A.I. Burnasyan FMBC clinical bulletin. 2026 № 3
A.P. Chuprina1, A.D. Kazakov2, I.M. Kuznetsov3, A.D. Kucherenko3, O.A. Kudryavtseva1, D.V. Gudanovich4, A.A. Kurkin2
Surgical Approach for Thoracoabdominal Wounds in Combination with Pericardial or Heart Damage
1Branch of the Military Medical Academy of S.M. Kirov in Moscow, Moscow, Russia
21602 Military Clinical Hospital of the Ministry of Defense of the Russian Federation, Rostov-on-Don, Russia
3Military Medical Academy of S.M. Kirov, Saint Petersburg, Russia
4Leningrad Military District, Ministry of Defense of the Russian Federation, Saint Petersburg, Russia
Contact person: Kazakov Alexandеr Dmitrievich: kazakovad.97@mail.ru
Abstract
Thoracoabdominal wound with damage to the heart and pericardium are accompanied by a high frequency of postoperative complication and fatal outcomes. Thus, selection of the most efficient diagnostical and treatment approach for these injuries is an urgent choice at every stage of medical evacuation.
Aim: to analyze the results of provided medical care at the different levels of medical evacuation among combatants with thoracoabdominal wounds combined with pericardial or heart damage.
Material and methods: medical documentation of 466 patients with thoracoabdominal wounds was analysed.
Result: the indication for thoracotomy at the level 2 and 2+ of surgical care was cardiac tamponade in 4 patients, and ongoing intrapleural bleeding in 1 patient. Pericardial fenestration and drainage the pericardial cavity with drainage fluid assessment were performed in 2 patients. In one case, thoracotomy was done because of the ongoing bleeding. The increase of the hemopericardium based on the ultrasound examination (US) in clinically stable patient became the indication for thoracotomy in 1 patient. Dynamic observation in combination with periodical measurement of blood volume in pericardium (monitored by US) was successfully implied in 6 patients.
Conclusions: due to severe clinical status in patients with thoracoabdominal wounds and high risks of surgery on abdomen chest and diaphragm, it may be recommended to use the method of “active” monitoring and treatment for acute complications.
Keywords: тhoracoabdominal wound, gunshot wound to the heart and pericardium, gunshot wound of the diaphragm
For citation: Chuprina AP, Kazakov AD, Kuznetsov IM, Kucherenko AD, Kudryavtseva OA, Gudanovich DV, Kurkin AA. Surgical Approach for Thoracoabdominal Wounds in Combination with Pericardial or Heart Damage. A.I. Burnasyan Federal Medical Biophysical Center Clinical Bulletin. 2026.3:84-87. (In Russian) DOI: 10.33266/2782-6430-2026-3-84-87
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Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 27.05.2026. Accepted for publication: 18.06.20226