+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Prospective trial of the six hour rule in stab wound of the chest

, : Prospective trial of the six hour rule in stab wound of the chest. Surgery Gynecology & Obstetrics 169(3): 223-225

Stab wounds of the chest may be associated with a spectrum of injuries ranging from the lethal to the insignificant. The management of asymptomatic patients with the stab wounds of the chest is controversial. The results of previous reports have asserted that asymptomatic patients with stab wounds of the chest do not have delayed complications develop if roentgenograms of the chest taken six hours after the injury are normal. This "rule" has not been validated. A three year, prospective study of patients with stab wounds of the chest was done. Patients were excluded from the study if they had symtpoms on arrival, evidence of physiologic derangement caused by intrathoracic injury, wounds near the subclavian vessels or precordial wounds. Patients with lower thoracic stab wound were evaluated by diagnostic peritoneal lavage. If findings from lavage were negative, the patients were included in the study. One hundred and five patients met the criteria for inclusion in the study group. All of the patients were hospitalized and examined serially. All had roentgenograms of the chest performed at admission, at six hours and at 24 hours. Four patients had apneumothorax or hemothorax develop between the time of admission and six hours of hospitalization. In the remaining 101 patients, none had a pneumothorax or hemothorax between six and 24 hours. No patient asymptomatic on admission had a tension pneumothorax develop later. No patient had delayed evidence of abdominal injury. An asymptomatic patient with a stab wound of the chest that is not precordial, not in proximity to the subclavian artery and not suspected of diaphragmatic penetration should be serially examined and have a follow-up roentgenogram of the chest at six hours. If the patient remains asymptomatic and the six hour film is normal, delayed complications are rearely, if ever, encountered and the patient does not require further studies or hospitalization. The six hour rule for stab wounds of the chest is valid.


PMID: 2772791

Other references

Peppe, A.; Pierantozzi, M.; Chiavalon, C.; Marchetti, F.; Caltagirone, C.; Musicco, M.; Stanzione, P.; Stefani, A., 2011: Deep brain stimulation of the pedunculopontine tegmentum and subthalamic nucleus: effects on gait in Parkinson's disease. This study examines the effects of subthalamic nucleus (STN) deep brain stimulation (DBS) and pedunculopontine tegmentum (PPTg) DBS in advanced Parkinson's disease using gait analysis. Five people underwent bilateral DBS in both the STN and P...

Macedo, W., 1985: Effect of sources and rates of phosphorus and lime applied to pastures in Rio Grande do Sul. In field trials at 4 sites in Rio Grande do Sul, Brazil in 1979-82, 0-259 kg P2O5/ha was applied as triple superphosphate, Gafsa phosphate or Marrocos phosphate before sowing a Festuca arundinacea cv. K 31/Trifolium pratense cv. Montgomery/Lotus c...

Goel, A.; Nguyen, T-Phuong.; Leung, H-Chiu.E.; Nagasaka, T.; Rhees, J.; Hotchkiss, E.; Arnold, M.; Banerji, P.; Koi, M.; Kwok, C-To.; Packham, D.; Lipton, L.; Boland, C.Richard.; Ward, R.L.; Hitchins, M.P., 2011: De novo constitutional MLH1 epimutations confer early-onset colorectal cancer in two new sporadic Lynch syndrome cases, with derivation of the epimutation on the paternal allele in one. Lynch syndrome is an autosomal dominant cancer predisposition syndrome classically caused by germline mutations of the mismatch repair genes, MLH1, MSH2, MSH6 and PMS2. Constitutional epimutations of the MLH1 gene, characterized by soma-wide methy...

Cane, Violet R., 1967: Mathematical models for neural networks. There are 2 problems for which a network model is required: to discuss the way in which excitation flows through nerve tissue and to discuss the behavior of a brain as a whole. The complexity of connection of actual nerve cells, and the fact that...

Gilden, D.; Cohrs, R.J.; Mahalingam, R.; Nagel, M.A., 2010: Neurological disease produced by varicella zoster virus reactivation without rash. Reactivation of varicella zoster virus (VZV) from latently infected human ganglia usually produces herpes zoster (shingles), characterized by dermatomal distribution pain and rash. Zoster is often followed by chronic pain (postherpetic neuralgia o...

Starinsky-Elbaz, S.; Faigenbloom, L.; Friedman, E.; Stein, R.; Kloog, Y., 2010: The pre-GAP-related domain of neurofibromin regulates cell migration through the LIM kinase/cofilin pathway. Neurofibromin contains several domains, most notably a GAP-related domain (GRD), that down-regulates Ras pathways. The functions of the non-GRD neurofibromin domains are largely known. Here we show that the pre-GRD region of neurofibromin alters t...

Prantl, F., 1940: Poznamky k nomenklatura ceskych trilobitu (Bemerkungen zu der Nomenklatur der bohmischen Trilobiten) Cas. Narod Mus Prag, 1142: 98-102

Anderson, D.W., 2002: Bilateral diaphragm rupture: a unique presentation. Journal of Trauma 52(3): 560-561

Thomson Robert, 1945: Some recent developments in the Dogpaw-Kakagi Lakes area, Ontario. Precambrian (Winnipeg): , Pages 8-9. 1945.

Fong, N.P.; Ray, R., 1988: Perception of the elderly towards services provided at the senior citizens' health care centre: a community-based survey, 1987. Singapore Medical Journal 29(4): 341-346