Clinical Observation of 127 Cases of Wounds of Chest in Viet-Nam War

월남전에서 치험한 흉부손상 120례에 대한 임상적 고찰

During the 35 month period from November 1966 to November 1967 and from June 1971 to March 1973 I had experienced 127 cases of non fatal wounds of chest in Viet-Nam. .Among these 127 cases, 62[45.4%] were gun shot wounds, 49[35.8%] were shrapnel wounds and the other were traffic accident. stab wounds and miscellanous. Approximately 21% of gun shot wound were perforating and 79% were penetrating but all cases of shrapnel wounds were penetrating. Of these 127 cases. 90% evacuated to hospital within 6 hours and average time 2.5 hours. The tranfusion requirement of these cases ranged from zero to 36 pints of whole blood with an average of 2.600cc. Initial intrathoracic findings were hemopneumothorax and hemothorax mostly. and the incidence of open thoracotomy was 9.5%[12cases] and closed thoracotomy was 82.8%[104cases], which were contrast to the reports from Korean conflict. I had experienced 24 cases with complication, such as large hematoma in lung parenchyme[8 cases], atelectasis[4 cases], pyothorax [3 cases], pneumonia [3 cases], fibrothorax [3 cases], pleural effusion [2 cases] and wound infection [2 cases]. Mortality rate for entire group was 4.7% but the cases associated with brain injury was 100%, with spinal cord injury was 50%, with large vessel 50%, and abdominal injury was 33.3%, and nobody died solely of thoracic injury.