Penetrating chest trauma causes a broad spectrum of injury that requires a variety of diagnostic and resuscitative skills. Prompt resuscitation and decisive action are mandatory for patients who present in extremis, whereas a thorough diagnostic evaluation and appropriate observation are indicated in less compelling circumstances. Clinical skill and judgment along with plain radiographs provide the basis for treatment in most cases. More sophisticated imaging techniques, with the exception of angiography, are of limited value. A systematic approach based on wound location, be it central, peripheral, or proximate to the diaphragm, should result in timely resuscitation and sound diagnostic evaluation.
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