Thoraco-abdominal injuries: the general surgeon's perspective

Thoraco-abdominal traumatic injuries affect the inferior part of the thoracic cavity and the superior part of the abdominal cavity. This study summarizes five years of our surgical department's experience in the diagnosis and management of thoracoabdominal trauma patients.

We examined records from our surgical and emergency room departments from January 1996 to December 2000, and selected patients with thoraco-abdominal injuries.

Fifty-five patients were treated who suffered coexisting trauma of the thoracic and abdominal cavity. Males represented the majority of patients and mean age was 38.2 years. Traffic accidents were the major cause (55%) followed by criminal acts of violence (32%) and falls (13%). The most common thoracic injuries were rib fractures (40%) and simple lung contusions (35%) and the abdominal organs most commonly injured were the spleen (35%), liver (25%) and kidney (20%). Surgical interventions were performed in 68% of patients, whereas the remaining patients were treated conservatively.

Thoraco-abdominal injuries are characterized by high heterogeneity and can provide significant decision-making challenges. The accurate diagnosis of all coexisting injuries is critically important, as the diagnosis will determine surgical or non-operative management of these injuries.