Double jeopardy: Thoracoabdominal injuries requiring surgical intervention in both chest and abdomen

A. Hirshberg, M. J. Wall, M. K. Allen, K. L. Mattox, J. A. Asensio, S. Brotman, G. M. Watkins, Grace Rozycki, J. D. Richardson

Research output: Contribution to journalArticle

Abstract

The critical decisions in patients with thoracoabdominal trauma are establishing the need to explore either or both cavities and determining appropriate sequencing. The causes and patterns of management difficulties were analyzed in 82 consecutive patients with penetrating thoracoabdominal injuries. Nine thoracotomies (11%) and 16 laparotomies (22%) were negative, with the major causes being misleading chest tube outputs, bullet trajectories, and abdominal tenderness. Inappropriate sequencing occurred in 19 patients (23%), and 15% required reoperation within 24 hours. Pitfalls and misjudgments in management of penetrating thoracoabdominal injuries occur in distinct patterns. The unreliability of chest tube output and abdominal examination must be kept in mind, and intraoperative clues of ongoing hemorrhage outside the operative field must be sought.

Original languageEnglish (US)
Pages (from-to)225-231
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume39
Issue number2
DOIs
Publication statusPublished - Sep 12 1995
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Hirshberg, A., Wall, M. J., Allen, M. K., Mattox, K. L., Asensio, J. A., Brotman, S., ... Richardson, J. D. (1995). Double jeopardy: Thoracoabdominal injuries requiring surgical intervention in both chest and abdomen. Journal of Trauma - Injury, Infection and Critical Care, 39(2), 225-231. https://doi.org/10.1097/00005373-199508000-00007