Chest Trauma: Thoracic Injuries and Conditions

2021 ◽  
Author(s):  
Kristi Colbenson
Keyword(s):  
Chest Trauma ◽  
Thoracic Injuries

scholarly journals Pattern and management of penetrating and nonpenetrating thoracic injuries

2019 ◽  
Vol 7 (8) ◽  
pp. 3133
Author(s):  
Naresh Pal ◽  
Vineet Mishra ◽  
Udit Jain ◽  
Poonam .
Keyword(s):  
Head Injury ◽  
Chest Trauma ◽  
Road Traffic ◽  
Public Health Problem ◽  
Tracheobronchial Tree ◽  
Chest Injury ◽  
Common Mechanism ◽  
Blunt Injury ◽  
Major Public Health Problem ◽  
Thoracic Injuries

Background: Chest trauma constitutes a major public health problem which  includes the injuries to chest wall, pleura, tracheobronchial tree, lungs, diaphragm, oesophagus, heart and great vessels. It consist of more than ten percent of all traumas and twenty five percent of death due to trauma occurs because of chest injury. Chest trauma is increasing in frequency in urban hospitals. Penetrating and nonpenetrating thoracic injuries the most serious injuries leading to significant morbidity and mortality.Methods: This study was prospective observational study of 220 patients of thoracic trauma both penetrating and non-penetrating. These patients admitted in general surgical units from August 2017 to May 2018  of Pandit Bhagwat Dayal  Sharma,  PGIMS  Rohtak Haryana India. The study was pertaining to both penetrating  and non-penetrating chest trauma.Results: Out of 220 chest injury patients who were studied during the said period, Males were 203 and females 17 by a ratio of 12:1 and age ranged from lowest 18 years to 85 years of age. Majority of the patients (90.45%) sustained blunt injuries. RTA was the common mechanism of blunt injury affecting (50.45%) of patients. Multiple Rib fractures was the commonest type of chest injury (21.36%) followed by head injury (17.27%). Head injury was the commonest associated injury seen in our patients. Conclusions: Chest trauma resulting from road traffic accident remains a major mechanism of chest injury. The  measures to decrease the trauma are, educating people about traffic rules and regulations and strictly implementing them is necessary to reduce incidence of chest injuries.

Penetrating Chest Trauma in Nigeria

2005 ◽  
Vol 13 (2) ◽  
pp. 103-106 ◽  
Author(s):  
Martins O Thomas ◽  
Ezekiel O Ogunleye
Keyword(s):  
Traffic Accidents ◽  
Chest Trauma ◽  
Thoracic Injuries ◽  
Hospital Level ◽  
Tube Insertion ◽  
Female Ratio ◽  
Penetrating Chest Trauma ◽  
Study Results ◽  
Male To Female

Penetrating chest trauma occurs worldwide, and various accounts of it have been reported in the literature. 1 – 5 Blunt trauma is not usually associated with military or civilian violence, while penetrating chest trauma often is. Penetrating chest trauma is frequently caused by gunshots and non gunshot-related incidents such as stabs, traffic accidents, and impalements. This prospective study was conducted to determine a pattern of penetrating thoracic injuries, including their causes, the role of surgery, and intervention outcomes. In this study, we treated 168 patients (142 males and 26 females, giving a male-to-female ratio of 5.5:1). Gunshots caused 60.1% of the injuries while traffic accidents caused 27.3% of the injuries. Chest tube insertion alone was the main treatment initiated. This technique was used on 73.8% of the patients. To reduce the occurrence of penetrating chest trauma in Lagos, Nigeria, study results suggest that the Nigerian people and their property need greater security, and that pre-hospital level of care for trauma victims must improve.

scholarly journals THORACIC TRAUMA

2011 ◽  
Vol 18 (03) ◽  
pp. 373-379
Author(s):  
E B KESIEME ◽  
E F OCHELI ◽  
C N KESIEME ◽  
C P Kaduru
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Thoracic Trauma ◽  
Chest Trauma ◽  
Road Traffic ◽  
Ventilatory Support ◽  
Thoracic Injuries ◽  
University Hospitals ◽  
Traumatic Diaphragmatic Hernia

