[For educational purpose!] This 16 year old arrived stable to the emergency department with a gunshot wound to the thorax.
They took him to the OR and his heart stopped when the anaestesia started. The team decided to perform an emergency left thoracotomy (surgical opening of the chest cavity, or thorax), which revealed blood accumulation in the pericardium and decided to extend the incision to the other side, along the sternum.
There was a wound hole in the left atrium that was sutured and 2 thoracic drains were placed before closing back the wound.
Open thoracotomy is done upon the anterior chest and is performed by surgeons to gain access to the thoracic organs, most commonly the heart, the lungs, or the esophagus, or for access to the thoracic aorta or the anterior spine (the latter necessary in case of tumors in the spine). A resuscitative or emergency thoracotomy may be performed to resuscitate a patient who is near death as a result of a chest injury. It provides access to the chest cavity to control injury-related bleeding from the heart, cardiac compressions to restore a normal heart rhythm, or to relieve pressure on the heart caused by cardiac tamponade (accumulation of fluid in the space between the heart's muscle and outer lining).