Diagnostics and Treatment of Chest Injuries


Authors: Jiří Voves 1;  Leopold Pleva 1,2
Authors‘ workplace: Traumatologické centrum FN Ostrava- Poruba 1;  Ústav medicíny katastrof LF OU 2
Published in: Úraz chir. 23., 2015, č.1

Overview

Objective:
To evaluate the diagnostic and therapeutic algorithm. This is a retrospective study of 59 patients treated at the University Hospital in Ostrava for stab wounds to the chest.

Material and methods:
Between January 1, 2004 and June 30, 2013 there were 59 patients with stab wounds to the chest admitted to the Trauma Centre of the University Hospital Ostrava, 49 male and 10 female. The average age was 35 years. The most common cause of injury was attack by another person. There were isolated chest injury in 40 cases and associated trauma occurred in 19 cases - most commonly injuries to the limbs. The average ISS score was 17. The average length of hospitalization was 7 days.

Results:
We performed CT scans with contrast diagnosing in 38 patients and only chest X-ray in 20 cases. Surgical revision (mainly anterolateral thoracothomy) was required in 29 cases. We performed wound revision without thoracotomy in 30 patients: with chest tube insertion to the injured hemithorax in 11 patients and without chest drainage in 19 patients. One patient died.

Conclusion:
The basic diagnostics is clinical examination and chest X-ray. CT scans of the chest with contrast can be done in clinically stable patients. Surgical revision by thoracotomy was the main therapeutic procedure in 29 patients. For 30 patients conservative treatment was sufficient - i.e. wound revision with or without drainage of injured side of chest.

Key words:
Stab wounds to the chest, CT scans with contrast, anterolateral thoracotomy, conservative treatment.


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Labels
Surgery Traumatology Trauma surgery
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