Transmediastinal and Thoracoabdominal Injuries: Damage Control and Surgical Techniques for Their Management
Thoracoabdominal and transmediastinal injuries represent some of the most challenging injuries facing trauma surgeons. The diagnostic challenge of multiple body cavity injuries, the notorious difficulty of establishing the proper sequence for intervention, the injury severity and frequent hemodynamic instability, and the inherent danger of cross-cavity contamination conspire to increase morbidity and mortality for these injuries. Herein, we describe the evolution of diagnostic and operative techniques for thoracoabdominal and transmediastinal injuries. With a focus on operative management and decision considerations for these vexing and lethal injuries we describe evidence-based management guidelines and surgical techniques for transmediastinal penetrating injuries, thoracoabdominal penetrating, and damage control cardiothoracic surgery. This text can be used as a reference for the surgeon who seeks a foundational knowledge for the management of these injuries.
