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pneumothorax, chest tubes, head trauma

Fong-Dee Huang, Wen-Bin Yeh, Sheng-Shih Chen, Yuan-Yuarn Liu, I-Yin Lu, Yi-Pin Chou, Tzu-Chin Wu
BACKGROUND: Major blunt chest injury usually leads to the development of retained hemothorax and pneumothorax, and needs further intervention. However, since blunt chest injury may be combined with blunt head injury that typically requires patient observation for 3-4 days, other critical surgical interventions may be delayed. The purpose of this study is to analyze the outcomes of head injury patients who received early, versus delayed thoracic surgeries. MATERIALS AND METHODS: From May 2005 to February 2012, 61 patients with major blunt injuries to the chest and head were prospectively enrolled...
January 5, 2018: World Journal of Surgery
Konstantina Chrysou, Gabriel Halat, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. METHODS: In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014...
April 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Frank Cheau-Feng Lin, Ruei-Yun Li, Yung-Wei Tung, Kee-Ching Jeng, Stella Chin-Shaw Tsai
BACKGROUND: Thoracic trauma is responsible for approximately 25% of trauma deaths, and rib fractures are present in as many as 40-80% of patients, and intensive care and/or ventilator support are frequently required for these patients. To identify their risk factors would improve treatment strategies for these patients. METHODS: Between March 2005 and December 2013, consecutive patients with blunt thoracic trauma, who were admitted to the Department of Thoracic Surgery at Tungs' Taichung Metro Harbor Hospital (Taichung, Taiwan), were reviewed in this retrospective cohort study with the approval of the Institutional Review Board...
June 2016: Journal of the Chinese Medical Association: JCMA
Reinhard Strametz, Christoph Pachler, Johanna F Kramer, Christian Byhahn, Andrea Siebenhofer, Tobias Weberschock
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) is one of the most common bedside surgical procedures performed in critically ill adult patients on intensive care units (ICUs) who require long-term ventilation. PDT is generally associated with relevant life-threatening complications (e.g. cuff rupture leading to possible hypoxia or aspiration, puncture of the oesophagus, accidental extubation, mediastinitis, pneumothorax, emphysema). The patient's airway can be secured with an endotracheal tube (ETT) or a laryngeal mask airway (LMA)...
2014: Cochrane Database of Systematic Reviews
Wilfred Chukwuemeka Mezue, Chika A Ndubuisi, Uwadiegwu A Erechukwu, Samuel C Ohaegbulam
BACKGROUND: Although there have been significant advances in the management of traumatic brain injury (TBI), associated severe injuries, in particular chest injuries, remain a major challenge. This paper analyses the contribution of chest injuries to the outcome of head injuries in the University of Nigeria Teaching Hospital (UNTH) and the Memfys Hospital for Neurosurgery (MHN) in Enugu, Nigeria. MATERIALS AND METHODS: This is a retrospective review of the medical records, operative notes, and radiological findings of all patients admitted for head injury who had associated significant chest injuries in the MHN from 2002 to 2009 and the UNTH between 2007 and 2010...
January 2012: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
Mohamed Fouad Ismail, Reda Ibrahim al-Refaie
Trauma is the leading cause of mortality in children over one year of age in industrialized countries. In this retrospective study we reviewed all chest trauma in pediatric patients admitted to Mansoura University Emergency Hospital from January 1997 to January 2007. Our hospital received 472 patients under the age of 18. Male patients were 374 with a mean age of 9.2±4.9 years. Causes were penetrating trauma (2.1%) and blunt trauma (97.9%). The trauma was pedestrian injuries (38.3%), motor vehicle (28.1%), motorcycle crash (19...
October 2012: Archivos de Bronconeumología
Ibrahim Al-Koudmani, Bassam Darwish, Kamal Al-Kateb, Yahia Taifour
BACKGROUND: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. In this study, we present our 11-year experience in the management and clinical outcome of 888 chest trauma cases as a result of blunt and penetrating injuries in our university hospital in Damascus, Syria. METHODS: We reviewed files of 888 consequent cases of chest trauma between January 2000 and January 2011. The mean age of our patients was 31 ± 17 years mostly males with blunt injuries...
