scholarly journals Simple X-ray versus ultrasonography examination in blunt chest trauma: effective tools of accurate diagnosis and considerations for rib fractures

2016 ◽  
Vol 12 (6) ◽  
pp. 637-641 ◽  
Author(s):  
Eun Gu Hwang ◽  
Yunjung Lee
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Accurate Diagnosis ◽  
Rib Fractures ◽  
X Ray

Perils of Rib Fractures

2008 ◽  
Vol 74 (4) ◽  
pp. 310-314 ◽  
Author(s):  
Om P. Sharma ◽  
Michael F. Oswanski ◽  
Shashank Jolly ◽  
Sherry K. Lauer ◽  
Rhonda Dressel ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Rib Fractures ◽  
Trauma Patients ◽  
Close Observation ◽  
Motorcycle Crashes ◽  
Level 1 Trauma Center

Rib fractures (RF) are noted in 4 to 12 per cent of trauma admissions. To define RF risks at a Level 1 trauma center, investigators conducted a 10-year (1995–2004) retrospective analysis of all trauma patients. Blunt chest trauma was seen in 13 per cent (1,475/11,533) of patients and RF in 808 patients (55% blunt chest trauma, 7% blunt trauma). RF were observed in 26 per cent of children (<18 years), 56 per cent of adults (18–64 years), and 65 per cent of elderly patients (≥65 years). RF were caused by motorcycle crashes (16%, 57/347), motor vehicle crashes (12%, 411/3493), pedestrian-auto collisions (8%, 31/404), and falls (5%, 227/5018). Mortality was 12 per cent (97/808; children 17%, 8/46; adults 9%, 46/522; elderly 18%, 43/240) and was linearly associated with a higher number of RF (5% 1–2 RF, 15% 3–5 RF, 34% ≥6 RF). Elderly patients had the highest mortality in each RF category. Patients with an injury severity score ≥15 had 20 per cent mortality versus 2.7 per cent with ISS <15 ( P < 0.0001). Increasing age and number of RF were inversely related to the percentage of patients discharged home. ISS, age, number of RF, and injury mechanism determine patients’ course and outcome. Patients with associated injuries, extremes of age, and ≥3 RF should be admitted for close observation.

scholarly journals Pneumomediastinum in Blunt Chest Trauma: A Case Report and Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Gregory Mansella ◽  
Roland Bingisser ◽  
Christian H. Nickel
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Common Mechanism ◽  
Cervical Trauma ◽  
X Ray ◽  
Retrosternal Pain ◽  
Chest X Ray ◽  
Bedside Diagnosis

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.

scholarly journals Patterns of serial rib fractures after blunt chest trauma: An analysis of 380 cases

PLoS ONE ◽  
2019 ◽  
Vol 14 (12) ◽  
pp. e0224105 ◽  
Author(s):  
Christian Liebsch ◽  
Tina Seiffert ◽  
Markus Vlcek ◽  
Meinrad Beer ◽  
Markus Huber-Lang ◽  
...  
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Rib Fractures

scholarly journals Rib fractures in blunt chest trauma-morbidity and mortality: self-experience study

2014 ◽  
Vol 12 (3) ◽  
pp. 272-276 ◽  
Author(s):  
Iv. Novakov ◽  
◽  
P. Timonov ◽  
Ch. Stefanov ◽  
G. Petkov ◽  
...  
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Rib Fractures ◽  
Morbidity And Mortality

scholarly journals Analysis of blunt chest trauma with rib fractures

2012 ◽  
Vol 26 (7) ◽  
pp. 713-718
Author(s):  
Daisuke Okutani ◽  
Shigeharu Moriyama
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Rib Fractures

DIAGNOSTIC ACCURACY OF CHEST X-RAY IN THE DETECTION OF PNEUMOTHORAX IN BLUNT CHEST TRAUMA PATIENTS WITH CT AS THE GOLD STANDARD

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Danquale Vance Kynshikhar ◽  
Chaman Lal Kaushal ◽  
Ashwani Tomar ◽  
Neeti Aggarwal
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Trauma Patients ◽  
Care Level ◽  
X Ray ◽  
Primary Health ◽  
Chest X Ray

