IMMEDIATE THORACOTOMY FOR A STAB WOUND OF THE HEART.
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PENETRATING WOUNDS of the chest involving the heart may allow survival for a variable period of time after injury. In those wounds that are not rapidly fatal, a fairly uniform approach has evolved in which cardiac tamponade is treated by pericardial aspiration, and shock with blood transfusion.1-4Failure to respond to these measures, or recurring tamponade, requires a planned thoracotomy. Some have proposed a planned thoracotomy for all such wounds.5, 6 An occasional patient will survive long enough to get to a hospital but will die shortly thereafter. Such patients have not been included in treated series because of the overwhelming problems involved. The following case illustrates a problem in which an immediate thoracotomy in an emergency room a few minutes after admission was necessary and successful. Report of a Case A 27-year-old man was admitted to the emergency ward with a 3 cm stab wound in the
[1] E. H. Ellison,et al. CURRENT SURGICAL MANAGEMENT , 1958 .
[2] M. Avecilla. The Management of Wounds of the Heart. A Recent Series of 43 Cases with Comment on Pericardicentesis in Hemopericardium , 1956, Annals of surgery.
[3] M. DeBakey,et al. Treatment of penetrating wounds of the heart: experimental and clinical observations. , 1955, Surgery.
[4] D. Elkin,et al. CARDIAC TAMPONADE: TREATMENT BY ASPIRATION , 1951, Annals of surgery.