Gunshot wounds traversing the mediastinum: guidelines for evaluation and management
Falcon, O.; Knott-Craig, C.J.; Elkins, R.C.
Journal of the Oklahoma State Medical Association 87(4): 174-177
1994
ISSN/ISBN: 0030-1876 PMID: 8006725 Document Number: 430084
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.