Falcon O, Knott-Craig C J, Elkins R C
Division of Thoracic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City 73190.
J Okla State Med Assoc. 1994 Apr;87(4):174-7.
When there is suspicion that a penetrating would to the chest has crossed the midline, it is incumbent upon the medical staff to actively exclude injuries to mediastinal structures such as the heart, aortic arch, bronchial tree, and esophagus, even though injury to such structures may not be immediately clinically apparent. The successful management of a patient with a gunshot wound apparently traversing the anterior mediastinum is presented; an esophagram identified an unsuspected through-and-through injury to the esophagus. The evaluation of this patient is discussed, and an algorithm for the evaluation and management of similar patients is proposed.
当怀疑胸部贯通伤已越过中线时，医务人员有责任积极排除纵隔结构如心脏、主动脉弓、支气管树和食管的损伤，即使此类结构的损伤在临床上可能不会立即显现。本文介绍了一名枪伤明显穿过前纵隔患者的成功治疗情况；食管造影发现了一处此前未被怀疑的食管贯通伤。文中讨论了该患者的评估过程，并提出了类似患者评估和治疗的算法。
