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A Journal on Surgery

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Minerva Chirurgica 2001 October;56(5):483-6

language: Italian

Recent concepts regarding the treatment of traumatic hemopneumothorax

Migliore M., Buffone A., Polara R., Caragliano P., Tabbì R., Basile G.


Background. The aim of the study was to examine the different therapeutic options for traumatic hemopneumothorax and in particular the latest concepts (videothoracoscopy).
Methods. A retrospective study was performed on a group of 20 patients with post-traumatic hemothorax and/or pneumothorax attending the emergency department at Ospedale Vittorio Emanuele in Catania over the past 10 years where 2500 patients with abdominal and/or thoracic trauma were treated during the same period. The patients included 18 males and 2 females with a mean age of 35 years (range 13-70). The cause of injury was a gunshot wound in 8 patients, a blunt trauma following a road accident in 9 and a stab wound in 3 patients. A drainage tube was inserted in 15 patients (a videothoracoscopic approach was used in 2 cases); 3 patients required a diaphragmatic suture and 2 thoracotomy (inferior lobectomy and repair of the main left bronchus).
Results. Three out of 20 patients died with an overall mortality rate of 15%. Two patients died respectively from severe brain and abdominal injuries associated with thoracic trauma, while the third patient died from septic complications.
Conclusions. In the past few years videothoracoscopy has allowed a different approach to be used in patients affected by hemo-pneumothorax since it allows a more accurate diagnosis (extent and origin of bleeding, identification of associated diaphragmatic lesion) and the possibility of treating pleuro-pulmonary injuries without performing extensive thoracotomies.

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