CT imaging of blunt chest trauma

Abstract

BackgroundThoracic injury overall is the third most common cause of trauma following injury to the head and extremities. Thoracic trauma has a high morbidity and mortality, accounting for approximately 25% of trauma-related deaths, second only to head trauma. More than 70% of cases of blunt thoracic trauma are due to motor vehicle collisions, with the remainder caused by falls or blows from blunt objects.MethodsThe mechanisms of injury, spectrum of abnormalities and radiological findings encountered in blunt thoracic trauma are categorised into injuries of the pleural space (pneumothorax, hemothorax), the lungs (pulmonary contusion, laceration and herniation), the airways (tracheobronchial lacerations, Macklin effect), the oesophagus, the heart, the aorta, the diaphragm and the chest wall (rib, scapular, sternal fractures and sternoclavicular dislocations). The possible coexistence of multiple types of injury in a single patient is stressed, and therefore systematic exclusion after thorough investigation of all types of injury is warranted.ResultsThe superiority of CT over chest radiography in diagnosing chest trauma is well documented. Moreover, with the advent of MDCT the imaging time for trauma patients has been significantly reduced to several seconds, allowing more time for appropriate post-diagnosis care.ConclusionHigh-quality multiplanar and volumetric reformatted CT images greatly improve the detection of injuries and enhance the understanding of mechanisms of trauma-related abnormalities.

Lung Herniation Associated with Rib Fracture in an 11-year-old child

“…Toraks yaralanmaları kafa ve ekstremite yaralanmalarından sonra 3. sırada yer almaktadır (1) . Toraks yaralanmalarının spektrumu geniş olup, plevral zarı tutarak hemotoraks ve pnömotoraksa, akciğer parankimini tutarak akciğer kontüzyonu ve herniasyona, göğüs duvarını tutarak kosta fraktürlerine neden olabilir.…”

“…Kosta fraktürle-rinin yönetimi genellikle konservatiftir. Ancak, ciddi toraks yaralanmalarının %50'den fazlasına mekanik ventilasyon veya cerrahi girişim gerekebilmektedir (1) . Konservatif tedavi kararı alınan nondeplase kosta fraktürü olan hastalarda daha sonra gelişebilecek atelektazi ve pnömoninin önlenebilmesi için iyi ağrı yönetimi ve dolayısıyla iyi akciğer ventilasyonu sağ-lanmalıdır.…”

“…Toraks yaralanmaları künt ve penetran yaralanmalar olarak sınıflandırılmakta, bu yaralanmaların %90'ına yakını künt travmalar sonucu meydana gelmektedir (1) . Toraks travmalarının %70'i motorlu araç kazaları sonrası, %10-17'si yüksekten düşme sonrası meydana gelmektedir (2) .…”

Cardiac Contusions

“…The recent use of multi-detector CT scan (MDCT) with CT-angiography capabilities has resulted in some encouraging data. MDCT has been shown to be highly sensitive in blunt chest trauma and to be helpful in the characterization of blunt thoracic injuries [33][34][35][36][37]. A prospective study by Shiekh et al found that 64 MDCT was 92 % sensitivity and 98 % specificity in detecting coronary artery disease [38].…”

Comparison of pediatric and adult patients with thoracic trauma in emergency department

“…They account for 25% of trauma-related deaths and are the third leading trauma following head and extremity traumas (Regel et al, 1995 ;Oikonomou and Prassopoulos, 2011).…”