Abstract
BackgroundThoracic injury overall is the third most common cause of trauma following injury to the head and extremities. Thoracic trauma has a high morbidity and mortality, accounting for approximately 25% of trauma-related deaths, second only to head trauma. More than 70% of cases of blunt thoracic trauma are due to motor vehicle collisions, with the remainder caused by falls or blows from blunt objects.MethodsThe mechanisms of injury, spectrum of abnormalities and radiological findings encountered in blunt thoracic trauma are categorised into injuries of the pleural space (pneumothorax, hemothorax), the lungs (pulmonary contusion, laceration and herniation), the airways (tracheobronchial lacerations, Macklin effect), the oesophagus, the heart, the aorta, the diaphragm and the chest wall (rib, scapular, sternal fractures and sternoclavicular dislocations). The possible coexistence of multiple types of injury in a single patient is stressed, and therefore systematic exclusion after thorough investigation of all types of injury is warranted.ResultsThe superiority of CT over chest radiography in diagnosing chest trauma is well documented. Moreover, with the advent of MDCT the imaging time for trauma patients has been significantly reduced to several seconds, allowing more time for appropriate post-diagnosis care.ConclusionHigh-quality multiplanar and volumetric reformatted CT images greatly improve the detection of injuries and enhance the understanding of mechanisms of trauma-related abnormalities.
Highlights
Chest trauma is classified as blunt or penetrating, with blunt trauma being the cause of most thoracic injuries (90%)
The main difference lies in the presence of an opening to the inner thorax in penetrating trauma, created by stabbing or gunshot wounds, which is absent in blunt chest trauma [1]
Trauma-related pneumothorax occurs in 30–40% of cases, and it is most commonly associated with rib fractures that lacerate the lung
Summary
Chest trauma is classified as blunt or penetrating, with blunt trauma being the cause of most thoracic injuries (90%). CT is far more effective than chest radiography in detecting pulmonary contusion, thoracic aortic injury and osseous trauma, especially at the cervicorthoracic spine. Thoracic compression may cause contusion or laceration of the lung parenchyma, pneumothorax or haemothorax, tracheobronchial fractures as well as rupture of the diaphragm.
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