Damage control thoracotomy with chest packing for hemorrhage control in massive hemothorax and shock: a case report

Severe hemorrhagic shock is a leading cause of death among potentially salvageable casualties. We report the case of a 24-year-old man who sustained a gunshot wound to the right hemithorax and presented with class IV hemorrhagic shock. He underwent resuscitative damage control via a right posterolateral thoracotomy. Intraoperatively, the bleeding source was identified as a lacerated posterior intercostal artery at the level of the 11th dorsal vertebra. Because access to the bleeding site remained limited even after extending the incision, right thoracic packing was performed to control the hemorrhage. On reevaluation 48 hours later, no active bleeding was observed.