The treatment for wounds that penetrate the pleura is diametrically opposed in many respects to the treatment for wounds that penetrate the peritoneal cavity. The treatment for wounds that penetrate the abdominal cavity usually is radically operative; for those wounds which penetrate the thoracic cavity, the conservative nonoperative treatment is often the best. The presence of blood within the abdominal cavity is of little moment. It may be left undisturbed. Blood left within the pleural cavity may lead to extensive empyema and death.
The surgical principles that govern the treatment for wounds of the peritoneal cavity cannot be applied to the treatment for wounds of the pleural cavity. This distinction is important. It saves life. If the surgeon performs an exploratory thoracotomy on the same premises that he does an exploratory laparotomy, for example, for a penetrating gunshot wound, many patients whose chests are explored will die who otherwise would
ALLEN DS. THE TREATMENT FOR PENETRATING WOUNDS OF THE PLEURAL CAVITY. Arch Surg. 1930;21(6):1161-1172. doi:10.1001/archsurg.1930.01150180277017