Objective: To assess the pattern of thoracic trauma in two semi urban university hospitals in Nigeria, to determine the injuries associated with thoracic trauma, its management and outcome in a setting of small thoracic units and limited intensive care unit facilities. Study Design: Observational Method: The hospital records of 142 patients who sustained thoracic trauma between September 2007 and September 2010 were reviewed. The mode of injury, specific intrathoracic trauma, associated injuries, management and outcome were analyzed. Results: Eighty-two percent (82%) of patients were males and 73% of patients were above 40 years. Blunt thoracic trauma accounted for 77% of thoracic injuries. Road Traffic Accident (RTA) was the commonest cause of Blunt Chest Trauma (90%) while Gunshot injuries constituted the commonest cause of Penetrating Chest Trauma (73%). The commonest specific thoracic injuries were Rib fractures and Haemopneumothorax. Extremity injuries were the commonest associated extrathoracic injuries. Mechanical ventilatory assistance was indicated in 8.5% of patients. Only 1.4% of patients had delayed thoracotomy on account of clotted haemothorax and Empyema Thoracis. 2.8% of patients had Laparotomy for repair of Traumatic Diaphragmatic hernia. Others were managed conservatively. The mortality rate was 9.9%. Mortality was mainly among patients who required mechanical ventilatory support and those with associated severe extra thoracic injuries. Most of the patients were discharged before 20 days on admission. Conclusions: The incidence of chest trauma can be reduced by minimizing the frequency of road traffic accidents, abating violence and improving security. Most patients that sustain thoracic trauma can be managed conservatively. Mortality usually occurs in patients with associated severe extrathoracic trauma and those who require ventilatory support. Improving Intensive care unit facilities and training more trauma/thoracic surgeons and intensivists in the developing countries will help to reduce the mortality rate of chest trauma.

Chest Trauma: Nonvascular Injuries

Chest Imaging ◽  
2019 ◽  
pp. 123-128
Author(s):  
Constantine Raptis
Keyword(s):  
Case Management ◽  
Vascular Injury ◽  
Thoracic Trauma ◽  
Chest Trauma ◽  
Penetrating Trauma ◽  
Morbidity And Mortality ◽  
Vascular Injuries ◽  
Thoracic Injuries ◽  
Substantial Morbidity

In the setting of trauma, thoracic injuries are third in frequency after injuries to the head and extremities. While the greatest source of mortality in the setting of thoracic trauma is vascular injury, nonvascular injuries are much more common and can result in substantial morbidity and mortality, complicating overall case management. This section will focus on non vascular injuries that may be seen in the setting of trauma involving the lungs, diaphragm, mediastinum, thoracic skeleton, heart and pleura. Findings in both blunt and penetrating trauma will be highlighted.

Clinical Outcome of Urgent Thoracotomy in Patients with Penetrating and Blunt Chest Trauma: A Retrospective Survey

2017 ◽  
Vol 66 (08) ◽  
pp. 686-692
Author(s):  
Yael Refaely ◽  
Leonid Koyfman ◽  
Michael Friger ◽  
Leonid Ruderman ◽  
Mahmud Saleh ◽  
...  
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Injury Severity ◽  
Penetrating Trauma ◽  
Apache Ii Score ◽  
Thoracic Injuries ◽  
Icu Stay ◽  
Chest Injuries ◽  
Arterial Blood ◽  
Trauma Group

Introduction In contrast to an emergency department of thoracotomy (EDT), an urgent thoracotomy (UT) is defined as a surgical thoracic intervention performed in the operating room within the first 48 hours of the patient's intensive care unit (ICU) stay. The factors affecting survival after UT are not fully understood. In this study, we retrospectively analyzed the clinical data and outcome of patients with blunt and penetrating chest injuries who underwent UT. Methods All adult patients who had blunt or penetrating chest trauma and who underwent UT, were included in the study. All data were collected from the patients' hospital and ICU records. Forty-five patients with thoracic injuries who underwent UT during the first 48 hours of ICU stay were analyzed. Of these, 25 had penetrating chest injuries, and 20 had blunt thoracic injuries. Of the penetrating injuries, 16 were stab wounds, and 9 were gunshot wounds. Results Overall ICU mortality was 29% (n = 13) and was significantly higher in the blunt chest trauma group than in the penetrating trauma group (45% vs 16%; p = 0.04). Lung parenchyma injuries (lacerations and contusions) were the most common intraoperative findings in both groups. The following independent predictors of in-hospital mortality were found: an Injury Severity Score (ISS) of >40; an Acute Physiology and Chronic Evaluation II (APACHE II) score of >30; prolonged duration of UT; low body temperature on admission to the ED; abnormal arterial blood lactate, bicarbonate, and pH at the end of UT; and use of vasopressors during the first 24 hours of ICU stay. Conclusion Mortality after UT was higher in patients with blunt chest trauma. The UT should be performed in both penetrating and blunt chest trauma as quickly as possible and should be limited to damage control. It also emerges that acidosis and hypothermia in chest trauma patients need to be treated extremely aggressively before, during, and after UT.

