Methods: A total of 258 patients (255 males, 3 females; mean age 24 years; range 16 to 53 years) were treated for thoracic gunshot injuries between January 1996 and June 2005. The patients were evaluated with respect to time to hospital admission, type of injury, associated injuries, treatment methods, mortality, and morbidity.

Results: The most frequent thoracic pathologies were hemopneumothorax (43%) and pulmonary contusion (43%), followed by hemothorax (27.1%). The most common extrathoracic injuries included intraabdominal organ injuries (13.2%), fractures (5.4%), and major vessel injuries (3.5%). Tube thoracostomy was performed in 247 patients. Thoracotomy was required in 71 cases (57 early, 14 late). Eleven cases were treated without any drainage procedures. Surgical procedures included pneumorrhaphy (n=40), diaphragm repair (n=14), hemostasis (n=9), partial rib resection (n=3), chest wall reconstruction (n=2), tracheal repair (n=2), segmentectomy (n=1), and wedge resection (n=1). Postoperative complications occurred in 38 patients (14.7%). The most common complication was atelectasis in 15 patients, which was treated by nasotracheal aspiration in three patients, and bronchial aspiration by fiberoptic bronchoscopy in 12 patients, all of whom manifested radiologic improvement within seven to 14 days. Mortality occurred in 19 patients (7.4%) due to major vessel injuries and/or multiple organ injuries. Mortality rates were 5.4% and 1.9% in patients who were brought to hospital within 0 to 60 minutes and 60 to 120 minutes, respectively. The mean hospital stay was 11.8 days (range 2 to 28 days).

Conclusion: Although the thoracic region is more commonly affected in high-velocity gunshot injuries, accompanying extrathoracic injuries should also be considered.