Injuries of the thoracic cavity organs

With closed trauma, a reaction to a concussion of the lung is manifested by edema and hemorrhage into the alveoli. The course is asymptomatic, often dyspnea, mild hemopathy. X-ray diffuse or local darkening of lung tissue. Usually, special therapy is not required. The post-concussion reaction disappears after 3-4 days. In severe cases with severe hypoxia, oxygen therapy is needed, performed through the nasal catheters. The prognosis is favorable.

A closed trauma such as chest compression can cause a rupture of the trachea and / or bronchus. The horizontal fractures of the trachea above the carina are most frequent, or the horizontal ruptures of the main bronchi are 1-2 cm below the carina. Signs of the rupture are cyanosis, pain, hematopoies, cough, shock. X-ray is determined by pneumothorax, often mediastinal emphysema, the combination of which is pathognomonic. The diagnosis is confirmed bronchoscopically. Early surgical treatment is shown. The prognosis is poor, at 30% death occurs within the first hour.

Hematoseropneumothorax traumatic origin is expressed by the accumulation of blood, plasma and air in the pleural cavity. The common symptom is respiratory failure. Diagnosis is based on chest X-ray, in which air and liquid are detected. After a test diagnostic puncture, the pleural cavity is drained for air and liquid aspiration, as well as diagnostic washing (hemoglobin level!). When the symptoms increase, the operation is shown. The prognosis for timely treatment is favorable.

Rupture of lung tissue with closed trauma leads to pneumothorax, accompanied by collapse of lung tissue. With a collapse of 50% or more, there is a shift in the mediastinal organs, which are characterized by tachycardia, a fall in blood pressure, respiratory failure. Especially dangerous is the straining valve pneumothorax. Diagnosis (see Pneumothorax spontaneous) is approved by roentgenological examination.The first aid is puncture of the pleural cavity in the third to fourth intercostal space along the mid-succinic line with air aspiration and, if necessary, Bülow splinting.

Open trauma of the chest cavity is always accompanied by an open pneumothorax, which comes instantaneously or prolonged (with oblique stab wounds). The diagnosis is practically not difficult. The task of the first aid is to transfer the open pneumothorax to the closed one by imposing an occlusive one, it can be an adhesive tape, bandages, and then it is necessary to make sure that the pneumothorax does not grow, which is very real with a combined wound of the chest wall and lung. With increasing pneumothorax, in addition to the occlusive dressing, a puncture thoracocentesis with a needle is necessary, the finger of the rubber glove with the cut off end firmly fixed to the pavilion is the prototype of the valve according to Bylau.

Transportation in an elevated position in the surgical department.

The prognosis with adequate treatment is favorable.