SURGICAL DISEASES, TRAUMATOLOGY, ORTHOPEDICS, UROLOGY : CONTUSIONS OF THE CHEST AND THE DAMAGE OF THE THORACIC CAVITY - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Bruised chest occurs when different types of injury is often accompanied by a fracture of the ribs. The main danger is the damage of organs located in the chest cavity. Heart, blood vessels, bronchi with a closed injury damage only rarely. More likely to suffer pleura and lung tissue. When damage to the pleura and lung main characteristics will be: subcutaneous emphysema, pneumothorax, hematocrits.
Compression of the chest is a characteristic of congestive hemorrhage extending into the head, eyes, neck, upper part of the chest in the form of dot hemorrhages (achimota). The skin of the face, neck becomes cyanotic, there is swelling. The same achimota appear on mucous membranes, soft palate, trachea, pharynx. Achimota occur due to rupture of small veins and bleeding due to a sudden increase in intrathoracic pressure.
In the absence of concomitant injuries when creating peace of clinical phenomena to be liquidated quickly.
Subcutaneous emphysema is the accumulation of air in the subcutaneous tissue due to damage of the lung and pleura. Emphysema can get damaged intrathoracic Department of the trachea and bronchi, but without damage to the lung tissue. When air bubbles are distributed in the subcutaneous tissue, forming an extensive pillow. Recognition of subcutaneous emphysema is based on crepitate (feeling the crunch of air under the skin. Subcutaneous emphysema usually disappears fairly quickly, spontaneously, without any treatment. Threatening complication is mediastinal emphysema caused by air infiltration of the organs of the neck or from the pleural cavity. In this case violated the breath crushed vessels, shifting heart.
Pneumothorax is the accumulation of air in the pleural cavity. When closed, the injury can only be closed pneumothorax. It is a little dangerous if the flow of air from the lung quickly terminated. The presence of air in the pleural cavity is defined percutere and auscultation. With significant wounds lightweight and long-term communication between the lungs and the pleural cavity the amount of air in the pleural cavity progressively increases. The air gradually compresses the lung, shifts the heart. There comes a sudden impairment of circulation and respiration. With the increasing pneumothorax recommended the introduction into the chest cavity drainage valve on Petrov.
Hematocrits - accumulation of blood in the cavity of the pleura due to injury of the lung and pleura. Moderate amounts of fluid (400 ml) in the pleural cavity percutere not defined. Danger to life are heavy bleeding, leading to exsanguination of the patient and to offset intrathoracic organs; especially dangerous displacement of large blood vessels and the heart. Streamed into the chest cavity blood for the most part remains liquid only partially forms clots. A small number of usually are absorbed. When large clusters recommended for repeated early punctures (on 3 - 4th day). In order to avoid infection (possible purulent pleurisy, empyema), one should observe strict asepsis. At high temperatures, the sulfonamides (1,0 4 hours for 5 to 6 days), penicillin in the usual way. The source of bleeding are mainly damaged lungs, intrathoracic vessels, vessels of the chest wall. When combined injuries of the chest and abdomen (when rupture of the diaphragm) the source of bleeding can be damaged organs in the abdominal cavity, most commonly the liver, spleen. Typical intake of whole blood from the abdomen into the chest cavity (pressure difference). Clinically determined a sharp bleeding victim, the fall of cardiac activity, severe respiratory distress.
Treatment of injury of the chest, compression of the thorax, subcutaneous emphysema at an alarming cases online.
Treatment of pneumothorax, hematocrits - urgent surgical intervention.