The sensitivity of chest X-ray (CXR) for the detection of significant thoracic injury in children exposed to blast

Abstract. The share of mechanical chest injuries in the structure of combat trauma is 35-45 % of the total number of chest injuries. More than 70 % of cases of closed injuries of the chest are mainly the result of the indirect effect of the blast wave. At the same time, bruises and ruptures occur more often, cavities in the lungs are formed less often. A high velocity of the damaging factor leads to alveolar trauma or subpleural hematomas, while a low velocity leads to central lung ruptures or large bronchus ruptures. The main methods of diagnosing lung damage due to closed combat trauma of the chest are radiological, which include standard x-ray examination, spiral computer tomography, and ultrasound diagnostics. The majority of domestic and foreign authors believe that among all methods of diagnosing lung damage, priority belongs only to CT as a highly informative and sensitive research method. The main task in the treatment of lung abscess is the active prevention of atelectasis, edema, pneumonia, abscess formation and the development of ARDS. The most difficult point in the treatment of patients with closed lung injuries is determining the indications for thoracotomy.

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The Use of Videothoracoscopic Technologies in the Treatment of Victims With Combat Thoracic Injuries at the Stage of Specialized Surgical Care

Boyko,

Minukhin,

Serenko

et al. 2024

Khark. Surg. Sch.

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Abstract. Introduction. The frequency of combat thoracic trauma in the conditions of a modern military conflict ranges from 8.2 to 12.5 %. The share of penetrating wounds of the chest was noted up to 51.2 %. Combat thoracic trauma is the second leading cause of death on the battlefield after cranial trauma. The total mortality rate reaches 12 %. The purpose of the work: to evaluate the possibilities of video thoracoscopic technologies in improving the results of treatment of wounded with combat thoracic trauma at the stage of specialized surgical care (SSC). Materials and methods: an analysis of the results of the treatment of 198 victims with combat thoracic trauma, who were treated in the surgical departments of the City Clinical Hospital of Rapid and Emergency Medical Care Prof. O.I. Meshchaninov and the clinic “ Institute of General and Emergency Surgery V.T. Zaitsev National Academy of Medical Sciences of Ukraine”, which are institutions for the provision of specialized surgical care, for the period from February 24, 2022 to February 2024. All victims were divided into 2 clinical groups and were representative. The comparison group (II group) included 92 (46.5 %) victims, the main group (I group) – 106 (53.5 %). In the treatment of patients of the main group minimally invasive video thoracoscopic technologies were mainly used. Results. Video thoracoscopy as a treatment method was used in 67 (63.2 %) of the wounded of the I group. An assessment of the effectiveness of the provision of SSC in the study groups was carried out. The proposed surgical tactics made it possible to reduce the total number of complications from 18.5 % in victims of the II group to 5.6 % in the I group; the number of open (thoracotomy) interventions decreased by 6.5 times; reduced duration of treatment from (22±3.2) to (12±2.8) days; mortality decreased by 3 times. Conclusions. Taking into account the results of the study, it can be argued that VTS technology should be considered as the method of choice in victims with combat thoracic trauma at the stage of SSC.

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The sensitivity of chest X-ray (CXR) for the detection of significant thoracic injury in children exposed to blast

Cited by 3 publications

References 14 publications

High risk and low prevalence diseases: Blast injuries

High risk and low prevalence diseases: Blast injuries

Intrapulmonary Hemorrhages in Closed Combat Trauma of the Chest

The Use of Videothoracoscopic Technologies in the Treatment of Victims With Combat Thoracic Injuries at the Stage of Specialized Surgical Care

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