c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Penetrating Thoracic Trauma: 4

A D V E R T I S E M E N T

   
 

An example of an emergency left anterolateral thoracotomy for a gunshot wound to the chest is shown. This incision is also the first choice for when emergency room thoracotomy is done for sudden collapse or cardiac arrest.       

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Penetrating Thoracic Trauma: 5

A D V E R T I S E M E N T

   
 

If initial exploration through a left anterolateral thoracotomy shows the need for additional exposure, the incision can be extended across the midline using sternal saw, Lebsche knife or Gigli saw to create a bilateral anterolateral thoracotomy (clamshell incision). The internal mammary arteries must be ligated. This incision is rarely used in a trauma setting anymore, and has been questioned as the standard for bilateral lung transplant because of the associated morbidity.      

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Penetrating Thoracic Trauma: 6

A D V E R T I S E M E N T

   
 

An example of the exposure from a clamshell incision is shown on a patient (who didn't make it) with a gunshot wound to the heart.       

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This page was last modified on 3/22/2002.