Resuscitative Thoracotomy for Penetrating Trauma, a Valid Option in the Right Circumstances

The need to perform a clamshell thoracotomy in the emergency department for thoracic injuries is infrequent. The rates of survival after emergency thoracotomy are considerably low, with penetrating trauma cases exhibiting survival rates of 9% to 12%, and blunt trauma cases observing survival rates of 1% to 2%. We present an atypical instance of survival following resuscitative thoracotomy performed in the emergency department. The procedure was undertaken on a 30-year-old male victim of gunshot wounds to the chest and abdomen. On arrival to emergency department, the patient had a traumatic cardiac arrest. A resuscitative thoracotomy was carried out, restoring a spontaneous heart rhythm before transferring the patient to the operating room. A midline exploratory laparotomy was performed for abdominal injuries. Remarkably, the patient survived the procedure and fully recovered. This case serves as an illustration of how clamshell thoracotomy can be an effective resuscitative lifesaving intervention for penetrating thoracic trauma when accompanied by the appropriate setup.