BACKGROUND: Military surgery has seen the arrival of the critical care provision and cross-sectional imaging enjoyed by civilian @entity130 surgeons. @entity130 to the thoracoabdominal region is uncommon but potentially devastating. The aim of this study was to analyze recent military experience of managing this injury complex. METHODS: The study is a retrospective analysis of @entity1 , admitted over a 12-month period, to the British Military Hospital in Afghanistan with ballistic thoracoabdominal injuries. RESULTS: In total, 27 @entity1 sustained combined @entity130 with a mean new injury severity score of 29  12, revised @entity130 score of 5.94  2.93 and predicted survival of 71.1%  39.1%. In all, 20 (74%) @entity1 underwent immediate operation, and 7 (26%) were initially managed nonoperatively. Of those requiring surgery, 11 required laparotomy and tube thoracostomy, and 9 required thoraco-laparotomy. Of the seven casualties who were initially observed and/or further investigated, two required laparotomy following computed tomography scanning, and five were managed conservatively, two of whom required delayed surgery. There were nine fatalities, all within 16 days of being wounded. Four @entity1 died from exsanguination, one from a @entity131 , and four from @entity177 . Five @entity1 presented with @entity1167 , two of whom survived. CONCLUSIONS: Exploration remains the default treatment. Resuscitative thoracotomy may yield unexpected survivors, even if subsequent laparotomy is required. Nonoperative management appears to be feasible in a small proportion of @entity1 but requires careful selection supported by cross-sectional imaging.

Ballistic XXXX : analysis of recent military experience in afghanistan.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity131 :: ('MESH:D001930', 'Disease') :: ['traumatic brain injury'] @entity177 :: ('MESH:D051437', 'Disease') :: ['multiorgan failure'] @entity1167 :: ('MESH:D006323', 'Disease') :: ['cardiac arrest'] @entity130 :: ('MESH:D014947', 'Disease') :: ['Ballistic injury', 'thoracoabdominal injury', 'trauma']
@entity130 :: (MESH:D014947,Disease) :: ['thoracoabdominal injury']
