Background Penetrating vertebral artery injuries (VAIs) are rare, difficult to diagnose, and pose a challenge to surgeons, given their complex anatomy and difficult surgical exposure. Due to the rarity of these injuries, few surgeons and trauma centers have developed a…
Carotid arterial injuries are the most difficult and certainly the most immediate life-threatening injuries found in penetrating neck trauma. Their propensity to bleed actively and potentially occlude the airway makes surgical intervention very challenging. Their potential for causing fatal neurologic…
The diagnosis of vascular trauma is usually not a problem, as most injuries manifest overt blood loss, shock, or loss of critical pulses. However, in certain instances, the lesion may not be recognized initially, only to manifest itself later by…
From Egyptian, Greek, and Roman battlefields centuries ago, extremity vascular injuries were identified and treated. Subsequently, knowledge regarding the management of vascular trauma has also been gained from more modern military conflicts. Napoleon’s surgeon Larrey was an expert with rapid…
Exsanguination has been defined as an extreme form of hemorrhage with ongoing bleeding that, if not surgically controlled, will lead to death. Exsanguination is second only to neurologic injury among causes of fatality after trauma. Therefore, the speed by which…
After blunt or penetrating abdominal trauma, the major sites of hemorrhage are the viscera, mesentery, and major abdominal vessels ( Figs. 1–3 ). “Abdominal vascular injury” refers to injury to major intraperitoneal and retroperitoneal vessels and is classified into four…
Penetrating cardiac injuries Historical perspective Cardiac injuries have been described since ancient times. The earliest descriptions of a cardiac injury are found in the Iliad and in the Edwin Smith Papyrus , written in approximately 3000 bc . Hippocrates stated…
Chest injuries were reported in the Edwin Smith Surgical Papyrus as early as 3000 bc . Ancient Greek chronicles reveal examples of penetrating chest wounds and pulmonary injuries; the Greeks had anatomic knowledge and were cognizant of the thoracic structures…
Thoracic injury is a significant cause of morbidity and death. Rib fractures, one of the most common manifestations of thoracic injury, are frequently encountered in victims of trauma. For example, 94% of severely or fatally injured seatbelt wearers have rib…
Emergency department thoracotomy (EDT) remains a formidable tool within the trauma surgeon’s armamentarium. Since its introduction during the 1960s, the use of this procedure has ranged from sparing to liberal. At many urban trauma centers, this procedure has found a…