Diagnosis and Management of Penetrating Thoracic Vascular Injury

Although penetrating vascular injuries only account for a small portion of thoracic trauma, they are challenging and can be lethal. Thus, it is imperative that the trauma surgeon understands how to diagnose and manage them. An abnormal pulse exam, an expanding hematoma, or active external hemorrhage are clear signs of a vascular injury. Imaging studies, such as CT angiography, provide valuable information in the hemodynamically normal patient. The patient who is hemodynamically compromised or hypotensive or both requires emergent exploration.