Thoracic Trauma

Abstract

Traumatic thoracic injuries account for approximately one quarter of trauma-related deaths worldwide. Severity of thoracic trauma varies from rib fractures, pneumothorax, and lung contusion to vascular injuries of major thoracic vessels. Clinical examination of an injured patient plays a major and critical role during the management of these types of injuries. Therapeutic approach follows the ABCDE (Airway, Breathing, Circulation, Disability, Exposure) principles of advanced trauma life support (ATLS), followed by detection and treatment or exclusion of immediately life-threatening injuries such as airway obstruction, tension pneumothorax, hemothorax, flail chest, and cardiac tamponade. Imaging studies such as X-rays, ultrasound, and computed tomography assist during the course of treatment of thoracic injuries. Trauma physicians may face a variety of injuries in the emergency department such as thoracic fractures, lung contusion, traumatic pneumothorax, traumatic hemothorax, cardiac contusion, cardiac tamponade, esophageal injury, tracheobronchial injuries, thoracic aortic injury, and ruptured diaphragm. Most of thoracic injuries may be life threatening. Rapid identification of life-threatening injuries is of paramount importance. Surgeon’s involvement, as defined by the ATLS guidelines, is necessary during all three levels of care: the pre-hospital setting, the emergency room, and the definite treatment of thoracic injuries in the operating room.KeywordsThoracic traumaLung contusionTraumatic pneumothoraxTraumatic hemothoraxCardiac tamponadeTracheobronchial injuriesAortic injuryRuptured diaphragm