Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXVIII: Wounds and Injuries of the Chest
United States Department of Defense
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About one-half of casualties with penetrating wounds of the lung will present with hemopneumothorax, a situation to be expected because of the propensity of a missile to lacerate contiguous structures, such as bronchioles and arterioles. A frequent concomitant injury is pulmonary "contusion." There is increasing evidence that the contusion around the missile tract is actually hematoma in a parenchymal laceration. Contusion remote from the permanent missile tract is due to intraalveolar blood which has entered the bronchial tree and is aspirated into the uninjured lung. A more severe manifestation of combined bronchial and arterial injury is seen in many fatally wounded thoracic casualties who quite literally drown in their own blood.
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