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Chest Trauma, Iatrogenic Trauma including drainage tubes and some Post-surgical Conditions and Complications of Radiotherapy.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
This is the third commonest cause of death (after coronary heart disease and cancer) and is therefore an important subject for the radiologist as well as the accident surgeon, thoracic surgeon, etc. Chest trauma may be relatively trivial or life threatening, particularly when there are multiple concomitant injuries to the head, face, abdomen, or limbs, etc. Injuries may be penetrating, with knife or bullet wounds, but are more commonly due to blunt trauma. This may give rise to rib and/or sternal fractures, a flail anterior or lateral chest wall or damage to the diaphragm and/or heart or great vessels. The dorsal spine may be injured together with cord compression. Intra-thoracic nerves, such as the phrenics, may be stretched or divided.
Valve Disease
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Traumatic mitral valve regurgitation is rare with a variable clinical presentation depending on which component is damaged. The most common cause is blunt chest trauma due to road traffic accident. Papillary muscle rupture usually presents with acute failure whilst presentation with damage to the chords may be delayed.
Thoracic Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
The diagnosis should be suspected in survivors of any high-energy chest trauma with a suggestive examination and radio-graphic findings (Box 10.8), although there is no pattern of skeletal injuries that accurately predicts this condition.19 The patient may complain of chest and back pain, and examination may reveal absent or reduced pulses distally with differential blood pressure between arms and legs. No single radiographic sign absolutely predicts aortic rupture, although a widened mediastinum is the most consistent finding.
Predictive factors of nebulized morphine failure in North-African patients with chest trauma: a prospective pilot study
Published in Expert Review of Respiratory Medicine, 2022
Hela Attia, Helmi Ben Saad, Karim Masmoudi, Imen Bannour, Mouna Ouaz, Kais Gardabbou, Ali Majdoub
Chest trauma accounts for almost one-third of trauma admissions [1]. Two-thirds of them occur in a context of polytrauma [2]. Indeed, chest trauma is reported in 50% of fatal accidents [2], and it is the underlying cause of death in 25% of cases [3,4]. However, the pain resulting from chest trauma is constant, and it disrupts ventilatory dynamics, thus inducing respiratory complications [3]. Management of chest trauma-induced pain should be considered from the beginning, at the time of assessment [1]. The pain is related to a parietal origin and rib fractures, and it may be neuropathic resulting from intercostal nerve injury, and pleural or visceral lesions [5,6]. It ‘seems’ that the aforementioned components are most frequently combined [5,6]. Poor management of chest trauma-induced pain leads to ventilatory mechanics impairment, respiratory effort, and coughing due to pain, which could be a source of congestion and atelectasis, and consecutively of pneumonia and acute respiratory distress [1]. It also worsens the patient’s trauma experience and sets the stage for respiratory morbidity and mortality [3,7].
Importance of impact boundary conditions and pre-crash arm position for the prediction of thoracic response to pendulum, side sled, and near side vehicle impacts
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Donata Gierczycka, Duane Cronin
Current vehicle compliance test standards utilize Anthropometric Test Devices (ATDs) as occupant surrogates seated in standard driving positions (NHTSA 2012). The only standard side-impact assessments available involve the Moving Deformable Barrier (MDB) (Figure 1, NCAP-V) and pole tests (Appendix A, Figure A1) (NHTSA 2012). The thoracic injury probability is inferred based on chest compression registered by the ATD at three discrete locations (NHTSA 2012). Epidemiological data on the effectiveness of side-impact restraints for reducing injury severity indicated a reduction of the head injury risk due to side curtain airbags (Kahane 2014), but the expected reduction of chest trauma due to thoracic side airbags (tSABs) was not demonstrated (Maltese et al. 2002; Weber et al. 2004; Tencer et al. 2005b; Welsh et al. 2007; Yoganandan et al. 2007; Griffin et al. 2012; D’Elia et al. 2013; Gaylor and Junge 2015). Reduction of thoracic injuries requires further advancements in understanding occupant response under side-impact conditions.
Rotterdam and Marshall Scores for Prediction of in-hospital Mortality in Patients with Traumatic Brain Injury: An observational study
Published in Brain Injury, 2021
Mohammad Asim, Ayman El-Menyar, Ashok Parchani, Syed Nabir, Mohamed Nadeem Ahmed, Zahoor Ahmed, Ahmed Faidh Ramzee, Abdulaziz Al-Thani, Abdulrahman Al-Abdulmalek, Hassan Al-Thani
During the study period, a total of 1673 patients with TBI who required hospital admission. Head CT scans were retrieved through PACS (Picture Archiving and Communication System). PACS was available for 1205 cases. Rotterdam scoring was possible in 1059 cases and Marshall Scoring was possible in 1087 cases. We have included only those cases with both the CT scoring systems available for the final analysis (n = 1035). The mean±SD age of patients was 29.9 ± 14.5 years (range 1–85 years) and the majority were males (87.4%) (Table 1). The frequent mechanisms of injury constituted mainly motor vehicle crashes (21.5%), fall from height (12.7%) and pedestrian injuries (9%). Imaging findings showed that 61.7% had skull fracture followed brain contusion (56.9%), subarachnoid hemorrhage (35.3%), subdural hematoma (32.9%) and brain edema (27.8%). Chest trauma (49.7%) was most frequently associated with injury by anatomical region followed by abdomen (24.9%) and upper extremity (25.4%). The mean ISS was 25.0 ± 10.6 and head AIS was 3.9 ± 1.0.