Penetrating chest trauma

Abstract

Anticipation of organ injury based on wound location is helpful in managing victims of penetrating chest trauma. Functionally categorizing wounds into central, peripheral, and thoracoabdominal allows one to tailor the approach to the injuries that are likely present. Central wounds often present in dramatic fashion and require immediate surgical intervention, whereas peripheral wounds are unlikely to require surgery, and the patient often can be discharged after a relatively brief period of observation. Thoracoabdominal wounds present diagnostic difficulties that remain incompletely resolved, particularly regarding the diagnosis of isolated diaphragmatic injury. These variations in presentation offer a diverse challenge to the diagnostic and therapeutic skills of the physicians who choose to manage patients with penetrating chest trauma.