On traumatic pneumothorax with primary gas injection

Over the last 10-15 years, treatment of tuberculosis patients with artificial pneumothorax has become widespread and there are many works devoted to collapse therapy in the press; details of the technique, efficiency of treatment, and complications are discussed. Spontaneous pneumothorax (SP) is one of the most dangerous complications of pneumothorax. Under p. p. we understand gas accumulation in pleural cavity in case of lung perforation, as the result of pathological process in the lung, more often of subpleural cavernous cavity breakthrough, caseous focus, or due to lung parenchyma needle trauma while applying pneumothorax.

Comparative study between bedside chest ultrasound and chest CT scan in the diagnosis of traumatic pneumothorax

Background Traumatic pneumothorax (PTx) is common in chest trauma. Its incidence ranges between 10 and 28%. Chest X-ray (CXR) is the traditional imaging for the potential traumatic PTx, while CT chest is considered the gold standard diagnostic tool. However, it requires that the patient to be transferred from the Emergency Department (ED) with its resuscitative facilities. Chest US (E-FAST) has emerged as a sensitive tool that can be used on bedside basis with much higher sensitivity than CXR. The objective of this study was to compare between accuracy and usefulness of the bedside US chest and CT chest in the diagnosis of traumatic PTx, as well as its ability to quantify its size. This was a prospective clinical study that included two hundred patients who have been admitted to the ED. The inclusion criteria included any patient with chest trauma. Exclusion criteria included patients with clinical surgical emphysema, patients with life threatening PTx, and patients who did not undergo CT chest. Results Forty-seven hemithoraces were proved positive for PTx by CT chest, while forty-five hemithoraces out of those 47 were confirmed by bedside chest US. The sensitivity for chest US is 95.74% in detection of traumatic PTx. No false-positive cases were diagnosed. All of the forty-five hemithoraces diagnosed by chest US have been confirmed by CT scan making a specificity of 100%. Conclusions Chest US is a useful rapid diagnostic tool in the diagnosis and quantification of the traumatic PTx at ED. It avoids the delay in transportation of the critically ill patients to perform CT chest.

Is chest ultrasonography a reliable tool for the emergency diagnosis of traumatic pneumothorax. An Updated Meta-Analysis

Aims: A commonly encountered problem in emergency care is pneumothorax, identified by air present in pleural space, occurring spontaneously, principally because of trauma or pathogenic factors like a central venous catheter, mechanical ventilation, and biopsy. Employing Chest ultrasound for diagnosing pneumothorax in an emergency is currently investigated by many researchers. The present meta-analysis aimed to assess Chest ultrasound’s diagnostic accuracy in diagnosing the pneumothorax during emergencies. Material and Methods: Literature search of published articles in MEDLINE, Embase, Ovid, Scopus, and Journal on web databases from 2000 up to November 2020 were reviewed for the pre-described outcomes. Results: 12 articles were finally chosen for quantitative analysis. The overall sensitivity of ultrasound scan in pneumothorax diagnosis was 89% (95 % CI – 86 – 91%). Specificity was 96% (CI – 95% – 97%). The diagnostic odds ratio was 193.94 (59.009 – 637.40) at 95% CI, thus demonstrating greater chest ultrasound accuracy in diagnosing pneumothorax. Conclusion: A definite evidence of chest ultrasound accuracy was noted in pneumothorax.

EXTENSIVE EPIDEMIOLOGICAL STUDY OF TRAUMATIC PNEUMOTHORAX IN SAUDI ARABIA’S POPULATION

Objectives: Traumatic pneumothorax is one of the causes of trauma mortality and morbidity. It is a problem for developing countries as many accidents can be avoided and there are few epidemiological data to support programs injury prevention. The main objective of the current study was to determine demographic characteristics, patterns, and severity of the injury, thoracic, and extra-thoracic related injuries in a Level 1 trauma center, Riyadh, Saudi Arabia (SA). Methods: This retrospective observational study used the King Abdulaziz Medical City Trauma Center’s trauma registry to review the data of traumatic pneumothorax patients admitted to the hospital from January 2001 to December 2018. Demographic characteristics, admission date and time, type and mechanism of injury, involved body area, and severity rates were analyzed. Results: A total of 708 patients of whom 92.3% were males. Blunt trauma (75.8%) is the most common cause of injury. Motor Vehicle Accidents (MVA) were the most common cause (57%) of traumatic pneumothorax. Rib fractures (36.5%), lung contusions (31.5%), and hemothorax (23.5%) were the most common clinical forms of chest injury associated with traumatic pneumothorax. On the other hand, the head injury (34.8%) was the most common extra thoracic part associated. The mean Injury Severity Score in the current study was found to be 20.1. Conclusion: This study showed the trends of traumatic pneumothorax injuries in a Level 1 trauma center, Riyadh, SA, showing MVA are the leading cause of traumatic pneumothorax in our region. These demographic data will be crucial for local health-care systems to be optimally resourced.