Introduction:Road traffic accidents and the increasing violence are common causes of increasing chest injuries. Penetrating thoracic trauma (PTT) is a challenging problem,but fortunately most of these injuries can be managed non-operatively.

Aim:To determine the pattern of penetrating thoracic injury, including the causes, the role of surgery and intervention outcomes at South Egypt.

Patients and methods:This prospective study was conducted at Sohag university hospital, between January 2011 and December 2012. All patients presented to emergency department with penetrating chest trauma either isolated or associated with poly trauma were included. Patients with blunt chest injuries were excluded.

Results:436 patients were included. Majority of patients were male (84.4%), Most of the patients were of young age group, mean age 36.9 years, and 33.3 % of patients were presented by polytrauma. Firearm injuries were the most common mode of injury (43.1%), followed by stab injuries (33%).Haemopneumothorax was the most frequent presentation of chest injury (33.9%). Tube thoracostomy was done in 81% cases, while 9.2% patients underwent thoracotomy (while in 3.2 % sternotomy was done). Massive haemothorax was the most common indication of emergency thoracotomy.Abdominal injuries were the most common association seen in 15.6% patients. Atelectasis, pneumonia, wound infection, empyema, and ARDS were the most common complications noted. Total mortality was 7 %. Adult respiratory distress syndrome (ARDS) was the most common cause of mortality.

Conclusion: Penetrating thoracic trauma is really a challenging problem, and many patients die before reaching hospital, most of these injuries can be managed non-operatively both rapidly and simply. The pre-hospital levelof care for trauma victims and services at the secondary andtertiary hospitals needs more improvement. Finally to decrease the occurrence of penetrating chest trauma greater security is needed in the society.