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Mediastinal Vessels

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Penetrating Trauma

Abstract

Penetrating injuries to the mediastinal great vessels are daunting for even the most experienced trauma surgeon. The anatomy, clinical presentation and patterns of injury will be discussed. A practical management framework for the surgeon is presented, giving a strategy to approaching and dealing with these critically ill patients, detailing resuscitative strategies and surgery, screening investigations, and when and where to operate. The use of endovascular approaches and bypass/shunting is discussed. Individual injuries are described and a viable approach and repair technique detailed, including some less covered but important injuries. Finally, outcomes and complications with relevant factors are detailed.

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Further Reading

  • Burack JH, Kandil E, Sawas A et al (2007) Triage and outcome of patients with mediastinal penetrating trauma. Ann Thorac Surg 83(2):377–382; discussion 382

    Article  PubMed  Google Scholar 

  • Degiannis E, Benn CA, Leandros E et al (2000) Transmediastinal gunshot injuries. Surgery 128(1):54–58

    Article  PubMed  CAS  Google Scholar 

  • Demetriades D (1997) Penetrating injuries to the thoracic great vessels. J Card Surg 12(2 Suppl):173–179; discussion 179–180

    PubMed  CAS  Google Scholar 

  • Demetriades D, Theodorou D, Murray J et al (1996) Mortality and prognostic factors in penetrating injuries of the aorta. J Trauma 40(5):761–763

    Article  PubMed  CAS  Google Scholar 

  • Deneuville M (2000) Injury of the pulmonary artery and its branches due to penetrating chest trauma. Ann Vasc Surg 14(5):463–467

    Article  PubMed  CAS  Google Scholar 

  • du Toit DF, Odendaal W, Lambrechts A et al (2008) Surgical and endovascular management of penetrating innominate artery injuries. Eur J Vasc Endovasc Surg 36(1):56–62

    Article  PubMed  Google Scholar 

  • Fulton JO, de Groot KM, Buckels NJ et al (1997) Penetrating injuries involving the intrathoracic great vessels. S Afr J Surg 35(2):82–86

    PubMed  CAS  Google Scholar 

  • Hanpeter DE, Demetriades D, Asensio JA et al (2000) Helical computed tomographic scan in the evaluation of mediastinal gunshot wounds. J Trauma 49(4):689–694; discussion 694–685

    Article  PubMed  CAS  Google Scholar 

  • Ibirogba S, Nicol AJ, Navsaria PH (2007) Screening helical computed tomographic scanning in haemodynamic stable patients with transmediastinal gunshot wounds. Injury 38(1):48–52

    Article  PubMed  Google Scholar 

  • Marin ML, Veith FJ, Panetta TF et al (1994) Transluminally placed endovascular stented graft repair for arterial trauma. J Vasc Surg 20(3):466–472; discussion 472–463

    Article  PubMed  CAS  Google Scholar 

  • McGrath EE, Blades Z, Anderson PB (2010) Chylothorax: aetiology, diagnosis and therapeutic options. Respir Med 104(1):1–8

    Article  PubMed  Google Scholar 

  • Michelassi F, Pietrabissa A, Ferrari M et al (1990) Bullet emboli to the systemic and venous circulation. Surgery 107(3):239–245

    PubMed  CAS  Google Scholar 

  • Pate JW, Cole FH Jr, Walker WA et al (1993) Penetrating injuries of the aortic arch and its branches. Ann Thorac Surg 55(3):586–592

    Article  PubMed  CAS  Google Scholar 

  • Renz BM, Cava RA, Feliciano DV et al (2000) Transmediastinal gunshot wounds: a prospective study. J Trauma 48(3):416–421; discussion 421–412

    Article  PubMed  CAS  Google Scholar 

  • Roye GD, Zorn GL, McGiffin DC et al (1995) Acute repair of aorta-innominate vein fistulas. J Trauma 39(4):753–756

    Article  PubMed  CAS  Google Scholar 

  • Schonholz CJ, Uflacker R, De Gregorio MA et al (2007) Stent-graft treatment of trauma to the supra-aortic arteries. A review. J Cardiovasc Surg(Torino) 48(5):537–549

    CAS  Google Scholar 

  • Stassen NA, Lukan JK, Spain DA et al (2002) Reevaluation of diagnostic procedures for transmediastinal gunshot wounds. J Trauma 53(4):635–638; discussion 638

    Article  PubMed  Google Scholar 

  • Subramanian A, Vercruysse G, Dente C et al (2008) A decade’s experience with temporary intravascular shunts at a civilian level I trauma center. J Trauma 65(2):316–324; discussion 324–316

    Article  PubMed  Google Scholar 

  • Wall MJ Jr, Mattox KL, Debakey ME (2006) Injuries to the azygous venous system. J Trauma 60(2):357–362

    Article  PubMed  Google Scholar 

  • Yee ES, Verrier ED, Thomas AN (1983) Management of air embolism in blunt and penetrating thoracic trauma. J Thorac Cardiovasc Surg 85(5):661–668

    PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham Research Park, Vincent Drive, B15 2SQ, Birmingham, UK

    Philip R. Calderbank, Nigel R. M. Tai & Douglas M. Bowley

Authors
  1. Philip R. Calderbank
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  2. Nigel R. M. Tai
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  3. Douglas M. Bowley
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Corresponding author

Correspondence to Douglas M. Bowley .

Editor information

Editors and Affiliations

  1. Dept. Surgery, Massachusetts General Hospital, Fruit Street 55, Boston, 02114, Massachusetts, USA

    George C. Velmahos

  2. Medical School, Dept. Surgery, University of Witwatersrand, York Road 7, Johannesburg, 2193, South Africa

    Elias Degiannis

  3. Klinik für Viszeral-, Thorax- und, Gefäßchirurgie, Univ.Klinikum Marburg, Baldingerstraße, Marburg, 35043, Germany

    Dietrich Doll

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© 2012 Springer Berlin Heidelberg

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Calderbank, P.R., Tai, N.R.M., Bowley, D.M. (2012). Mediastinal Vessels. In: Velmahos, G., Degiannis, E., Doll, D. (eds) Penetrating Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-20453-1_34

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  • DOI: https://doi.org/10.1007/978-3-642-20453-1_34

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-20452-4

  • Online ISBN: 978-3-642-20453-1

  • eBook Packages: MedicineMedicine (R0)

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