Blast injury of the chest

Abstract

The authors describe the radiological findings encountered in 12 recent cases of blast injury of the chest. The clinical picture includes chest pain, dyspnea and hemoptysis without evidence of external injury. These symptoms were masked in cases of immersion blast by the clinical picture of acute abdomen due to severe abdominal injuries. Eleven out of the 12 cases of blast injury of the chest showed radiological signs in the initial chest film 8–9 hours after the blast. The radiological findings could be divided into two distinct groups: (A) Pulmonary hemorrhage, which showed only unilateral opacities in the lungs and which cleared within the first week, and (B) Pulmonary laceration, which showed widespread signs in the thoracic organs, often suggested by the presence of interstitial emphysema, pneumomediastinum or hemothorax. In four cases there was associated cardiac enlargement and widening of the azygos vein due to right heart failure secondary to extensive damage of the lungs. The recognition of these radiological signs of pulmonary laceration in cases of blast injury is required in order to alert the clinician to a careful emergency therapeutic approach to such patients. The authors describe the radiological findings encountered in 12 recent cases of blast injury of the chest. The clinical picture includes chest pain, dyspnea and hemoptysis without evidence of external injury. These symptoms were masked in cases of immersion blast by the clinical picture of acute abdomen due to severe abdominal injuries. Eleven out of the 12 cases of blast injury of the chest showed radiological signs in the initial chest film 8–9 hours after the blast. The radiological findings could be divided into two distinct groups: (A) Pulmonary hemorrhage, which showed only unilateral opacities in the lungs and which cleared within the first week, and (B) Pulmonary laceration, which showed widespread signs in the thoracic organs, often suggested by the presence of interstitial emphysema, pneumomediastinum or hemothorax. In four cases there was associated cardiac enlargement and widening of the azygos vein due to right heart failure secondary to extensive damage of the lungs. The recognition of these radiological signs of pulmonary laceration in cases of blast injury is required in order to alert the clinician to a careful emergency therapeutic approach to such patients.