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Sun Sep 13 17:31:23 BST 2009

It is nice when Dr Mattox and I both agree 

Norman

Norman McSwain MD
Professor - Tulane Univ. SOM
Trauma Director - Charity Hospital
504 988 5111

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of KMATTOX at aol.com
Sent: Sunday, September 13, 2009 11:24 AM
To: trauma-list at trauma.org
Subject: Re: GSW Mediastinal Travverse

BINGO.    You are learning.  I think we go to the CT  because all trauma

surgeons and emergency physicians must have stock in the  companies that
make 
the CT scanners.    The chest X-ray showed a  left hemothorax,
unevacuated 
completely, and with 1000 ml in the chest  collection system, and a 
trajectory which suggested an esophageal  injury.   There was clear
indication for a 
left thoracotomy, and at  the left thoracotomy, the surgeon states they
saw 
the esophageal injury,  confirmed by endoscopy.     At a T-2 location,
this 
is clear  indication for a RIGHT posterolateral thoracotomy 4th  
interspace..    

In a message dated 9/13/2009 11:17:50 A.M. Central Daylight Time,  
rfsmithmd at comcast.net writes:

OK, so  why go to CT then, with a pt. who's bp is in the  40s?

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GSW Mediastinal Travverse