scholarly journals Scapular Fractures in Blunt Chest Trauma – Self-Experience Study

2016 ◽  
Vol 4 (4) ◽  
pp. 688-691 ◽  
Author(s):  
Tabet A. Al-Sadek ◽  
Desislav Niklev ◽  
Ahmed Al-Sadek ◽  
Lina Al-Sadek
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Pleural Cavity ◽  
High Energy ◽  
The Body ◽  
Pulmonary Contusion ◽  
Trauma Patients ◽  
Thoracic Injuries ◽  
Scapular Fractures

AIM: The aim of this retrospective study was to report the scapular fractures in patients with blunt chest trauma and to present the type and the frequency of associated thoracic injuries.MATERIAL AND METHODS: Nine patients with fractures of the scapula were included in the study. The mechanisms of the injury, the type of scapular fractures and associated thoracic injuries were analysed.RESULTS: Scapular fractures were caused by high-energy blunt chest trauma. The body of the scapula was fractured in all scapular fractures. In all cases, scapular fractures were associated with other thoracic injuries (average 3.25/per case). Rib fractures were present in eight patients, fractured clavicula - in four cases, the affection of pleural cavity - in eight of the patients and pulmonary contusion in all nine cases. Eight patients were discharged from the hospital up to the 15th day. One patient had died on the 3rd day because of postconcussional lung oedema.CONCLUSIONS:The study confirms the role of scapular fractures as a marker for the severity of the chest trauma (based on the number of associated thoracic injuries), but doesn’t present scapular fractures as an indicator for high mortality in blunt chest trauma patients. 

scholarly journals Experimental Model of Blunt Chest Trauma in Rats

2014 ◽  
Vol 7 (1) ◽  
pp. 15-19
Author(s):  
Ivan P. Novakov ◽  
Delyan P. Delev ◽  
Svitlana Y. Bachurska ◽  
Dmitrii G. Staikov
Keyword(s):  
Experimental Model ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Small Animal ◽  
Laboratory Animals ◽  
Histological Evaluation ◽  
Albino Rats ◽  
Thoracic Injuries ◽  
Myocardial Contusion ◽  
Bilateral Lung

Abstract The aim of the study was to present our own experimental model of blunt chest trauma in small laboratory animals. Fifteen Wistar albino rats (body weight 290.0-320.0 g) were used in the experiment. An originally designed platform was used to inflict blunt thoracic trauma in the rats. Gross examination and histological evaluation of the heart and lung were performed. It was established that blunt chest trauma caused three thoracic injuries: bilateral lung contusion, myocardial contusion and hemopericardium. These thoracic injuries occurred as a result from direct compression of the chest wall towards the lung and the heart. The severity of lung parenchymal and myocardial pathological findings depended on the energy of blunt chest trauma. The study presents a reproducible small-animal experimental model of blunt chest trauma. The model gives opportunities for further studying different aspects of lung and myocardial contusion.

scholarly journals Rib fractures in blunt chest trauma - associated thoracic injuries

2017 ◽  
Vol 15 (3) ◽  
pp. 216-219
Author(s):  
Iv. Dimitrov ◽  
Iv. Iv. Novakov ◽  
P. P. Bonev ◽  
A. Uchikov
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Rib Fractures ◽  
Thoracic Injuries

Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Tube Thoracostomy ◽  
Rib Fracture ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

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