Background: Penetrating injuries to the chest present a frequent and challenging problem.
The majority of these injuries can be managed non-operatively. The selection of patients for
operation or observation can be made by clinical examination and appropriate investigations.
This study is conducted to present our experience in management of the chest gunshot during
Libyan revolution and in a situation where the basic diagnostic tool (X-ray) was unavailable.
Methods: we retrospectively reviewed 32 patients seen at our hospital over a 6-day period
during revolution (16-21 Feb). The data evaluated and analysed.
Results: The group comprised 32 male patients, with a mean age of 29 years (17-58). Of
these patients,17 (53.2%) had left-sided, 15 (46.8%) had right-sided, 19(59.4%) had isolated
chest injury and 13 (40.6%) patients had associated other injuries.. Thorcostomy tube was
the only therapy required in 19 patients (59.4%), whereas 13 patients (40.6%) underwent
thoracotomy and exploration. Mean hospitalization period for patients with thoracostomy tube
was 6 days whereas median hospitalization duration in the exploration group was 9 days.
Complications recorded in 2 cases.
Conclusion: In this study we emphasize that in the situation where x-ray is not available , the
clinical examination, pleural aspiration and the thoracostomy tube are the appropriate
methods of managing penetrating chest injuries.
Keywords: Penetrating thoracic trauma, tube thoracostomy, thoracotomy

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