Citation

Rupprecht H, Dormann H, Gaab K. GMS Interdiscip Plast Reconstr Surg DGPW 2019; 8: Doc07.

Copyright

(Copyright © 2019, Deutsche Gesellschaft für Plastische und Wiederherstellungschirurgie, Publisher German Medical Science)

DOI

10.3205/iprs000133

PMID

31275797

PMCID

PMC6545437

Abstract

Thoracic injuries are the most lethal penetrating injuries. After attempting suicide, two patients with a penetrating thoracic wound were admitted to our emergency department. During CT scan they became hemodynamically unstable, which is why we had to perform an emergency thoracotomy. In both cases, a perforation in the left ventricle as well as multiple lesions of the lung parenchyma and vessel injuries were found. After the treatment of the different injuries, a massive edema of the heart and lung prevented a primary closure of the thorax. Due to massive diffuse bleeding, a "packing" of the pleural cavity became necessary. To prevent a thoracic compartment syndrome, the thoracic wall was left open and the skin was closed with a plastic sheet. Due to the "open chest" procedure combined with "packing" of the thoracic cavity, the majority of patients with an edema of the heart and lung after a penetrating chest injury can be saved. Pitfalls of preclinical and clinical treatment, aspects of diagnostics and surgery are discussed.

Language: en

Keywords

compartment syndrome; bogota bag; myocardial and lung edema; packing; penetrating heart and lung injury