Chest injury: Difference between revisions
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{{Infobox |
{{Infobox medical condition (new) |
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| name = Chest injury |
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| synonyms = Chest trauma, Commotio thoracis |
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| image = File:Pulmonary contusion.jpg |
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| caption = A [[chest X-ray]] of a right sided pulmonary contusion associated with flail chest and [[subcutaneous emphysema]] |
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A '''chest injury''' is any form of physical [[injury]] to the [[chest]] including the [[heart]] and [[lungs]]. Chest injuries account for 25% of all deaths from traumatic injury.<ref>Peitzman |
A '''chest injury''', also known as '''chest trauma''', is any form of physical [[injury]] to the [[chest]] including the [[ribs]], [[heart]] and [[lungs]]. Chest injuries account for 25% of all deaths from traumatic injury.<ref>{{cite book |author1=Andrew B., MD Peitzman |author2=Andrew B. Peitzman |author3=Michael, MD Sabom |author4=Donald M., MD Yearly |author5=Timothy C., MD Fabian |title=The trauma manual |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2002 |isbn=0-7817-2641-7 |page=203}}</ref> Typically chest injuries are caused by blunt mechanisms such as direct, indirect, compression, contusion, deceleration, or blasts<ref>Marini, John J., Dries, David J... ''Critical Care Medicine: The Essentials and More''. 5th Edition. Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103 USA:Lippincott Williams & Wilkins; 2019. Available from: Books@Ovid at http://ovidsp.ovid.com .</ref> caused by [[motor vehicle collisions]] or penetrating mechanisms such as [[Stab wound|stabbings]].<ref>{{cite book |author1=Feliciano, David V. |author2=Mattox, Kenneth L. |author3=Moore, Ernest J. |title=Trauma, Seventh Edition (Trauma (Moore)) |publisher=McGraw-Hill Professional |year=2012 |isbn=978-0-07-166351-9|page=468}}</ref> |
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==Classification== |
==Classification== |
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Chest injuries can be classified as [[blunt trauma|blunt]] or [[penetrating trauma|penetrating]]. Blunt and penetrating injuries have different [[pathophysiology|pathophysiologies]] and clinical courses. |
Chest injuries can be classified as [[blunt trauma|blunt]] or [[penetrating trauma|penetrating]]. Blunt and penetrating injuries have different [[pathophysiology|pathophysiologies]] and clinical courses. |
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Specific types of injuries include: |
Specific types of injuries include: |
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* Injuries to the [[chest wall]] |
* Injuries to the [[chest wall]] |
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** Chest wall [[contusion]]s or [[hematoma]]s |
** Chest wall [[contusion]]s or [[hematoma]]s |
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** [[Rib fracture]]s |
** [[Rib fracture]]s |
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** [[Flail chest]] |
** [[Flail chest]] |
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** [[Myocardial contusion]] |
** [[Myocardial contusion]] |
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** [[Traumatic arrest]] |
** [[Traumatic arrest]] |
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** [[Hemopericardium]] |
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* Blood vessel injuries |
* Blood vessel injuries |
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** [[Traumatic aortic rupture]] |
** [[Traumatic aortic rupture]] |
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** [[Thoracic aorta injury]] |
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** [[Aortic dissection]] |
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* And injuries to other structures within the torso |
* And injuries to other structures within the torso |
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** [[Esophageal injury]] ([[Boerhaave syndrome]]) |
** [[Esophageal injury]] ([[Boerhaave syndrome]]) |
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Most blunt injuries are managed with relatively simple interventions like [[tracheal intubation]] and [[mechanical ventilation]] and [[chest tube]] insertion. Diagnosis of blunt injuries may be more difficult and require additional investigations such as [[CT scan]]ning. Penetrating injuries often require [[surgery]], and complex investigations are usually not needed to come to a diagnosis. Patients with penetrating trauma may deteriorate rapidly, but may also recover much faster than patients with blunt injury. |
Most blunt injuries are managed with relatively simple interventions like [[tracheal intubation]] and [[mechanical ventilation]] and [[chest tube]] insertion. Diagnosis of blunt injuries may be more difficult and require additional investigations such as [[CT scan]]ning. Penetrating injuries often require [[surgery]], and complex investigations are usually not needed to come to a diagnosis. Patients with penetrating trauma may deteriorate rapidly, but may also recover much faster than patients with blunt injury. |
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==Outcomes== |
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:-D |
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Chest trauma outcomes depend on the severity of the chest injury as well as associated injuries (such as head or spinal trauma) and the patient’s general health condition. |
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Early management in specialist centres offers better survival. Management is a mixture of medical (eg pain relief, respiratory support, chest drainage and antibiotics), non-medical (physiotherapy and rehabilitation) and surgical (fixation of rib fractures if appropriate and operative treatment of cardiac, lung, airway, diaphragm and oesophageal injuries). |
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Those who survive chest trauma and are discharged from hospital have a long-term survival comparable to the general population.<ref>{{Cite journal |last=Ariyaratnam |first=P |date=February 2023 |title=Predictors of long-term survival in 5,680 patients admitted to a UK major trauma centre with thoracic injuries |journal=The Annals of the Royal College of Surgeons of England|volume=105 |issue=6 |pages=540–547 |doi=10.1308/rcsann.2023.0001 |pmid=36779446 |pmc=10313447 }}</ref> |
