Posterior Box Stab Wounds

The "Posterior Box" is the posterior chest - bounded laterally by the scapulae and inferiorly by the costal margin.

Organs at risk from a stab wound in this area include:

• Lungs
• aorta
• esophagus

All patients should receive a chest xray to rule out hemothorax or pneumothorax.  If negative, a 6 hour repeat CXR should be done.

Because of the low incidence of injury from a stab would (unlike gunshot wounds) to the aorta or esophagus, we tailor our work up depending on  CXR findings.

• If there is a widened mediastinum or other evidence of peri-aortic hematoma, an angiogram is performed
• If there is mediastinal air, both an esophagram and a esophagoscopy are performed.