Transmediastinal gunshot wounds: A reconsideration of the role of aortography

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

Research output: Contribution to journalArticle

34 Scopus citations

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

All Science Journal Classification (ASJC) codes

  • Surgery

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    Cornwell, E. E., Kennedy, F., Ayad, I. A., Berne, T. V., Velmahos, G., Asensio, J., & Demetriades, D. (1996). Transmediastinal gunshot wounds: A reconsideration of the role of aortography. Archives of Surgery, 131(9), 949-953. https://doi.org/10.1001/archsurg.1996.01430210047009