Blunt Thoracic Trauma

Weyant, Michael J.; Fullerton, David A.

doi:10.1053/j.semtcvs.2008.01.002

Cited by 24 publications

(6 citation statements)

References 32 publications

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“…High-speed motor vehicle accidents account for 90% of all BDR; therefore, other serious injuries are associated with BDR. Associated injures are seen in as many as 80–100% of BDR cases, the most common being hemothorax or pneumothorax, and injuries to the spleen or liver [6, 7]. …”

Section: Discussionmentioning

confidence: 99%

Hepatothorax: A Rare Outcome of High-Speed Trauma

Porcelli

Prychyna

Rosenthal

et al. 2011

Case Reports in Emergency Medicine

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Diaphragmatic ruptures are the result of severe blunt trauma or penetrating trauma. Motor vehicle crashes are a common mechanism associated with blunt diaphragmatic rupture (BDR). Incorporating diagnostic tools and laparotomy assist in the diagnosis and treatment of BDR. However, diagnosing BDR can be a challenge for practitioners. Early diagnosis and treatment improve the patient's outcomes. This paper details the events of a patient received in a level I trauma unit.

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Section: Discussionmentioning

confidence: 99%

Hepatothorax: A Rare Outcome of High-Speed Trauma

Porcelli

Prychyna

Rosenthal

et al. 2011

Case Reports in Emergency Medicine

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“…Injuries to the great vessels are rare in blunt trauma; however, patients with great vessel injury usually die at the scene, including up to 80-90 % of those with aortic rupture [45]. Blunt diaphragmatic rupture rarely occurs alone and often heralds more severe concomitant injuries with an associated injury rate of 80-100 % [46,47].…”

Section: Blunt Thoracic Injuriesmentioning

confidence: 98%

Blast-related lung injuries

Ferraro

Hiles

2016

Curr Pulmonol Rep

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Blast-related lung injuries are occurring with increased frequency in a variety of circumstances, necessitating that both civilian and military providers across the healthcare spectrum understand how to promptly diagnose and manage these injury patterns. Primary, secondary, and tertiary blast injury mechanisms are most commonly encountered and can result in primary blast lung injury, air embolism, pulmonary contusion, rib fractures, and penetrating lung injuries. Primary blast lung injury occurs when a blast wave injures the lung parenchyma and vasculature and presents as acute dyspnea, cough, and hypoxemia with airspace disease on chest imaging. The treatment of primary blast lung injury, as well as other blast-related lung injuries, involves maintaining oxygenation and using a lung-protective strategy with low tidal volumes and minimal PEEP for patients requiring mechanical ventilation. Pain management, preferably in the form of regional anesthesia, is also crucial in improving outcomes in patients with blast-related lung injury.Keywords Primary blast lung injury . Explosion . Blunt thoracic trauma . Penetrating lung injury A 25-year-old male with no past medical history is transported to a hospital by ambulance after suffering multiple traumatic thoracic injuries when a bomb was detonated within 30 m of him at a sporting event. He has several soft tissue injuries over the torso and extremities. Pressure dressings were applied by first responders with hemostasis achieved. His vital signs include a temperature of 37.8°C, heart rate of 114/min, blood pressure of 92/50 mmHg, respiratory rate of 28/min, and oxygen saturation of 91 % on 15 LPM of oxygen via nonrebreather mask. His thoracic injuries include several leftsided non-displaced rib fractures with associated pulmonary contusion, a left-sided pneumothorax, and primary blast lung injury (PBLI). A chest CT (Fig. 1) in the Emergency Department demonstrates some of these findings. How should his case be managed?

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“…Traumatic diaphragmatic injuries (TDIs) secondary to blunt or penetrating thoraco-abdominal trauma are difficult to diagnose in the acute trauma setting [1]. Despite advances in radiological imaging, it is known that the incidence of missed or delayed diagnosis of TDI is about 30% [2]. The diagnostic yield of chest radiography and ultrasound in the acute TDI is low [3], and computed tomography has a diagnostic yield of 61-72% [4].…”

Section: Introductionmentioning

confidence: 99%

Benefits of routine uniportal thoracoscopy during rib fixation in the diagnosis and repair of diaphragmatic injury

Derdiyok,

Temel

2024

Curr Thorac Surg

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Background:The incidence of missed diagnosis of traumatic diaphragmatic injury (TDI) is about 30%.Lower rib fractures may cause TDI. We aimed to present our clinical results of uniportal video-assisted thoracoscopic surgery (VATS) in terms of detecting and repairing TDI, in patients undergoing rib fixation. Materials and Methods:In this retrospective study, routine uniportal VATS was performed in patients planned to undergo rib fixation due to flail chest and severely displaced rib fractures between January 2021 and January 2023. The results of 11 patients with TDI were investigated.Results: All patients were male. Eighty-two percent of the patients had blunt type of injury. Most TDIs were detected during VATS (55%). There were 7 left and 4 right TDIs with diaphragmatic defects varying from 2 to 5 cm in size. Two patients had minor omental herniation. Mean number of fractured ribs was 4.Mean duration of operation was 139 minutes. Mean hospital stay was 7 days. Morbidity developed in 1 patient (9%, wound infection).Conclusions: Routine VATS in patients undergoing SSRF helps detecting and repair TDIs. Its diagnostic benefit in the diagnosis of acute TDI is greatest in patients with multiple rib fractures involving the lower chest wall, although there are no radiographic evidences of TDI.

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Blunt Thoracic Trauma

Cited by 24 publications

References 32 publications

Hepatothorax: A Rare Outcome of High-Speed Trauma

Hepatothorax: A Rare Outcome of High-Speed Trauma

Blast-related lung injuries

Benefits of routine uniportal thoracoscopy during rib fixation in the diagnosis and repair of diaphragmatic injury

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