Thorac Cardiovasc Surg. 2008;20:19–25.

Meyer DM. Hemothorax related to trauma. Thorac Surg Clin. 2007;17:47–55.

Scharff JR, Naunheim KS. Traumatic diaphragmatic injuries. Thorac Surg Clin. 2007;17:81–85.

Lema MK, Chalya PL, Mabula JB, Mahalu W. Pattern and outcome of chest injuries at Bugando Medical Centre in Northwestern Tanzania. J Cardiothorac Surg 2011; 6: 7.

Segers P, Van Schil P, Jorens P, Van Den Brande F. Th oracic trauma: an analysis of 187 patients. Acta Chir Belg 2001; 101: 277-82.

Th omas MO, Ogunleye EO. Penetrating chest trauma in Nigeria. Asian Cardiovasc Th orac Ann 2005; 13: 103-6.

Petrone P, Asensio JA. Surgical management of penetrating pulmonary injuries. Scand J Trauma Resusc Emerg Med 2009; 17: 8.

Murray JA, Berne J, Asensio JA. Penetrating thoracoabdominal trauma. Emerg Med Clin North Am. 1998;16:107–128.

Powell BS, Magnotti LJ, Schroeppel TJ. Diagnostic laparoscopy for the evaluation of occult diaphragmatic injury following penetrating thoracoabdominal trauma. Injury. 2008;39:530–534.

Cothren C, Moore EE, Biffl WL, Franciose RJ, Off ner PJ, Burch JM. Lung- sparing techniques are associated with improved outcome compared with anatomic resection for severe lung injuries. J Trauma 2002; 53: 483-7.