2012: Journal of Cardiothoracic Surgery
Kenji Inaba, Thomas Lustenberger, Gustavo Recinos, Crysanthos Georgiou, George C Velmahos, Carlos Brown, Ali Salim, Demetrios Demetriades, Peter Rhee
BACKGROUND: The optimal chest tube size for the drainage of traumatic hemothoraces and pneumothoraces is unknown. The purpose of this study was to compare the efficacy of small versus large chest tubes for use in thoracic trauma. Our hypothesis was that (1) there would be no difference in clinically relevant outcomes including retained hemothoraces, the need for additional tube insertion, and invasive procedures and (2) there would be an increase in pain with the insertion of large versus small tubes...
February 2012: Journal of Trauma and Acute Care Surgery
Kamil H Dogan, Serafettin Demirci, Zerrin Erkol, Guven S Sunam, Tevfik Kucukkartallar
Persons whose occupations are in animal husbandry may be seriously injured or killed while tending to animals. Bulls are among the most dangerous of these animals. In this study, seven deaths and 23 traumatic injury cases caused by bull attacks and treated in the General Surgery and Chest Surgery Department of Selcuk University Meram Medical Faculty Hospital are presented. Of the 30 total cases, 24 were male and 6 were female. The ages of the cases ranged from 33 to 86 years and the average age was 60.3 +/- 12...
2008: Journal of Agromedicine
Andrew W Kirkpatrick, Chad G Ball, Scott K D'Amours, David Zygun
Traumatic injury remains the leading cause of potentially preventable death in Canadians under age 40 years. Although only a minority of patients present with hemodynamic instability, these patients have a significant chance of dying. The causes of instability must be recognized and corrected quickly by using a systematic approach. To allow key supportive interventions to be undertaken swiftly, it is more important to identify and prioritize systemic compromise than to confirm specific diagnoses. Most potentially preventable trauma death relates to airway obstruction, hemopneumothorax, intracranial hemorrhage and intracavitary bleeding...
February 2008: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Moosa Zargar, Ali Khaji, Mojgan Karbakhsh Davari
OBJECTIVE: Chest injury, one of the most important aspects of trauma, directly accounts for 25% of all trauma-related deaths and plays a major contributing role in another 25% of trauma deaths. This paper aimed to explore the spectrum and outcome of thoracic injuries seen in a multi centric study of trauma patients. METHODS: A total of 276 consecutive trauma patients in 6 general hospitals were analyzed. The feature of injury, injury severity score (ISS), clinical treatment and mortality were recorded in a prospective manner and analyzed retrospectively...
October 2007: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Mustafa Inan, Suleyman Ayvaz, Necdet Sut, Burhan Aksu, Umit N Basaran, Turan Ceylan
BACKGROUND: Although thoracic injuries are uncommon in children, their rate of morbidity and mortality is high. The aim of this study was to evaluate the clinical features of children with blunt chest injury and to investigate the predictive accuracy of their paediatric trauma scores (PTS). METHODS: Between September 1996 and September 2006, children with blunt thoracic trauma were evaluated retrospectively. Clinical features and PTS of the patients were recorded...
August 2007: ANZ Journal of Surgery
Hans Olav Kjøs, Tora M Zimmer Lande, Ulrika Eriksson, Dag Nordhaug, Asbjørn Karevold, Rune Haaverstad
BACKGROUND: The purpose of this study was to establish patient characteristics and the severity and extent of thoracic injury for patients referred to a Norwegian regional trauma centre. MATERIAL AND METHODS: All patients (n = 436) treated for thoracic injuries at St. Olavs University Hospital between 01.01. 2003 and 31.12. 2004 were analysed retrospectively. The patients were identified from the hospital diagnosis registry by ICD-10 codes. RESULTS: Traffic accidents and falls accounted for 92% of all injuries...
May 31, 2007: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
A Al-Saigh, F M Fazili, A R Allam
BACKGROUND: Chest trauma in childhood is relatively uncommon in clinical practice, and has been the subject of few reports in the literature. This study was undertaken to examine our experience in dealing with chest trauma in children. PATIENTS AND METHODS: This was a retrospective study of 74 children who sustained chest trauma, and were referred to King Fahad Hospital in Medina over a two-year period. The age, cause of injury, severity of injury, associated extrathoracic injuries, treatment and outcome were analyzed...
