Combined chest and abdominal trauma in pedestrians injured during car accidents

Abstract

Purpose of the study. Revealing the features of the formation of damage to the structure of the chest and abdominal organs in pedestrians during their collisions with moving cars. Materials and methods. A forensic medical examination of 215 corpses of persons killed in collisions with moving cars was carried out. Among the dead there were 173 men and 42 women. The victims were between 14 and 75 years old. Research results and their discussion. It was found that among pedestrians who died in collisions with cars, injuries of two or more parts of the body with fractures of the limb bones (55.8%) and сombined injury (CI) of the head, chest, abdomen (23.3%) prevail. In the composition of CI, damage to the structure of the chest and organs of the chest cavity was noted in 85.6% of cases. Rib fractures were detected in 57.7% of cases; fractures in the midclavicular and axillary lines predominated in localization. Damage to the structure of organs and tissues of the abdominal cavity in the composition of the abdominal CI in pedestrians was -71.0%. At the same time, 80.8% of the dead pedestrians show signs of injury to organs and tissues with pronounced hemorrhages in the suspension apparatuses, walls and parenchyma of organs. In 23.2% of cases, along with hemorrhages, there is a violation of the anatomical integrity of organs, mainly the liver and spleen. The outlined nature of damage to the structure of the chest, organs of the chest and abdominal cavity made it possible to establish the possibility of their formation in the 3rd phase of car injury - the fall of the injured on the road surface. Traumatic (pleuropulmonary), hemorrhagic shock and hemorrhagic pneumothorax were the main causes of injuries at the prehospital stage.