DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20193407

Pattern and management of penetrating and nonpenetrating thoracic injuries

Naresh Pal, Vineet Mishra, Udit Jain, Poonam .

Abstract


Background: Chest trauma constitutes a major public health problem which  includes the injuries to chest wall, pleura, tracheobronchial tree, lungs, diaphragm, oesophagus, heart and great vessels. It consist of more than ten percent of all traumas and twenty five percent of death due to trauma occurs because of chest injury. Chest trauma is increasing in frequency in urban hospitals. Penetrating and nonpenetrating thoracic injuries the most serious injuries leading to significant morbidity and mortality.

Methods: This study was prospective observational study of 220 patients of thoracic trauma both penetrating and non-penetrating. These patients admitted in general surgical units from August 2017 to May 2018  of Pandit Bhagwat Dayal  Sharma,  PGIMS  Rohtak Haryana India. The study was pertaining to both penetrating  and non-penetrating chest trauma.

Results: Out of 220 chest injury patients who were studied during the said period, Males were 203 and females 17 by a ratio of 12:1 and age ranged from lowest 18 years to 85 years of age. Majority of the patients (90.45%) sustained blunt injuries. RTA was the common mechanism of blunt injury affecting (50.45%) of patients. Multiple Rib fractures was the commonest type of chest injury (21.36%) followed by head injury (17.27%). Head injury was the commonest associated injury seen in our patients. 

Conclusions: Chest trauma resulting from road traffic accident remains a major mechanism of chest injury. The  measures to decrease the trauma are, educating people about traffic rules and regulations and strictly implementing them is necessary to reduce incidence of chest injuries.


Keywords


Chest trauma, Head Injury, Multiple rib fractures , RTA (Road Traffic Accident), Tube thoracostomy

Full Text:

PDF

References


Wison RF, Murray Antonio DR. Non penetrating thoracic injury. Surg Clin North Am. 2000-2001;57:17-36.

Park K. Accidents. In: Park K, ed. Textbook of Social and Preventive Medicine. 17th ed. Jabalpur, Banarsidas Co; 2002:304-5.

Kent WJ. Thoracic trauma. Surg Clin N Am. 1980; 60:957-81.

Marya SKS, Singla SL. Management of chest injuries by a general surgeon. Ind J Surg. 1987;49: 235-8.

Kulshrestha P, Iyer KS, Das B, Balram A, Kumar AS, Sharma ML, et al. Chest injuries: A clinical and autopsy profile. J Trauma. 1988;28(6):844-7.

Adebonojo SA. Management of chest trauma: a review. West African J Med. 1993;12(2):122-32.

Wilson RF, Murray C, Antonenko DR. Nonpenetrating thoracic injuries. Surg Clin North Am. 1977;57(1):17-36.

Shorr RM, Crittenden M, Indeck M, Hartunian SL, Rodriguez A. Blunt thoracic trauma: analysis of 515 patients. Ann Surg. 1987;206:200-5.

American College of Surgeons. ATLS: Advanced Trauma Life Support for Doctors: student course manual. 10th ed. Chicago (IL): American College of Surgeons; 2018.

Aristomenis E, Guido S, Schmid Stephan W, Benoir S, Heinz Z. Do we really need routine computed tomographic scanning in the primary evaluation of blunt chest trauma in patients with “normal” chest radiograph?. J Trauma Inj Infect Crit Care. 2001;51(6):1173-6.

Sirmali M, Turut H, Topcu S, Gulhan E, Yazici U, Kaya S, et al. A comprehensive analysis of traumatic rib fracture: morbidity, mortality, and management: Euro J Cardiothoracic Surg. 2003;24(1):133-8.

Calhoon JH, Grover FL, Trinkle JK. Chest trauma: approach and management. Clin Chest Med. 1992;13:55-67.

Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma. 1994;37(6):975-9.

Mayberry JC, Trunkey DD. The fractured rib in chest wall trauma. Chest Surg Clin North Am. 1997;7(2):239-61.

Lee RB, Bass SM, Morris JA, MacKenzie E. Three or more rib fractures as an indicator for transfer to a level I center: A population-based study. J Trauma. 1990;30(6):689-94.

Atri M, Singh G, Kohli A. Chest trauma in Jammu region an institutional study. Indian J Thoracic Cardiovascular Surg. 2006;22(4):219-22.

Lema MK, Chalya PL, Mabula |JB, Mahalu W. Pattern and outcome of chest injuries in bugando medical centre in Northwest Tanzania. J Cardiothorac Surg. 2011;6:7.

Dehghan N, de Mestral C, McKee MD, Schemitsch EH, Nathens A. Flail chest injuries: a review of outcomes and treatment practices from the national trauma data bank. J Trauma Acute Care Surg. 2014;76(2):462-8.

Beg MH, Siddiqui Z, Ansari MN, Reyazuddin. Penetrating chest trauma: a review of 150 cases. J Indian Med Assoc. 1989;87(9):203-5.

Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S. Chest injury due to blunt trauma. Euro J Cardio-thoracic Surg. 2003;(23):374-8.

Al-Koudmani, Darwish B, Al-Kateb K, Taifour Y. Chest trauma experience over eleven-year period at al-mouassat university teaching hospital Damascus: a retrospective review of 888 cases. J Cardiothorac Surg. 2012;7(1):35.

Choudhary A, Prasad K, Sreeramulu PN. A clinico - epidemiological study of traumatic chest injuries in a rural tertiary care centre in India: our experience. Int J Biomed Adv Res. 2015;6(02):110-14.

Pasha MA. A 10-year retrospective review of chest trauma in Hospital University Sains Malaysia. IOSR J Dental Med Sci. 2015;14(8):68-74.

Ryan JM. Accident and emergency. In: Russell RCG, William NS, Bulstrode CJK, eds. Bailey and Love's Short Practice of Surgery. 23rd Ed. London; Arnold Publishers; 2000: 270-280.

Khan MLZ, Haider J, Alam SN, Jawaid M, Malik KA. Chest trauma management: good outcomes possible in a general surgical unit. Pak J Med Sci. 2009;25(2):217-21.

Joshipura MK, Shah HS, Patel PR, Divatia PA, Desai PM. Trauma care systems in India. Injury. 2003;34:686-92.

National Crime Records Bureau. Accidental deaths and suicides in India: New Delhi; 1999.

Joshipura MK, Shah HS, Patel PR, Divatia PA, Desai PM. Trauma care systems in India. Inj. 2003Sep1;34(9):686-92.

Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma. 1994;37(6):975-9.

Sirmàh M. Türüt H, Topçu S, Gülhan E, Yazici Ü, Kaya S, et al. A comprehensive analysis of traumatic rib fractures: Morbidity, mortality and management. Eur J Cardiothorac Surg. 2003;24(1):133-8.

Beg MH, Siddiqui Z, Ansari MN, Reyazuddin. Penetrating chest trauma: a review of 150 cases. J Indian Med Assoc. 1989;87(9):203-5.

Dougall AM, Paul ME, Finley RJ, Holliday RL, Coles JC, Duff JH. Chest trauma- current morbidity and mortality. J Trauma. 1977;17(7):547-53.