ArticleInternational journal of emergency medicine2025
Minimally invasive management of penetrating thoracic and abdominal injuries: a case series.
Article in International journal of emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Case Report: Self-limiting penetrating cardiothoracic injury from a barbed shark dart involving the right atrium.Frontiers in cardiovascular medicine · 2026Article
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Abstract
backgroundPenetrating thoracic and abdominal trauma presents a diagnostic and therapeutic challenge in the emergency department (ED). Traditionally managed with open laparotomy or thoracotomy, advances in minimally invasive surgery (MIS) have enabled safe, effective, and rapid diagnosis and intervention. We present a case series of four patients with penetrating gastric, hepatic, and pulmonary injuries successfully managed using MIS, highlighting its role in emergency care. CASE PRESENTATIONS: Four hemodynamically stable patients presented to the ED with penetrating abdominal or thoracic trauma: (1) Stab wound to epigastrium: Diagnostic laparoscopy revealed a 1 cm anterior gastric body perforation, repaired laparoscopically. The patient recovered uneventfully and remained asymptomatic at 3-year follow-up. (2) Gunshot to upper abdomen: Laparoscopic wedge resection of a gastric cardia perforation was performed. Recovery was uneventful, with 1-year follow-up showing no complications. (3) Gunshot to right upper abdomen with hepatic injury: Laparoscopic hemostasis and bullet extraction under fluoroscopy were successfully performed. Four-year follow-up was uneventful. (4) Gunshot to left upper chest: Video-assisted thoracoscopic left upper lobe segmentectomy and bullet extraction were carried out. Five-year follow-up revealed preserved pulmonary function and no complications. DISCUSSION: Early identification and triage in the ED, combined with MIS, enabled rapid diagnosis and definitive treatment while minimizing morbidity. Laparoscopy and thoracoscopy provide excellent visualization, reduce unnecessary open procedures, and shorten hospital stays.
conclusionMIS is a safe, effective, and feasible approach for selected hemodynamically stable penetrating thoracic and abdominal injuries in the ED. Careful patient selection and surgical expertise are essential for optimizing outcomes.
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