Thoracic Gun-shot Injury: Single Institute Experience in Taiwan

Abstract

Objective: Firearm-related injuries pose a serious public health problem and are increasingly the focus of public health concern. We present our clinical experience of the management of thoracic gun-shot injury. Methods: We retrospectively reviewed 285 patients with gun-shot injuries who were admitted to our hospital via the Emergency Department between 1995 and 2010. Patients with thoracic gun-shot injury were included, but patients who died before admission were excluded. We reviewed the demographic data, management, and outcomes of all patients with thoracic gun-shot injury. Results: Of the total patients with gun-shot injuries, 45 (17.79%) had thoracic injuries. The mean age of the patients with thoracic gun-shot injury was 24.56 years and the median age range was 21-25 years. The most common type of weapon was a rifle (68.89%), followed by a handgun (17.78%). The motive was suicide in 42.22% of patients, and homicide in 28.89%. The most common imaging finding on chest radiography was haemopneumothorax (75.56%), followed by rib fracture (31.11%), and intrapulmonary haemorrhage (31.11%). Of these patients, 42.22% underwent a simple tube thoracostomy, 33.33% a thoracotomy, and 17.78% a thoracotomy combined with laparotomy. One patient underwent thoracoscopic surgery to check bleeding and wedge resection of the lung. The most common associated abdominal injury was an injured spleen. Three patients underwent emergency thoracostomy because of great vessel injury right ventricle injury, dorsal scapular artery injury, and subclavian artery injury). All patients recovered well after surgery, except one who died (2.22%). Conclusions: Patients who experience gun-shot injuries are statistically likely to be young. The accurate diagnosis of associated injuries and aggressive management resulted in good prognosis.