Blunt Chest Trauma: General Principles of Management

Abstract

Lap and shoulder safety belts have changed the anatomic distribution of motor vehicle injuries. Head injuries have declined, while blunt chest trauma now appears more commonly. Unfortunately, and especially when enmeshed in the web of other more obvious internal and external insults, physicians may discover too late that the diagnosis of certain closed-chest injuries has eluded them. Accordingly, this monograph focuses our attention on blunt thoracic trauma. The best and truly unique chapters cover unusual lesions: tracheobronchial disruption, esophageal injuries, traumatic asphyxia, diaphragmatic rupture, aortic transection, and blunt pericardial and cardiac trauma. Regarding these topics, nowhere else can one find so much original case material and so extensive a literature review. Throughout, the authors emphasize the mechanism of injury to facilitate the high index of suspicion often necessary for their diagnosis. New approaches discussed by the authors include (1) a preference for open-chest resuscitation in patients with combined blunt-chest trauma