<prompt> Which is not an indication of thoracotomy ?Massive pneumothoraxPulmonary contusionBleeding more than 200m1hr. in thoracotomy tubeOesophageal rupture  <response>: Ans is b ie Pulmonary contusion Indications of thoracotomy after chest trauma a Cardiac arrest resuscitative thoracotomy b Massive hemothorax drainage of more than 1500 ml of blood when chest tube is first inseed or continuous haemorrhage of more than 200 mlhr for more than 3 consecutive hours. c Brisk bleeding 100 ml15 min d Penetrating injuries of the anterior chest with cardiac tamponade. e Large open wounds of the thoracic cage. f Rupture of the bronchus, aoa, esophagus or diaphragm. Non emergent indication of thoracotomy a Empyema not resolved with tube thoracostomy b Clotted hemothorax c Lung access d Thoracic duct injuries e Tracheoesophageal fistulas f Chronic sequelae of vascular injuries pseudo aneurysms AV fistulas Such an exhaustive list is prepared by mixing all the three books. Shwaz, Sabiston, Bailey Still Massive Pneumotharax has not been listed here but Bailey love, 23e, p 765 gives the tt of pneumothorax. If pneumothorax is not responding to initial conservative methods then thoracotomy and pleurectomy can be done. 