Experience in performing a simultaneous operation in the case of a gunshot wound to the chest

A clinical case of a chest gunshot wound in a private conscript is described. On admission, a gunshot (bullet) blind penetrating wound of the left half of the chest, a closed injury of the abdomen was diagnosed. Based on radiography and computed tomography data, combined damage to the chest and abdomen was established; bullet blind penetrating wound of the left half of the chest with a foreign body S9 lung; closed injury of the abdomen with damage to the spleen 2 degrees. According to the conclusion of the consultation, the patient was shown a planned simultaneous operation in the volume of laparotomy, splenectomy, revision of the left dome of the diaphragm, thoracoscopic resection of the S9 left lung with a foreign body (bullet). At the first stage of the operation, median laparotomy was performed, revision of the abdominal organs and the left diaphragm dome. Adhesiolysis, evacuation of the subphrenic hematoma, typical splenectomy, drainage of the left subdiaphragmatic space were performed. At the second stage, after a thoracoscopic revision of the organs of the left hemithorax, an atypical resection of the IX segment of the lung with a foreign body was performed using an endoscopic stapler. The postoperative period was uneventful. This clinical case shows the possibility of performing a planned simultaneous operation («laparotomy-thoracoscopy») in the early periods after a gunshot wound to the lung.

chest gunshot wound, closed abdominal trauma, simultaneous operation