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==See also== |
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* [[Transmediastinal gunshot wound]] |
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* [[Commotio thoracis]] |
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==References== |
==References== |
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{{Reflist}} |
{{Reflist}} |
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==Bibliography== |
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*{{cite book |author=Feliciano, David V.; Mattox, Kenneth L.; Moore, Ernest J |title=Trauma, Seventh Edition (Trauma (Moore)) |publisher=McGraw-Hill Professional |location= |year=2012 |pages= |isbn=0-07-166351-7}} |
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*{{cite book |author=Andrew B., MD Peitzman; Andrew B. Peitzman; Michael, MD Sabom; Donald M., MD Yearly; Timothy C., MD Fabian |title=The trauma manual |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2002 |pages= |isbn=0-7817-2641-7 |oclc= |doi= |accessdate=}} |
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== External links == |
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{{Injuries, other than fractures, dislocations, sprains and strains}} |
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{{Medical resources |
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| DiseasesDB = |
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| ICD10 = {{ICD10|S|20}}—{{ICD10|S|29}} |
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| ICD9 = {{ICD9|959.11}} |
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| ICDO = |
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| MedlinePlus = |
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| eMedicineSubj = |
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| eMedicineTopic = |
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| MeshID = D013898 |
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| GeneReviewsNBK = |
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| GeneReviewsName = |
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| SNOMED CT = 262525000 |
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}} |
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{{Chest trauma}} |
{{Chest trauma}} |
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{{General injuries}} |
{{General injuries}} |
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{{Trauma |state=autocollapse}} |
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{{Authority control}} |
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[[Category:Medical emergencies]] |
[[Category:Medical emergencies]] |
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[[Category:Chest trauma|*]] |
[[Category:Chest trauma|*]] |
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Latest revision as of 09:45, 14 September 2024
| Chest injury | |
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| Other names | Chest trauma, Commotio thoracis |
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| A chest X-ray of a right sided pulmonary contusion associated with flail chest and subcutaneous emphysema | |
| Specialty | Emergency medicine  |
A chest injury, also known as chest trauma, is any form of physical injury to the chest including the ribs, heart and lungs. Chest injuries account for 25% of all deaths from traumatic injury.[1] Typically chest injuries are caused by blunt mechanisms such as direct, indirect, compression, contusion, deceleration, or blasts[2] caused by motor vehicle collisions or penetrating mechanisms such as stabbings.[3]
Classification
[edit]Chest injuries can be classified as blunt or penetrating. Blunt and penetrating injuries have different pathophysiologies and clinical courses.
Specific types of injuries include:
- Injuries to the chest wall
- Chest wall contusions or hematomas
- Rib fractures
- Flail chest
- Sternal fractures
- Fractures of the shoulder girdle
- Pulmonary injury (injury to the lung) and injuries involving the pleural space
- Injury to the airways
- Cardiac injury
- Blood vessel injuries
- And injuries to other structures within the torso
Diagnosis
[edit]Most blunt injuries are managed with relatively simple interventions like tracheal intubation and mechanical ventilation and chest tube insertion. Diagnosis of blunt injuries may be more difficult and require additional investigations such as CT scanning. Penetrating injuries often require surgery, and complex investigations are usually not needed to come to a diagnosis. Patients with penetrating trauma may deteriorate rapidly, but may also recover much faster than patients with blunt injury.
Outcomes
[edit]Chest trauma outcomes depend on the severity of the chest injury as well as associated injuries (such as head or spinal trauma) and the patient’s general health condition.
Early management in specialist centres offers better survival. Management is a mixture of medical (eg pain relief, respiratory support, chest drainage and antibiotics), non-medical (physiotherapy and rehabilitation) and surgical (fixation of rib fractures if appropriate and operative treatment of cardiac, lung, airway, diaphragm and oesophageal injuries).
Those who survive chest trauma and are discharged from hospital have a long-term survival comparable to the general population.[4]
See also
[edit]References
[edit]- ^ Andrew B., MD Peitzman; Andrew B. Peitzman; Michael, MD Sabom; Donald M., MD Yearly; Timothy C., MD Fabian (2002). The trauma manual. Hagerstwon, MD: Lippincott Williams & Wilkins. p. 203. ISBN 0-7817-2641-7.
- ^ Marini, John J., Dries, David J... Critical Care Medicine: The Essentials and More. 5th Edition. Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103 USA:Lippincott Williams & Wilkins; 2019. Available from: Books@Ovid at http://ovidsp.ovid.com .
- ^ Feliciano, David V.; Mattox, Kenneth L.; Moore, Ernest J. (2012). Trauma, Seventh Edition (Trauma (Moore)). McGraw-Hill Professional. p. 468. ISBN 978-0-07-166351-9.
- ^ Ariyaratnam, P (February 2023). "Predictors of long-term survival in 5,680 patients admitted to a UK major trauma centre with thoracic injuries". The Annals of the Royal College of Surgeons of England. 105 (6): 540–547. doi:10.1308/rcsann.2023.0001. PMC 10313447. PMID 36779446.
External links
[edit]| Authority control databases: National |
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