A prospective evaluation of thoracoscopy for the diagnosis of penetrating thoracoabdominal trauma

Ricardo A. Uribe, Camilo E. Pachon, Scott B. Frame, Blaine Enderson, Fernando Escobar, Guillermo A. Garcia

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Penetrating thoracoabdominal trauma presents a difficult diagnostic dilemma. Violation of the diaphragm may be very difficult to establish. Conventional diagnostic procedures such as chest radiography, computed tomography, and diagnostic peritoneal lavage have been shown to be unreliable. Mandatory exploratory celiotomy carries a 20%-30% negative rate. Twenty-eight patients with penetrating thoracoabdominal trauma over a 6-month period were prospectively evaluated by thoracoscopy at a major urban trauma center. All patients were hemodynamically stable, had no indications for immediate celiotomy, and demonstrated thoracic injury on chest radiography or physical examination. All thoracoscopy was performed in the operating room under general anesthesia. Patients consisted of 25 males and 3 females with an age range of 15-48 years. Mechanism of injury consisted of 24 stab wounds and 4 gunshot wounds. Twelve of the procedures were for right chest wounds and 16 involved the left hemithorax. Diaphragmatic injury was identified at thoracoscopy in 9 patients (32%), with all confirmed and repaired at celiotomy. Eight of 9 patients (89%) undergoing celiotomy were found to have significant intra-abdominal injuries requiring surgical repair. Thoracoscopy was also useful for evacuation of blood from the pleural space. There were no procedure-related complications. Thoracoscopy is a safe, accurate, reliable diagnostic technique for evaluating thoracoabdominal penetrating trauma. It is less invasive than celiotomy and has the added benefit of diagnosis and therapy of the intrathoracic injuries.

Original languageEnglish (US)
Pages (from-to)650-654
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume37
Issue number4
DOIs
StatePublished - Jan 1 1994

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Thoracoscopy
Wounds and Injuries
Thorax
Radiography
Stab Wounds
Peritoneal Lavage
Abdominal Injuries
Gunshot Wounds
Thoracic Injuries
Trauma Centers
Operating Rooms
Diaphragm
General Anesthesia
Physical Examination
Tomography

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

A prospective evaluation of thoracoscopy for the diagnosis of penetrating thoracoabdominal trauma. / Uribe, Ricardo A.; Pachon, Camilo E.; Frame, Scott B.; Enderson, Blaine; Escobar, Fernando; Garcia, Guillermo A.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 37, No. 4, 01.01.1994, p. 650-654.

Research output: Contribution to journalArticle

Uribe, Ricardo A. ; Pachon, Camilo E. ; Frame, Scott B. ; Enderson, Blaine ; Escobar, Fernando ; Garcia, Guillermo A. / A prospective evaluation of thoracoscopy for the diagnosis of penetrating thoracoabdominal trauma. In: Journal of Trauma - Injury, Infection and Critical Care. 1994 ; Vol. 37, No. 4. pp. 650-654.
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