Delayed life-threatening hemothorax without rib fractures after blunt chest trauma

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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Comparison of Chest Computed Tomography and Chest X-Ray in the Diagnosis of Rib Fractures in Patients with Blunt Chest Trauma

Journal of Academic Emergency Medicine ◽

10.5152/jaem.2012.025 ◽

2012 ◽

Cited By ~ 1

Author(s):

Rasih Yazkan ◽

Gokhan Ergene ◽

Cumhur Murat Tulay ◽

Sedat Gunes ◽

Serdar Han

Keyword(s):

Computed Tomography ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Rib Fractures ◽

Chest Computed Tomography ◽

X Ray ◽

Chest X Ray

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Thoracic Anesthesia and Cross Field Ventilation for Tracheobronchial Injuries: A Challenge for Anesthesiologists

Case Reports in Anesthesiology ◽

10.1155/2014/972762 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Sankalp Sehgal ◽

Joshua C. Chance ◽

Matthew A. Steliga

Keyword(s):

Pain Control ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Lung Ventilation ◽

Postoperative Pain Control ◽

One Lung Ventilation ◽

Tracheal Reconstruction ◽

Thoracic Anesthesia ◽

Tracheobronchial Injuries ◽

Life Threatening

Tracheobronchial injuries are rare but life threatening sequel of blunt chest trauma. Due to the difficult nature of these injuries and the demanding attributes of the involved surgery, the anesthesiologist faces tough challenges while securing the airway, controlling oxygenation, undertaking one-lung ventilation, maintaining anesthesia during tracheal reconstruction, and gaining adequate postoperative pain control. Amongst the few techniques that can be used with tracheobronchial injuries, cross field ventilation is a remotely described and rarely used technique, especially in injuries around the carina. We effectively applied cross field ventilation in both our cases and the outcome was excellent.

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Perils of Rib Fractures

The American Surgeon ◽

10.1177/000313480807400406 ◽

2008 ◽

Vol 74 (4) ◽

pp. 310-314 ◽

Cited By ~ 30

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.

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Late Intrathoracic Tracheal Stricture After Blunt Chest Trauma: A Rare Life-Threatening Condition

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2015.04.101 ◽

2016 ◽

Vol 101 (2) ◽

pp. 766-769

Author(s):

Ikram Chaudhry ◽

Fozan W. Aldulaijan ◽

Zahra Alhajji ◽

Ahsan Cheema ◽

Hadi Mutairi

Keyword(s):

Blunt Chest Trauma ◽

Chest Trauma ◽

Threatening Condition ◽

Life Threatening ◽

Tracheal Stricture

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

PLoS ONE ◽

10.1371/journal.pone.0224105 ◽

2019 ◽

Vol 14 (12) ◽

pp. e0224105 ◽

Cited By ~ 1

Author(s):

Christian Liebsch ◽

Tina Seiffert ◽

Markus Vlcek ◽

Meinrad Beer ◽

Markus Huber-Lang ◽

...

Keyword(s):

Blunt Chest Trauma ◽

Chest Trauma ◽

Rib Fractures

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Cardiac tamponade as a late complication of a minor trauma due to syncope: A case report and literature review

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918793790 ◽

2018 ◽

Vol 27 (2) ◽

pp. 103-106 ◽

Cited By ~ 1

Author(s):

Matteo Guarino ◽

Alessandra Bologna ◽

Alfredo De Giorgi ◽

Michele D Spampinato ◽

Christian Molino ◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Cardiac Tamponade ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Late Complication ◽

Minor Trauma ◽

Threatening Condition ◽

Life Threatening ◽

A Minor

Haemopericardium with cardiac tamponade following minor blunt trauma is a rare, life-threatening condition. The diagnosis of cardiac tamponade as well as therapeutic management may be delayed, since the link between trauma and illness is often overlooked. We report the case of an old woman who developed a relatively delayed cardiac tamponade due to an otherwise minor blunt chest trauma following syncope.

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Pneumomediastinum and Pneumopericardium in an 11-Year-Old Rugby Player: A Case Report

Journal of Athletic Training ◽

10.4085/1062-6050-48.1.11 ◽

2013 ◽

Vol 48 (2) ◽

pp. 277-281 ◽

Cited By ~ 4

Author(s):

Valentina Vanzo ◽

Samuela Bugin ◽

Deborah Snijders ◽

Laura Bottecchia ◽

Veronica Storer ◽

...

Keyword(s):

Emergency Department ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Acute Asthma ◽

Simultaneous Occurrence ◽

Trauma Symptoms ◽

Young Athletes ◽

Tracheal Rupture ◽

Acute Asthma Exacerbation ◽

Life Threatening

Objective: Pneumomediastinum and pneumopericardium are rare occurrences in young athletes, but they can result in potentially life-threatening consequences. Background: While involved in a rugby match, an 11-year-old boy received a chest compression by 3 players during a tackle. He continued to play, but 2 hours later, he developed sharp retrosternal chest pain. A chest radiograph and an echocardiograph at the nearest emergency department showed pneumopericardium and pneumomediastinum. Differential Diagnosis: Sternal and rib contusions, rib fractures, heartburn, acute asthma exacerbation, pneumomediastinum, pneumopericardium, pneumothorax, traumatic tracheal rupture, myocardial infarction, and costochondritis (Tietze syndrome). Treatment: Acetaminophen for pain control. Uniqueness: To our knowledge, this is the only case in the international literature of the simultaneous occurrence of pneumomediastinum and pneumopericardium in a child as a consequence of blunt chest trauma during a rugby match. Conclusions: Pneumomediastinum and pneumopericardium may be consequences of rugby blunt chest trauma. Symptoms can appear 1 to 2 hours later, and the conditions may result in serious complications. Immediate admission to the emergency department is required.

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