Penetrating and Perforating Thoracic Injuries

Mattila, S; Laustela, E; Tala, P

doi:10.3109/14017438109101033

Cited by 15 publications

(6 citation statements)

References 20 publications

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“…A meticulous analysis was conducted of 22 relevant publications evaluating conservative treatment for patients with traumatic PTX. We selected 12 articles [12][13][14][15][16][17][18][19][20][21][22][23] where needle aspiration was also discussed as a conservative treatment option. We summarized all data extracted from these 12 studies in Table 1, which includes the first author, the year of publication, the study reference, patient groups, study type, outcomes, and study weaknesses.…”

Section: Resultsmentioning

confidence: 99%

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Successful Needle Aspiration of a Traumatic Pneumothorax: a Case Report and Literature Review.

Bettoni,

Gheda,

Altomare

et al. 2024

Preprint

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Traumatic pneumothorax (PTX) occurs in up to 50% of patients with severe polytrauma and chest injuries. Patients with traumatic PTX with clinical signs of tension physiology and hemodynamic instability are typically treated with an urgent decompressive thoracostomy, tube thoracostomy, or needle decompression. There is recent evidence that non-breathless patients with hemodynamically stable traumatic PTX can be managed conservatively through observation or a percutaneous pigtail catheter. We present here a 52-year-old woman who presented to the emergency department with 55 mm traumatic PTX. Following aspiration of 1500 ml of air, clinical improvement was immediately observed, allowing the patient to be discharged shortly thereafter. In hemodynamically stable patients with posttraumatic PTX, without specific risk factors or oxygen desaturation, observation or simple needle aspiration can be a reasonable approach. We aimed in this article to review the available literature on needle aspiration and conservative treatment of traumatic pneumothorax. A total of 12 studies were selected out of 190 articles on traumatic PTX, where conservative treatment versus chest tube decompression was compared. Our case report demonstrated that even a large PTX in a hemodynamically stable patient without other risk conditions, can be successfully treated conservatively with simple needle aspiration to avoid tube thoracostomy complications.

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Section: Resultsmentioning

confidence: 99%

“…Data of twelve selected papers[12][13][14][15][16][17][18][19][20][21][22][23] on conservative management of PTX are summarized in the table, including the first author, the year of publication, study reference, patient groups, type of study, and outcomes. (LOS: length of stay, RCT: randomized clinical trial; RD respiratory distress).…”

mentioning

confidence: 99%

Successful Needle Aspiration of a Traumatic Pneumothorax: a Case Report and Literature Review.

Bettoni,

Gheda,

Altomare

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…A meticulous analysis was conducted of 22 relevant publications evaluating conservative treatment for patients with a traumatic PTX. We selected 12 articles [13][14][15][16][17][18][19][20][21][22][23][24] where needle aspiration was also discussed as a conservative treatment option. We summarize all data extracted from these 12 studies in Table 1, which includes the first author, the year of publication, the study reference, patient groups, the study type, and outcomes and key results.…”

Section: Resultsmentioning

confidence: 99%

Successful Needle Aspiration of a Traumatic Pneumothorax: A Case Report and Literature Review

Bettoni,

Gheda,

Altomare

et al. 2024

Medicina

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Traumatic pneumothorax (PTX) occurs in up to 50% of patients with severe polytrauma and chest injuries. Patients with a traumatic PTX with clinical signs of tension physiology and hemodynamic instability are typically treated with an urgent decompressive thoracostomy, tube thoracostomy, or needle decompression. There is recent evidence that non-breathless patients with a hemodynamically stable traumatic PTX can be managed conservatively through observation or a percutaneous pigtail catheter. We present here a 52-year-old woman who presented to the emergency department with a 55 mm traumatic PTX. Following aspiration of 1500 mL of air, a clinical improvement was immediately observed, allowing the patient to be discharged shortly thereafter. In hemodynamically stable patients with a post-traumatic PTX, without specific risk factors or oxygen desaturation, observation or simple needle aspiration can be a reasonable approach. Although the recent medical literature supports conservative management of small traumatic PTXs, guidelines are lacking for hemodynamically stable patients with a significantly large PTX. This case report documents our successful experience with needle aspiration in such a setting of large traumatic PTX. We aimed in this article to review the available literature on needle aspiration and conservative treatment of traumatic pneumothorax. A total of 12 studies were selected out of 190 articles on traumatic PTX where conservative treatment and chest tube decompression were compared. Our case report offers a novel contribution by illustrating the successful resolution of a sizable pneumothorax through needle aspiration, suggesting that even a large PTX in a hemodynamically stable patient, without other risk conditions, can be successfully treated conservatively with simple needle aspiration in order to avoid tube thoracostomy complications.

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“…Closure of traumatic VSD is controversial and based on a consideration of hemodynamics, defect size, and heart failure symptoms [ 8 ]. Symptomatic and moderate-to-large VSDs with pulmonary-to-systemic shunts greater than 1.5:1.0 should be considered for closure [ 9 ]. As an alternative to surgery, transcatheter techniques have recently been introduced as a less-invasive treatment modality for VSD closure in trauma patients [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Traumatic ventricular septal defect resulting in severe pulmonary hypertension

Crompton¹,

Nacev²,

Upham³

et al. 2014

Journal of Surgical Case Reports

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Traumatic ventricular septal defect (VSD) is a widely-recognized complication of both penetrating and blunt trauma. Most cases are repaired operatively without the long-term complications of pulmonary hypertension and heart failure that are associated with unrepaired congenital VSD in the pediatric population. To our knowledge, this is the first case report of a patient with a traumatic VSD who declined surgical repair at the time of injury and subsequently developed long-term complications of pulmonary hypertension and heart failure. With nearly 20 years of follow-up, this case demonstrates that the absence of surgical treatment in asymptomatic adult patients at the time of injury can lead to long-term complications associated with VSD. This case also shows that aggressive surgical treatment in patients with severe pulmonary vascular disease and heart failure secondary to traumatic VSD can be performed safely and should be considered in cases refractory to efficacious medical interventions.

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Penetrating and Perforating Thoracic Injuries

Cited by 15 publications

References 20 publications

Successful Needle Aspiration of a Traumatic Pneumothorax: a Case Report and Literature Review.

Successful Needle Aspiration of a Traumatic Pneumothorax: a Case Report and Literature Review.

Successful Needle Aspiration of a Traumatic Pneumothorax: A Case Report and Literature Review

Traumatic ventricular septal defect resulting in severe pulmonary hypertension

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