Main description:

Transmediastinal gunshot injuries present the risk of immediately life threatening injuries. Stable patients have been evaluated by a combination of esophageal swallow and endoscopy, aortography and bronchoscopy. There is an increasing trend favoring CT scan. Unstable patients require immediate exploration, being prepared to enter both hemi-thoraces. Selected References: * Bergsland J, Karamanoukian HL, Soltoski PR, Salerno TA. Single suture forcircumflex exposure in coronary artery bypass grafting. Ann Thorac Surg.1999;68: 1428-1430. * Fedalen PA, Bard MR, Piacentino V, et al. Intraluminal shunt placement and off- pump coronary revascularization for coronary artery stab wound. J Trauma 200 1;50: 133-135 * Hanpeter DE, Demetriades D, Asensio JA, Berne TV, Velmahos G, Murraygunshot wounds. J Trauma 2000;49(4):689-695. * MacPherson D. Bullet Penetration: Modeling the dynamics and the incapacitation resulting from wound trauma. Ballistics Publications, EI Segundo, CA, 1994 * Wall MJ, Soltero E. Damage control for thoracic injuries, Surg Clin North AmI997;77(4):863-878.
* Rozycki GS, Feliciano DV, Oschner MG, Knudson MM, Hoyt DB, Davis F, Hammerman D, Figueredo V, Harviel JD, Han DC, Schmidt JA. The role ofUltrasound in patients with possible penetrating cardiac wounds: aProspective multicenter study. J Trauma 1999; 46(4):543-552. * Roussseau H, Soula P, Bui B, D'Othee BJ, Massabuau P, Meites G, Concina P,Mazzerolles M, Joffre F, Otal P. Delayed treatment of traumatic ruptureof the thoracic aorta with endoluminal covered stent. Circulation 1999 Feb2; 99(4): 498-504.

Contents:

Section 1: Underlying Principles. 1.1. Trauma Scores: Recent Advances; S.M. Fakhry, N.A. Khan. 1.2. Care of the Multiple Injured Patient with Thoracic Trauma; F.N. Obeid, et al. 1.3. Assessing Adequacy of Resuscitation; R. Nirula, L.M. Gentilello. 1.4. Reperfusion Injury; T.H. Pohlman. Section 2: Thoracostomy, Thorascopy and Thoracotomy. 2.1. Tube Thoracostomy; J. Cuschieri. 2.2. Incisions and Approaches for Thoracic Trauma; M.S. Farber, F.N. Obeid. 2.3. Emergency Department Thoracotomy: Indications and Outcomes; A. Goldin, et al. 2.4. Urgent Thoracotomy; M. Rosengart, R. Karmy-Jones. 2.5. Abbreviated Thoracotomy: The Evolving Role of Damage Control in Thoracic Trauma; D.J. DiBardino, S.I. Brundage. 2.6. Transmediastinal Gunshot Wounds; D.V. Shatz, R.J. Serurola Jr. 2.7. The Role of Thoracoscopy in Chest Trauma; J. Monson, R. Karmy-Jones. 2.8. Management of Retained Hemothorax; D. Gourlay. 2.9. Open Chest Human Cardiopulmonary Resuscitation; M.E. Boczar, E.P. Rivers. Section 3: Pulmonary and Airway Emergencies. 3.1. Penetrating Lung Injuries; K. Kralovich. 3.2. Tracheobroncial Injuries; D. Wood. 3.3. Traumatic Asphyxia; J. Cushieri. 3.4. Primary Pulmonary Blast Injury; R. DuBose, R. Karmy-Jones. 3.5. Inhalation Injury; G.J. Bauer, et al. 3.6. Thoracic Missile Emboli and Retained Bullets; J.B. Kortbeek, et al. 3.7. Imaging of Blunt and Penetrating Trauma to the Pulmonary Parenchyma. 3.8. Surgical Management of Airway Obstruction; D.E. Wood. 3.9. Complications of Lung Transplantation; M.S. Mulligan. 3.10. Air Ambolism; D. Oxorn. 3.11. Massive Hemoptysis; C.J. McNamee, et al. 3.12. Tracheo-Inominate Artery Fistula; B. Achen, et al. 3.13. PA Catheter Induced Hemoptysis; C.J. McNamee, et al. 3.14. Re-expansion Pulmonary Edema; K. Wagner, G.D. Trachiotis. 3.15. Postpneumonectomy Pulmonary Edema; J. Urschel. 3.16. The Sonographic Detection of Pneumothoraces; A.W. Kirkpatrick, S. Nicolaou. Section 4: Chest Wall Trauma. 4.1. Pulmonary Contusion; S. Sattler, R.V. Maier. 4.2. Reconstruction of Complex Chest Wall Defects; C.A. White, F.F. Isik. 4.3. Burns of the Chest Wall; N. Gibran. 4.4. Traumatic Lung Hernia; L.S. Kao. 4.5. Diaphragmatic Injuries; V.J. Sorenson. Section 5: Esophageal Emergencies. 5.1. Caustic Injury of the Esophagus; T. Eubanks. 5.2. Esophageal Perforation and Injury; L. Kao, R. Karmy-Jones. Section 6: Cardiovascular Emergencies. 6.1. Blunt Cardiac Injury; W.L. Biffl, E.E. Moore. 6.2. Blunt Cerebrovascular Trauma; L.A. Nelson, et al. 6.3. Penetrating Cardiac Injuries; S. Worrell, R. Karmy-Jones. 6.4. Management of Great Vessel Injuries; S.C. Nicholls. 6.5. Blunt Thoracic Aortic Injuries: Diagnosis; J. Borsa. 6.6. Operative Management of Blunt Thoracic Aortic Injuries;