Background: To study the diagnostic accuracy of chest X-ray in the detection of pneumothorax in blunt chest trauma patients with CT as the Gold Standard Methods: The present study was conducted from 31th July 2018 to 30th July 2019. A total of 36 patients were enrolled in the study. Results: On Chest X-Ray Supine AP view, pneumothorax was detected in 11 of 24 patients. The sensitivity of Chest X-Ray Supine AP view was 45.83%, specificity was 100%, positive predictive value (PPV) was 100%, negative predictive value (NPV) was 48% and accuracy was 63.89% for the diagnosis of pneumothorax. Conclusion: A Chest radiograph is the most preferred and relevant primary investigation in the diagnosis of pneumothorax even with the various advanced techniques that are available. X-ray being relatively cheaper and is easily available even at the peripheral centers at the primary health care level. Keywords: X-ray, CT, Pneumothorax

Delayed Respiratory Failure After Blunt Chest Trauma

2020 ◽  
pp. 000313482096627
Author(s):  
Christina S. Martin ◽  
Ning Lu ◽  
David S. Inouye ◽  
Kazuma Nakagawa ◽  
Karen Ng ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Injury Severity ◽  
Rib Fractures ◽  
P Value ◽  
Clinical Predictors ◽  
Chi Square ◽  
Risk Patients ◽  
Student’S T

Background Patient factors associated with delayed respiratory failure (DRF) after blunt chest trauma are not well documented. Earlier identification and closer monitoring may improve outcomes for these patients. The purpose of this study was to identify the prevalence and clinical predictors of DRF in patients after blunt chest trauma. Materials and Methods A retrospective review of adult patients admitted to a Level 1 trauma center after blunt chest trauma between January 1, 2009 and December 31, 2013, was conducted. Patients with early respiratory failure were compared to patients with DRF using Fisher’s exact tests, chi square, and Student’s t-tests. A P-value of <.05 was considered significant. Results 1299 patients had blunt chest trauma and at least 1 rib fracture, of which 830 met inclusion criteria. 5.8% of patients progressed to respiratory failure. Respiratory failure was delayed in 25% of these patients. DRF patients had significantly lower ISS (16.5 vs. 22.7, P = .04), more bilateral rib fractures (66.7% vs. 28.7%, P = .02) and fewer pulmonary contusions (16.7% vs. 50.0%, P = .04). Discussion Injury patterns, including bilateral rib fractures without pulmonary contusions and low but severe Injury Severity Score burden, may help identify high-risk patients who may benefit from closer monitoring and more aggressive therapy.

scholarly journals Solitary Pulmonary Hematoma Radiographically Indistinguishable from Mediastinal Tumor

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Teruya Komatsu ◽  
Naoki Date ◽  
Takuji Fujinaga ◽  
Akira Hara ◽  
Tatsuo Kato
Keyword(s):  
Blunt Chest Trauma ◽  
Mediastinal Tumor ◽  
Chest Trauma ◽  
Callus Formation ◽  
Wedge Resection ◽  
Lower Lobe ◽  
X Ray ◽  
Pulmonary Tumor ◽  
Chest X Ray ◽  
Posterior Mediastinal

Solitary pulmonary hematoma is a rare consequence of blunt chest trauma. Moreover, there has been no reported case of solitary pulmonary hematoma radiographically diagnosed as a posterior mediastinal tumor. We present the case of a 63-year-old man who was referred for an oval-shaped opacity at the left paraspinal area on a chest X-ray. Chest computed tomography showed a well-circumscribed posterior mediastinal tumor on the left paraspinal lesion with extrapleural sign and callus formation on the left ribs posteriorly (7th to 11th ribs). The tumor was thoracoscopically confirmed to be a subpleural pulmonary tumor of the left lower lobe, and wedge resection was performed. Histological examination confirmed the diagnosis of pulmonary hematoma. On reviewing the callus formation of the ribs, which was suggestive of rib fractures, the pulmonary hematoma was determined to be traumatic in origin. The postoperative course was uneventful. We reviewed a rare case of pathologically proven traumatic solitary pulmonary hematoma. The rarity of this case is enhanced because the hematoma initially appeared to be a posterior mediastinal tumor.

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