Transthoracic Firearm Injury Causing Massive Pulmonary Destruction

Öz

Transthoracic gunshot injuries acquire immediate intervention with a correct approach as they have high mortality rates. The high mortality mainly depends on the presence of a probable concomitant injury of the cardiac, pulmonary and major thoracal vascular structures. In this case report, the emergent surgical management of a young female referred with a thoracal gunshot wound causing a massive pulmonary destruction is presented.

Anahtar Kelimeler

• Firearms,thorax,lung injury

Ağır Akciğer Hasarına Yol Açan Transtorasik Ateşli Silah Yaralanması

Öz

Transtorasik ateşli silah yaralanmaları yüksek mortaliteye sahip olduklarından, doğru bir yaklaşımla acil müdahale gerektirirler. Yüksek mortalitenin ana nedeni, kardiak, pulmoner ve torasik büyük damar yaralanmalarının birlikte görülebilmesidir. Bu olgu sunumunda, masif akciğer hasarına yol açan transtorasik ateşli silah yaralanması ile gelen genç bir kadının acil cerrahi müdahalesi sunulmaktadır.

Anahtar Kelimeler

• Ateşli silah,toraks,akciğer hasarı

Kaynakça

1. 1- Okoye OT, Talving P, Teixeira PG, Chervonski M, Smith JA, Inaba K, et al. Transmediastinal gunshot wounds in a mature trauma centre: Changing perspectives. Injury 2013;44(9):1198-203.
2. 2- Stassen NA, Lukan JK, Spain DA, Miller FB, Carrillo EH, Richardson JD. Reevaluation of diagnostic procedures for transmediastinal gunshot wounds. J Trauma 2002;53(4):635-8.
3. 3- Cornwell EE, Kennedy F, Ayad IA, Berne TV, Velmahos G, Asensio J, et al. Transmediastinal gunshot wounds: a reconsideration of the role of aortography. Arch Surg 1996;131(9):949-53.
4. 4- Smith RM, Conn AK. Prehospital carescoop and run or stay and play? Injury 2009;40(Suppl. 4):S23-6.
5. 5- Bradley MN. Transmediastinal wounds. Am Surg 1966;32:847-52.
6. 6- Kerimoğlu B, Köse S, Özışık K, Ertürk M, Koşar A, Orhan G. Yüksek hızlı ateşli silahlarla oluşan toraks yaralanmaları. Tr Klin J Med Sci 2001;21(4):249-52.
7. 7- Nagy KK, Roberts RR, Smith RF, Joseph KT, An GC, Bokhari F, et al. Transmediastinal gunshot wounds: are ‘‘stable’’ patients really stable? World J Surg 2002;26:1247-50.
8. 8- Degiannis E, Benn CA, Leandros E, Goosen J, Boffard K, Saadia R. Transmediastinal gunshot injuries. Surgery 2000;128:54-8.

9. 9- Richardson JD, Flint LM, Snow NJ, Gray Jr LA, Trinkle JK. Management of transmediastinal gunshot wounds. Surgery 1981;90:671-6.
10. 10- Grossman MD, May AK, Schwab CW, Reilly PM, McMahon DJ, Rotondo M, et al. Determining anatomic injury with computed tomography in selected torso gunshot wounds. J Trauma 1998;45:446-56.
11. 11- Hanpeter DE, Demetriades D, Asensio JA, Berne TV, Velmahos G, Murray J. Helical computed tomographic scan in the evaluation of mediastinal gunshot wounds. J Trauma 2000;49:689-94.
12. 12- Peper WA, Obeid FN, Horst HM, Bivins BA. Penetrating injuries of the mediastinum. Am Surg 1986;52:359-65.
13. 13- O’Connor JV, Scalea TM. Penetrating thoracic great vessel injury: impact of admission hemodynamics and preoperative imaging. J Trauma 2010;68:834-7.
14. 14- Working Group, Ad Hoc Subcommittee on Outcomes, American College of Surgeons. Committee on trauma, practice management guidelines for emergency department thoracotomy. working group, ad hoc subcommittee on outcomes, American college of surgeons-committee on trauma. J Am Coll Surg 2001;193:303-9.