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Traumatic pneumothorax

Cumhur Murat Tulay, Sadık Yaldız, Adnan Bilge
PURPOSE: To identify occult pneumothorax with oblique chest X-ray (OCXR) in clinically suspected patients. METHODS: In this retrospective study, we examined 1082 adult multitrauma patients who were admitted to our emergency service between January 2016 and January 2017. Clinical findings that suggest occult pneumothorax were rib fracture, flail chest, chest pain, subcutaneous emphysema, abrasion or ecchymosis and moderate to severe hypoxia in clinical parameters...
March 16, 2018: Annals of Thoracic and Cardiovascular Surgery
Nicholas R Phillips, Derek E Kunz
While overall sports participation continues at high rates, chest injuries occur relatively infrequently. Many conditions of chest injury are benign, related to simple contusions and strains, but the more rare, severe injuries carry a much higher risk of morbidity and mortality than the typical issues encountered in athletic medicine. Missed or delayed diagnosis can prove to be catastrophic. Sports medicine providers must be prepared to encounter a wide range of traumatic conditions relating to the torso, varying from the benign chest wall contusion to the life-threatening tension pneumothorax...
March 2018: Current Sports Medicine Reports
Toshihiro Ikeda, Jun Nakano, Hiroyasu Yokomise
A 73-year-old man was injured after crashing his automobile into a concrete wall, and was admitted to our hospital with breathing difficulties. Chest computed tomography showed extensive mediastinal emphysema, right traumatic pneumothorax, and a suspected tracheal injury at the membranous region. Because of the associated tracheomalacia, the site of the tracheal injury was difficult to find by bronchoscopy. In addition, as the patient's respiratory condition was stable, surgical treatment was not chosen. Due to the continuous air leakage from the right lung, the patient underwent surgery after mediastinal and subcutaneous emphysema improved...
February 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Kaan Yusufoğlu, Mehmet Özgür Erdoğan, İsmail Tayfur, Mustafa Ahmet Afacan, Şahin Çolak
Background/aim: This study aimed to evaluate traumatic thorax complications in post-CPR patients and to investigate whether or not there has been a decrease in these complications since the adoption of current chest compression recommendations. Materials and methods: Post-CPR patients with return of spontaneous circulation (ROSC) were admitted between January 2014 and January 2016 were analyzed retrospectively. Patients admitted to the ED in 2014 were resuscitated according to 2010 AHA CPR guidelines, while those admitted to the ED in 2015 were resuscitated according to current ERC CPR guidelines...
February 23, 2018: Turkish Journal of Medical Sciences
Leonardo Jönck Staub, Roberta Rodolfo Mazzali Biscaro, Erikson Kaszubowski, Rosemeri Maurici
OBJECTIVE: To assess the diagnostic of the chest ultrasonography for the emergency diagnosis of traumatic pneumothorax and haemothorax in adults. STUDY DESIGN: Systematic review and meta-analysis. METHODS: PubMed, EMBASE, Scopus, Web of Science and LILACS (up to 2016) were systematically searched for prospective studies on the diagnostic accuracy of ultrasonography for pneumothorax and haemothorax in adult trauma patients. The references of other systematic reviews and the included studies were checked for further articles...
February 8, 2018: Injury
Case Newsom, Rebecca Jeanmonod, Wendy Woolley, Nirali Shah, Shellie Asher, Eric Bruno, Michael Silberman, Mark Reiter, Donald Jeanmonod
OBJECTIVES: To prospectively validate and refine previously published criteria to determine the potential utility of chest x-ray (CXR) in the evaluation and management of patients presenting to the emergency department (ED) with non-traumatic chest pain. METHODS: A prospective observational study was performed of patients presenting to three EDs in the US with a chief complaint of non-traumatic chest pain. Previously defined high-risk history and exam elements were combined into a refined decision rule and these elements were recorded for each patient by the ED physician...
