Introduction: Thoracic wounds by firearms are frequent and severe. They may involve the patient’s prognosis. Objective: To study the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of th...Introduction: Thoracic wounds by firearms are frequent and severe. They may involve the patient’s prognosis. Objective: To study the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of the thoracic wounds by firearms. Material and method: This was a cross-sectional, descriptive study of all patients over the age of 15 who consulted in the university hospital-YO in the department of general and digestive surgery over a period of 5 years. Results: We collected 50 cases of thoracic wounds by firearms on 183 thoracic wounds with a prevalence of 27.3%. There were 48 men (96%). The average age was 30 years. The patients came from urban areas in 66% of cases;the informal sector accounted for 44% of the cases. The pistol was the most involved firearm (46.9%). The consultation period was less than 6 hours in 78% of patients. An unstable hemodynamic state was found in 42% (n = 21). A fluid and mixed pleural effusion syndrome was found in 46% and 26% of patients, respectively. Associated lesions were diaphragm involvement, and lesions of intra-abdominal hollow organs. Thoracic drainage was performed in 24 patients (48%) and was associated with a laparotomy in 8 patients. The average hospital stay was 7.5 days. Mortality was 14%. Conclusion: the thoracic wounds by firearms are frequent in civilian practice. The thoracic CT allows mapping of the lesions and thoracic drainage constitutes the essential part of surgical treatment. The fight against the proliferation of weapons deserves to be promoted.展开更多
Objective: To improve the outcome of treatment in patients with craniocerebral firearm wound. Methods: Prospectively and retrospectively reviewed a series of 93 patients presented to the Xi Jing Hospital of Fourth Mil...Objective: To improve the outcome of treatment in patients with craniocerebral firearm wound. Methods: Prospectively and retrospectively reviewed a series of 93 patients presented to the Xi Jing Hospital of Fourth Military Medical University with a diagnosis of craniocerebral firearm wound during a period of 27 years from July 1970 to July 1997. All the patients had acute craniocerebral firearm wound. Of these, it consisted of 81 males (87.1%) and 12 females (12.9%) ranging from 3 months to 58 years in age (median 24.6 years). The lesion included 16 tangential wounds, 58 tubular wounds and 19 through and through wounds. The cases were urgent and in serious and unstable condition. All the patients underwent surgical intervention and aggressive perioperative management in the neurosurgical intensive care, including resuscitative protocols. Results: After emergency treatment and operation, 9 cases died (9.7%). Follow up studies at three months postoperative showed that 56 cases (66.7%) had made good recovery. Rates of moderate disability, severe disability or vegetative state in this series were 19.0%, 10.7% and 3.6 %, respectively. Long term follow up studies (median 5.5 years) found that 42 (50.0%) were capable of resuming their occupation. Conclusions: Craniocerebral firearm wounds are often severe, needing urgent treatment for the patients. Timely, proper and thorough initial debridement are crucial for avoiding rapid neurological deterioration.展开更多
Penetrating craniocerebral firearm injuries remains one of the most lethal of all head traumas and are common in both war and peace time. Data were reviewed for 6487 moderately, severely head injuring patients (Glasgo...Penetrating craniocerebral firearm injuries remains one of the most lethal of all head traumas and are common in both war and peace time. Data were reviewed for 6487 moderately, severely head injuring patients (Glasgow Coma Scale (GCS) scores 3 to 12) tre展开更多
Appropriate management of penetrating trauma to the thorax requires knowledge of vulnating agents, as well as the principles of ballistic injury. The importance of the approach’s choice for surgical exploration of th...Appropriate management of penetrating trauma to the thorax requires knowledge of vulnating agents, as well as the principles of ballistic injury. The importance of the approach’s choice for surgical exploration of these injuries, and parietal damage, is an essential factor in decision making in the management and definition of the therapeutic strategy for these injuries. The authors report a clinical case of a penetrating traumatic ballistic wound of the thorax managed in a context of difficult diagnosis in the surgical Unit of the CHUPB.展开更多
文摘Introduction: Thoracic wounds by firearms are frequent and severe. They may involve the patient’s prognosis. Objective: To study the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of the thoracic wounds by firearms. Material and method: This was a cross-sectional, descriptive study of all patients over the age of 15 who consulted in the university hospital-YO in the department of general and digestive surgery over a period of 5 years. Results: We collected 50 cases of thoracic wounds by firearms on 183 thoracic wounds with a prevalence of 27.3%. There were 48 men (96%). The average age was 30 years. The patients came from urban areas in 66% of cases;the informal sector accounted for 44% of the cases. The pistol was the most involved firearm (46.9%). The consultation period was less than 6 hours in 78% of patients. An unstable hemodynamic state was found in 42% (n = 21). A fluid and mixed pleural effusion syndrome was found in 46% and 26% of patients, respectively. Associated lesions were diaphragm involvement, and lesions of intra-abdominal hollow organs. Thoracic drainage was performed in 24 patients (48%) and was associated with a laparotomy in 8 patients. The average hospital stay was 7.5 days. Mortality was 14%. Conclusion: the thoracic wounds by firearms are frequent in civilian practice. The thoracic CT allows mapping of the lesions and thoracic drainage constitutes the essential part of surgical treatment. The fight against the proliferation of weapons deserves to be promoted.
文摘Objective: To improve the outcome of treatment in patients with craniocerebral firearm wound. Methods: Prospectively and retrospectively reviewed a series of 93 patients presented to the Xi Jing Hospital of Fourth Military Medical University with a diagnosis of craniocerebral firearm wound during a period of 27 years from July 1970 to July 1997. All the patients had acute craniocerebral firearm wound. Of these, it consisted of 81 males (87.1%) and 12 females (12.9%) ranging from 3 months to 58 years in age (median 24.6 years). The lesion included 16 tangential wounds, 58 tubular wounds and 19 through and through wounds. The cases were urgent and in serious and unstable condition. All the patients underwent surgical intervention and aggressive perioperative management in the neurosurgical intensive care, including resuscitative protocols. Results: After emergency treatment and operation, 9 cases died (9.7%). Follow up studies at three months postoperative showed that 56 cases (66.7%) had made good recovery. Rates of moderate disability, severe disability or vegetative state in this series were 19.0%, 10.7% and 3.6 %, respectively. Long term follow up studies (median 5.5 years) found that 42 (50.0%) were capable of resuming their occupation. Conclusions: Craniocerebral firearm wounds are often severe, needing urgent treatment for the patients. Timely, proper and thorough initial debridement are crucial for avoiding rapid neurological deterioration.
文摘Penetrating craniocerebral firearm injuries remains one of the most lethal of all head traumas and are common in both war and peace time. Data were reviewed for 6487 moderately, severely head injuring patients (Glasgow Coma Scale (GCS) scores 3 to 12) tre
文摘Appropriate management of penetrating trauma to the thorax requires knowledge of vulnating agents, as well as the principles of ballistic injury. The importance of the approach’s choice for surgical exploration of these injuries, and parietal damage, is an essential factor in decision making in the management and definition of the therapeutic strategy for these injuries. The authors report a clinical case of a penetrating traumatic ballistic wound of the thorax managed in a context of difficult diagnosis in the surgical Unit of the CHUPB.
