The Utility of Physical Examination to Detect Hemopneumothorax in Patients with Blunt Chest Trauma

2003 ◽  
Vol 54 (6) ◽  
pp. 1255-1256
Author(s):  
Stewart S. Chan
2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Gregory Mansella ◽  
Roland Bingisser ◽  
Christian H. Nickel

Blunt trauma is the most common mechanism of injury in patients with pneumomediastinum and may occur in up to 10% of patients with severe blunt thoracic and cervical trauma. In this case report we present a 24-year-old man with pneumomediastinum due to blunt chest trauma after jumping from a bridge into a river. He complained of persistent retrosternal pain with exacerbation during deep inspiration. Physical examination showed only a slight tenderness of the sternum and the extended Focused Assessment with Sonography for Trauma (e-FAST) was normal. Pneumomediastinum was suspected by chest X-ray and confirmed by computed tomography, which showed a lung contusion as probable cause of the pneumomediastinum due to the “Mackling effect.” Sonographic findings consistent with pneumomediastinum, like the “air gap” sign, are helpful for quick bedside diagnosis, but the diagnostic criteria are not yet as well established as for pneumothorax. This present case shows that despite minimal findings in physical examination and a normal e-FAST a pneumomediastinum is still possible in a patient with chest pain after blunt chest trauma. Therefore, pneumomediastinum should always be considered to prevent missing major aerodigestive injuries, which can be associated with a high mortality rate.


1987 ◽  
Vol 28 (1) ◽  
pp. 53-54 ◽  
Author(s):  
B. Rossen ◽  
N. O. Laursen ◽  
S. Just

The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6 (30%) of the 20 patients with hemo/-pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma.


Ultrasound ◽  
2021 ◽  
pp. 1742271X2199460
Author(s):  
Serena Rovida ◽  
Daniele Orso ◽  
Salman Naeem ◽  
Luigi Vetrugno ◽  
Giovanni Volpicelli

Introduction Bedside lung sonography is recognized as a reliable diagnostic modality in trauma settings due to its ability to detect alterations both in lung parenchyma and in pleural cavities. In severe blunt chest trauma, lung ultrasound can identify promptly life-threatening conditions which may need direct intervention, whereas in minor trauma, lung ultrasound contributes to detection of acute pathologies which are often initially radio-occult and helps in the selection of those patients that might need further investigation. Topic Description We did a literature search on databases EMBASE, PubMed, SCOPUS and Google Scholar using the terms ‘trauma’, ‘lung contusion’, ‘pneumothorax’, ‘hemothorax’ and ‘lung ultrasound’. The latest articles were reviewed and this article was written using the most current and validated information. Discussion Lung ultrasound is quite accurate in diagnosing pneumothorax by using a combination of four sonographic signs; absence of lung sliding, B-lines, lung pulse and presence of lung point. It provides a rapid diagnosis in hemodynamically unstable patients. Lung contusions and hemothorax can be diagnosed and assessed with lung ultrasound. Ultrasound is also very useful for evaluating rib and sternal fractures and for imaging the pericardium for effusion and tamponade. Conclusion Bedside lung ultrasound can lead to rapid and accurate diagnosis of major life-threatening pathologies in blunt chest trauma patients.


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