Assessment of Severe Blunt Thoracic Trauma

Abstract

Trauma is the leading cause of death in patients under 50 years. Thoracic trauma is frequent and accounts for one third of admissions in trauma centers. During road accident, thoracic trauma occurs in 50% of patients who die at the scene, and is considered to be the main cause of death in 25% of these patients [1]. Among patients with blunt thoracic trauma, few of them require emergency surgery. However, an accurate assessment of thoracic lesions is crucial for the survival of the multiple trauma patient. In addition to rare indications for immediate thoracotomy because of severe intrathoracic blood loss, delayed surgery may be mandatory in some patients with great vessel injury. Moreover, assessment of non-surgical lesions such as pulmonary and cardiac confusion or pneumothorax may be essential for adequate resuscitation and anesthesia of the multiple trauma patient. Piain chest X-ray, angiography, and computerized tomography (CT) have been extensively used to assess severe thoracic trauma. Recently, echocardiography has proven to be a reliable and valuable means for the assessment of thoracic trauma.