Penetrating Thoracic Traumas: Clinical Profile and Management Strategies

<bold>Introduction:</bold> Penetrating thoracic traumas(PTT) present a significant challenge for both pre-hospital and trauma hospital teams, often associated with increased morbidity and mortality compared to closed thoracic traumas The aim of our study was to evaluate PTT management, and to analyse modalities <bold>Methods:</bold> We conducted a retrospective and descriptive study including all patients admitted for PTT in the department of Cardiovascular and Thoracic Surgery of CHU Habib Bourguiba between January 2018 and December 2023 <bold>Results:</bold> We gathered data from 73 cases of PTT, with an average annual incidence of 24.3 cases per year. The male-female ratio was 32:4. Most PTT cases resulted from assaults (86.3%), while other causes included workplace accidents, firearm injuries and public road accidents. Sharp weapons were identified as the primary causative agent in 84.9% of cases. The most frequent lesions observed were pneumothorax (69.9%), hemothorax (50.7%), and pulmonary contusion (38.4%). Additionally, PTT was found to be associated with extra-thoracic injuries in 12.3% of cases, particularly abdominal traumas. Conservative treatmentwas the most common attitude(58.9%), followed by thoracic drainage (35.6%) and surgical intervention (5.5%). Among surgical interventions, posterolateral thoracotomy was performed in 19.2% of cases, and 50% of operated cases underwent elective surgery. The mean hospitalization duration was 4.5 days. Postoperative complications were observed in 25% of operated cases, while the overall mortality rate was 2.7% <bold>Conclusion:</bold> Surgical management of PTT is guided by hemodynamic stability and the mechanism of injury. Early mortality, often due to haemorrhage, underscores the urgent need for timely intervention