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Penetrating Thoracoabdominal Injury

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The persistent diagnostic challenge of thoracoabdominal stab wounds.
Berg RJ, Karamanos E, Inaba K, Okoye O, Teixeira PG, Demetriades D.
J Trauma Acute Care Surg. 2014 Feb;76(2):418-23.

Rationale for inclusion: Large contemporary series of thoracoabdominal stab wounds that reveals a 12 % nontherapeutic laparotomy rate and 32% miss rate for diaphragmatic injury on CT scan.

Citations - 16 (as of July 2017)

Penetrating torso trauma: triple-contrast helical CT in peritoneal violation and organ injury--a prospective study in 200 patients.
Shanmuganathan K, Mirvis SE, Chiu WC, Killeen KL, Hogan GJ, Scalea TM.
Radiology. 2004 Jun;231(3):775-84.

Rationale for inclusion: 200 patients prospectively underwent CT scan for penetrating torso injuries with 97% sensitivity, 98% specificity for peritoneal violation.

Citations - 194 (as of July 2017)

Penetrating thoracoabdominal injuries: ongoing dilemma-which cavity and when?
Asensio JA, Arroyo H Jr, Veloz W, Forno W, Gambaro E, Roldan GA, Murray J, Velmahos G, Demetriades D.
World J Surg. 2002 May;26(5):539-43.

Rationale for inclusion: In a series of 254 patients with penetrating thoracoabdominal injuries, 44% had inappropriate sequencing, most often indicated by persistent hypotension and misleading chest tube output.

Citations - 124 (as of July 2017)

Determining the need for laparotomy in penetrating torso trauma: a prospective study using triple-contrast enhanced abdominopelvic computed tomography.
Chiu WC, Shanmuganathan K, Mirvis SE, Scalea TM.
J Trauma. 2001 Nov;51(5):860-8; discussion 868-9.

Rationale for inclusion: CT accurately predicted need for laparotomy in 71 of 75 patients.

Citations - 115 (as of July 2017)

Occult injuries to the diaphragm: prospective evaluation of laparoscopy in penetrating injuries to the left lower chest.
Murray JA, Demetriades D, Asensio JA, Cornwell EE 3rd, Velmahos GC, Belzberg H, Berne TV.
J Am Coll Surg. 1998 Dec;187(6):626-30.

Rationale for inclusion: 24% of patients with penetrating injuries of the left lower chest were found to have occult diaphragmatic injuries on laparoscopy.

Citations - 188 (as of July 2017)

Surgeon-performed ultrasound for the assessment of truncal injuries: lessons learned from 1540 patients.
Rozycki GS, Ballard RB, Feliciano DV, Schmidt JA, Pennington SD.
Ann Surg. 1998 Oct;228(4):557-67.

Rationale for inclusion: FAST was found to be most accurate in precordial wounds blunt torso injuries with hypotension in 1540 patients.

Citations - 372 (as of July 2017)

Gunshot wounds to the right thoracoabdomen: a prospective study of nonoperative management.
Renz BM, Feliciano DV.
J Trauma. 1994 Nov;37(5):737-44.

Rationale for inclusion: The first series to evaluate nonoperative management of right thoracoabdominal gunshot wounds.

Citations - 124 (as of July 2017)

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