February 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Leah Demetri, Myriam M Martinez Aguilar, Jordan D Bohnen, Ryan Whitesell, D Dante Yeh, David King, Marc de Moya
BACKGROUND: Eastern Association for the Surgery of Trauma guidelines suggest tube thoracostomy (TT) be considered for all traumatic hemothoraces. However, previous research has suggested that some traumatic hemothoraces may be observed safely. We sought to (1) determine the safety of selective observation for traumatic hemothorax and (2) identify predictors of failed observation. METHODS: All patients with traumatic hemothorax from 2000 to 2014 at a Level I trauma center were identified and categorized by size as small (<300 cc) or large (≥300 cc) based on chest computed tomography (CT) scan measurements...
March 2018: Journal of Trauma and Acute Care Surgery
Dohun Kim, Hong-Ju Shin, Si-Wook Kim, Jong-Myeon Hong, Kang Soo Lee, Sang-Hyuk Lee
Objective: The aims of the study were to investigate psychological distress in pneumothorax patients. Methods: A cohort study was performed in 101 patients with spontaneous pneumothorax. They were divided into three groups: (A) under 19 years old, (B) those of an intermediate age, and (C) over 45 years old. General well-being [Psychological Wellbeing Index-Short Form (PWI-SF)], traumatic event [Impact of Event Scale (IES)], and resilience [Life Orientation Test-Revised (LOT-R)] were assessed...
November 2017: Psychiatry Investigation
Amit Gupta, Amulya Rattan, Sunil Kumar, Vinita Rathi
A 13-year-old girl, who did not receive any treatment for few hours following Road Traffic Injury (RTI), reported to the Casualty Department and found to have patent airway with clinically normal C spine, air-hunger (RR 42/minute), trachea deviated to left, distended neck veins and absent breath sounds on the right side. The chest X-ray she carried, done immediately after the injury, showed right sided tension pneumothorax. She was put on oxygen at 11 L/minute and an Intercostal chest tube drainage (ICD) was inserted on right side...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
Myftar Torba, Arben Gjata, Francesco Rulli, Ilir Kajo, Sotir Ceka, Tajar Asqeri
INTRODUCTION: Despite technological advancement, high grade pancreatic injuries following blunt abdominal trauma continues to remain a disease that is associated with high morbidity and mortality rates, particularly in cases of delayed diagnosis. The aim of this paper was the presentation of delayed diagnosis and treatment peculiarities of high grade pancreatic trauma and a review of literature. CASE REPORT: A 55-years old man, involved in motor vehicle crashes, was referred to our level I trauma center...
November 29, 2017: Annali Italiani di Chirurgia
Azam Basheer, Mohamed Macki, Asim Mahmood
Traumatic pneumocephaly is literally defined as 'air in the head' after trauma. While this phenomenon has been well described in the literature, our case report is unique in describing diffuse pneumocephalus in the subaponeurotic space, subdural space, subarachnoid space, brain and ventricles without a break in the cranial vault: a 26-year-old man fell from a =9 meter scaffolding in a water tower. Following an arduous and delayed extrication, the patient was unresponsive with loss of pulse requiring intubation, cardiopulmonary resuscitation and release of tension pneumothorax with bilateral thoracostomy tubes...
November 25, 2017: BMJ Case Reports
Jost Schnell, Aris Koryllos, Alberto Lopez-Pastorini, Rolf Lefering, Erich Stoelben
BACKGROUND: Few reliable data are available on the epidemiology and treatment of spontaneous pneumothorax. We studied the sex and age distribution, frequency of hospitalization, mortality, and conservative versus surgical care of this condition in Germany in order to draw well-founded conclusions about its in-hospital diagnosis and treatment. METHODS: Data from all patients aged 10 or older who were hospitalized in the period 2011-2015 with a main discharge diagnosis of pneumothorax of neither traumatic nor iatrogenic origin were retrieved from the German Federal Statistical Office...
