Chest Trauma – Transmediastinal Wounds
For patients who have sustained gunshot wounds that have traversed the mediastinum and who are unstable, immediate operative repair is necessary.
For those patients who are hemodynamically stable the question is somewhat controversial, some surgeons would advocate immediate exploration whilst other would advocate a more conservative approach with CT scanning.
Advocates of the conservative approach indicate that 68% of patients who were stable following a transmediastinal gunshot wound had no injuries on CT scanning and were safely observed, no late complications were reported.
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