[Thorax trauma].

263 patients with severe thoracic trauma were treated between 1961 and 1977. In 219 cases, most of them being traffic accidents, the injury was caused by blunt trauma. 80% were thoracic emergencies. Injuries of the mediastinal organs were observed in 26 cases. Even the slightest suspicion of injuries of the airways demands bronchoscopy. In case of rupture early surgical intervention gives the best results. 3 of 7 patients with tracheo-bronchial rupture were saved. Complete rupture of the large vessels of the myocardium leads to fatal bleeding. Partial rupture can be survived. Angiography gives proof of dissecting aneurysm. 2 of our patients with traumatic aneurysms of the aorta have survived after resection of the aneurysm and interposition of a prosthesis. Massive bleeding into the pericardium causes shock and high venous pressure in most cases. In 2 cases of traumatic valve insufficiency a Björk-Shiley-valve could be implanted sucessfuly. Perforating thoracic injuries have been observed in 44 of our patients; 7 died. Besides surgical wound care and intravenous fluids, Bülau's drainage is often the only treatment necessary. While intraabdominal lesions require immediate laparotomy, lesions of the lung generally do not demand thoracotomy. However, whenever there is suspicion of injury to the mediastinal organs immediate surgery has to be performed.