March 1999: Annals of Saudi Medicine
O Moerer, J Heuer, I Benken, M Roessler, A Klockgether-Radke
Tracheo-bronchial lesions in blunt chest trauma are rare--the incidence is about 1%--but potentially life-threatening events. Indirect signs such as pneumothorax, pneumomediastinum, subcutaneous emphysema or an insufficient expansion of the lungs after drainage of a pneumothorax are ominous. The fastest and most reliable method to assess the definite diagnosis of tracheo-bronchial lesion is fibre-optic tracheobronchoscopy. Early surgical treatment is mandatory to prevent major pulmonary resection. This case shows that computer tomography might fail to provide the right diagnosis...
2004: Anaesthesiologie und Reanimation
P Cavadore, G Brunat, P F Perrigault, P Colson
A 20-year-old woman was admitted to the ICU following a road traffic accident. She had a periorbital haematoma with a normal cerebral state on CT-scan, intrahepatic and intrasplenic haematomas and several fractures of the limb that were fixed on day 3. Twenty-four hours later, she developed a cough with symptoms of decerebration The head CT-scan showed diffuse pneumocephalus suitable with cerebral air embolism and the chest X ray a right tension pneumothorax. A chest tube was inserted. Despite the lack of hyperbaric oxygen therapy the patient recovered fully...
April 2000: Annales Françaises D'anesthèsie et de Rèanimation
H Miura, O Taira, S Hiraguri, O Uchida, M Hagiwara, T Ikeda, H Kato
Of 161 patients with blunt thoracic injury, 135 were male (83.9%) and 26 were female. The most common cause of injury was traffic accidents (130 patients, 80.7%), followed by falls (22 patients), and crushing (7 patients). There were 46 third decade and 36 second decade patients. Thirty-two patients had single thoracic injury and the other had multiple organ injury. The most common associated injury was head injury (65 patients). Most traffic accidents involved motor cycle accident. Forty-four patients died, 32 within 24 hours, and 4 died to thoracic injury...
June 1998: Japanese Journal of Thoracic and Cardiovascular Surgery
J Casanova Viudez, C Morán Ovide, J Pac Ferrer, J Mariñán Gorospe, J M Izquierdo Elena, R Rojo Marcos, J C Rumbero García, A Martínez Jáuregui, F Vara Cuadrado
Two hundred forty-eight cases of thoracic trauma arriving at our hospital between 1990 and 1992 are analyzed in this report. Injuries were only thoracic in 29% of the cases. The remaining patients presented associated lesions, mainly in the extremities, followed by head injuries. Single or multiple rib fracture, in 193 (77.8%) patients, was the most frequent thoracic injury, followed by 94 (37.6%) cases of hemothorax and 80 (30.2%) instances of pneumothorax. Pulmonary contusion in 57 (22.9%) cases was a serious consequence with a mortality rate of 35...
May 1994: Archivos de Bronconeumología
B Marts, R Durham, M Shapiro, J E Mazuski, D Zuckerman, M Sundaram, W B Luchtefeld
BACKGROUND: Computed tomography (CT) is an important diagnostic modality in the evaluation of blunt head and abdominal injuries, but it has not been routinely used to evaluate blunt chest trauma. METHODS: One hundred seventy stable patients with blunt thoracic trauma were evaluated with chest x-ray (CXR), and subsequently by CT. RESULTS: Of a total of 131 fractures, 53% were identified on initial CXR, 39% on CT, and 26% were not seen on either study...
December 1994: American Journal of Surgery
S Ekeström, L Bergdahl
Intrathoracic tracheal rupture following closed chest trauma is a potentially lethal injury which can be successfully repaired if the diagnosis is made early. Dyspnoea, mediastinal emphysema and pneumothorax which do not respond to intercostal tube drainage should alert the clinician to the possibility of intrathoracic tracheal rupture. A case is described. A 17-year-old boy sustained two longitudinal lacerations of the membranous portion of the intrathoracic trachea in association with blunt chest trauma. The diagnosis was delayed because of coexisting head injury...
1983: Acta Chirurgica Scandinavica
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