Transmediastinal gunshot wounds

A reconsideration of the role of aortography

Edward E. Cornwell, Frank Kennedy, Ihab A. Ayad, Thomas V. Berne, George Velmahos, Juan A. Asensio, Demetrios Demetriades

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objective: To evaluate the contribution of aortography in the management of stable patients with transmediastinal gunshot wounds. Design: Retrospective review of clinical records. Setting: Level I urban trauma center. Patients: Forty-three patients with aortic or esophageal gunshot injuries. Interventions: Patients who were stable after initial resuscitation underwent aortography followed by esophagography. Main Outcome Measures: Hemodynamic status on admission, time devoted to diagnostic workup, surgical (or autopsy) findings, morbidity, and mortality. Results: There were 24 esophageal injuries and 20 aortic injuries. Patients with aortic injuries were less often stable for aortography (10% vs 42%; P=.02), and fewer of them survived (15% vs 58%; P=.01). In no patient was the aortic injury initially detected by aortography. Stable patients with esophageal injuries experienced an average 11-hour interval between injury and surgery (nearly 3 hours attributable to aortography). Conclusion: Esophageal evaluation should precede aortography in the workup of stable patients with transmediastinal gunshot wounds.

Original languageEnglish
Pages (from-to)949-953
Number of pages5
JournalArchives of Surgery
Volume131
Issue number9
StatePublished - Sep 1996
Externally publishedYes

Fingerprint

Aortography
Gunshot Wounds
Wounds and Injuries
Trauma Centers
Resuscitation
Autopsy
Hemodynamics
Outcome Assessment (Health Care)
Morbidity
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Cornwell, E. E., Kennedy, F., Ayad, I. A., Berne, T. V., Velmahos, G., Asensio, J. A., & Demetriades, D. (1996). Transmediastinal gunshot wounds: A reconsideration of the role of aortography. Archives of Surgery, 131(9), 949-953.

Transmediastinal gunshot wounds : A reconsideration of the role of aortography. / Cornwell, Edward E.; Kennedy, Frank; Ayad, Ihab A.; Berne, Thomas V.; Velmahos, George; Asensio, Juan A.; Demetriades, Demetrios.

In: Archives of Surgery, Vol. 131, No. 9, 09.1996, p. 949-953.

Research output: Contribution to journalArticle

Cornwell, EE, Kennedy, F, Ayad, IA, Berne, TV, Velmahos, G, Asensio, JA & Demetriades, D 1996, 'Transmediastinal gunshot wounds: A reconsideration of the role of aortography', Archives of Surgery, vol. 131, no. 9, pp. 949-953.
Cornwell EE, Kennedy F, Ayad IA, Berne TV, Velmahos G, Asensio JA et al. Transmediastinal gunshot wounds: A reconsideration of the role of aortography. Archives of Surgery. 1996 Sep;131(9):949-953.
Cornwell, Edward E. ; Kennedy, Frank ; Ayad, Ihab A. ; Berne, Thomas V. ; Velmahos, George ; Asensio, Juan A. ; Demetriades, Demetrios. / Transmediastinal gunshot wounds : A reconsideration of the role of aortography. In: Archives of Surgery. 1996 ; Vol. 131, No. 9. pp. 949-953.
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