November 3, 2017: Deutsches Ärzteblatt International
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
December 2017: Der Anaesthesist
Gregor M Dunham, Alexandre Perez-Girbes, Ferdia Bolster, Kellie Sheehan, Ken F Linnau
AIMS AND OBJECTIVES: We have recently implemented a dedicated sudden cardiac arrest (SCA) - whole-body computed tomography (WBCT) protocol to evaluate SCA patients with return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation (CPR). The aim of this study is to evaluate the number and pattern of CPR-related injuries in ROSC patients with SCA-WBCT. METHODS AND MATERIALS: Single-centre retrospective review of 39 patients (13 female; 20 male, mean age 51...
November 9, 2017: European Radiology
Hyun Oh Park, Dong Hoon Kang, Seong Ho Moon, Jun Ho Yang, Sung Hwan Kim, Joung Hun Byun
Background: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
Kohei Ishikawa, Kazuhiko Omori, Hiromichi Ohsaka, Kei Jitsuiki, Toshihiko Yoshizawa, Yasumasa Oode, Mutsumi Sakurada, Atsuhiko Mogami, Youichi Yanagawa
Aim: We review the case of a severely injured patient to evaluate the system of delivering medical staff by helicopter in areas with limited medical resources. Methods: The patient's chart was reviewed, summarized, and presented. Results: A 22-year-old woman attempted a suicidal fall after using a knife to stab herself. She was transported to a local hospital. A radiological study revealed fractures to the patient's face and the base of her skull, pneumocephalus, traumatic subarachnoid hemorrhage, stab wounds to the neck and chest, pneumothorax, unstable pelvic fracture, and right femoral shaft fracture...
January 2017: Acute Medicine & Surgery
Steven P Walker, Shaney L Barratt, Julian Thompson, Nick A Maskell
BACKGROUND: Traumatic pneumothoraces are a common consequence of major trauma. Despite this, there is a paucity of literature regarding their optimal management, including the role of conservative treatment. The aim of this study was to assess the treatment, complications, and outcomes of traumatic pneumothoraces in patients presenting to a major trauma center. METHODS: The prospectively collected Trauma Audit and Research Network (TARN) database was used to identify all patients presenting with traumatic pneumothoraces to a UK major trauma center from April 2012 to December 2016...
November 15, 2017: Chest
Hu-Lin C Wang, Cheng-Hung How, Heng-Fu Lin, Jang-Ming Lee
Tracheobronchial injuries are rare but life-threatening conditions in patients with blunt thoracic trauma. The diagnosis and management of such injury may often be delayed due to other concomitant severe injuries. No reported case of a robotic-assisted bronchial reconstruction has ever been performed for a traumatic bronchial injury. A 23-year-old male suffered from traumatic left main bronchial (LMB) rupture with an initial presentation of pneumothorax and pneumomediastinum that eventually progressed to left main bronchus fibrosis and total obstruction, which led to left lung atelectasis and consolidation...
January 2018: Respirology Case Reports
Lindsey B Armstrong, David P Mooney
INTRODUCTION: Traumatic pneumatoceles are reported to be rare in children and to have an uncertain clinical significance. We report a single institution series of traumatic pneumatoceles to better define their frequency and clinical significance. METHODS: After obtaining approval from the IRB, data were extracted from the trauma registry of a level 1 pediatric trauma center on children diagnosed with a pulmonary contusion (International Classification of Diseases-9th edition diagnosis codes: 861...
August 7, 2017: Journal of Pediatric Surgery
Kanwaljeet Garg, Ravi Sharma, Deepak Gupta, Sumit Sinha, Guru Dutt Satyarthee, Deepak Agarwal, Shashank Sarad Kale, Bhawani Shankar Sharma, Ashok Kumar Mahapatra
INTRODUCTION: Traumatic injuries are the leading cause of death and a major cause of disability among children. About 70%-80% of the accidental deaths in pediatric age group result directly from central nervous system lesions. METHODS: The purpose of our study was to study all the patients of ≤18 years of age with head or spinal injury admitted in neurointensive care unit at our center, an apex trauma center in a developing country, between June 2009 and September 2011...
April 2017: Journal of Pediatric Neurosciences
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