World J. Surg. 22, 438–442, 1998
WORLD Journal of SURGERY
© 1998 by the Socie´te´
Internationale de Chirurgie
Penetrating Chest Injuries: Unusually High Incidence of High-velocity Gunshot Wounds in Civilian Practice
Ilhan Inci, M.D.,1 Cemal Ozcelik, M.D.,1 Ibrahim Tac¸yildiz, M.D.,1 Ozgur Nizam, M.D.,
1Department of Thoracic and Cardiovascular Surgery, School of Medicine, Dicle University, Diyarbakir, 21280, Turkey
2Department of General Surgery, Dicle University, School of Medicine, Diyarbakir 21280, Turkey
Abstract. Penetrating chest injuries are a challenge to the thoracic or
trauma surgeon. Penetrating thoracic trauma, especially that due to
high-velocity gunshot wounds, is increasing at an alarming rate in our
region. We report our experience with penetrating chest injuries mainly
due to high-velocity gunshot wounds. During a period of 6 years we
retrospectively reviewed the hospital records of 755 patients admitted to
the Department of Thoracic and Cardiovascular Surgery, Dicle University
School of Medicine, with the diagnosis of penetrating thoracic trauma.
The mean age was 27.48 years, and 89.8% were male. The causes of
penetrating injury were stab wounds in 45.3% and gunshot wounds in
54.7%. About 30% of the wounds were due to high-velocity gunshots; and
among the gunshot wounds 56.2% were due to high-velocity shots. The
most common thoracic injury was hemothorax (n 5 190) followed by
hemopneumothorax (n 5 184). Isolated thoracic injuries were found in
53% of the patients. Nonoperative management was sufficient in 92% of
the patients. Thoracotomy was performed in 8.1%. The mean duration of
hospitalization was 11.2 days. The mean injury severity score (ISS) was
20.17 6 13.87. The morbidity was 23.3% and the mortality 5.6%. Fifty
percent of all deaths were due to adult respiratory distress syndrome.
Altogether 17% of patients with an ISS >25 died, whereas only 0.9% of
those with a score <16 died. The mortality due to firearms was 8.95%. We
concluded that in civilian practice chest tube thoracostomy remains by far
the most common method of treating penetrating injury to the chest. The
easy availability of high-velocity guns will continue to increase the
number of civilians injured by these weapons.
World J. Surg. 22, 438–442, 1998
WORLD Journal of SURGERY
© 1998 by the Socie´te´
Internationale de Chirurgie
Penetrating Chest Injuries: Unusually High Incidence of High-velocity Gunshot Wounds in Civilian Practice
Ilhan Inci, M.D.,1 Cemal Ozcelik, M.D.,1 Ibrahim Tac¸yildiz, M.D.,1 Ozgur Nizam, M.D.,
1Department of Thoracic and Cardiovascular Surgery, School of Medicine, Dicle University, Diyarbakir, 21280, Turkey
2Department of General Surgery, Dicle University, School of Medicine, Diyarbakir 21280, Turkey
Abstract. Penetrating chest injuries are a challenge to the thoracic or
trauma surgeon. Penetrating thoracic trauma, especially that due to
high-velocity gunshot wounds, is increasing at an alarming rate in our
region. We report our experience with penetrating chest injuries mainly
due to high-velocity gunshot wounds. During a period of 6 years we
retrospectively reviewed the hospital records of 755 patients admitted to
the Department of Thoracic and Cardiovascular Surgery, Dicle University
School of Medicine, with the diagnosis of penetrating thoracic trauma.
The mean age was 27.48 years, and 89.8% were male. The causes of
penetrating injury were stab wounds in 45.3% and gunshot wounds in
54.7%. About 30% of the wounds were due to high-velocity gunshots; and
among the gunshot wounds 56.2% were due to high-velocity shots. The
most common thoracic injury was hemothorax (n 5 190) followed by
hemopneumothorax (n 5 184). Isolated thoracic injuries were found in
53% of the patients. Nonoperative management was sufficient in 92% of
the patients. Thoracotomy was performed in 8.1%. The mean duration of
hospitalization was 11.2 days. The mean injury severity score (ISS) was
20.17 6 13.87. The morbidity was 23.3% and the mortality 5.6%. Fifty
percent of all deaths were due to adult respiratory distress syndrome.
Altogether 17% of patients with an ISS >25 died, whereas only 0.9% of
those with a score <16 died. The mortality due to firearms was 8.95%. We
concluded that in civilian practice chest tube thoracostomy remains by far
the most common method of treating penetrating injury to the chest. The
easy availability of high-velocity guns will continue to increase the
number of civilians injured by these weapons.