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Management of traumatic pneumothorax in isolated blunt chest trauma

Year 2019, Volume: 5 Issue: 2, 306 - 310, 04.03.2019
https://doi.org/10.18621/eurj.375947

Abstract

Objectives: Pneumothorax
is an important complication of blunt chest trauma. The aim of this study was
to report our experience in treatment strategy and outcomes of traumatic
pneumothorax.

Methods: A total of 78 patients who developed pneumothorax due
to isolated blunt chest trauma were evaluated in terms of age, gender, size of
pneumothorax, treatment methods, complications and length of hospital stay. The
size of pneumothorax was calculated with computer-aided volumetry.

Results: Tube thoracostomy was performed for 48 patients while observation was
undertaken for 30 cases. Chest tubes were inserted in 6 patients after 24 hours
following the traumatic event. A total of 8 patients who developed prolonged
air leakage and hemothorax as complications underwent video-assisted
thoracoscopic surgery. None of the patients developed any mortality or
morbidity.

Conclusions: Traumatic pneumothorax demands prompt diagnosis
and treatment. Monitoring all patients even with small sizes of traumatic
pneumothorax for at least 24 hours onset of their initial assessment and
applying chest tubes for cases who have pneumothorax larger than 50% at first
examination should be an appropriate modality for treatment. Moreover, the
minimally invasive approach of video-assisted thoracoscopic surgery benefits to
overcome the complications of thoracic trauma. 

References

  • [1] Haynes D, Baumann M. Management of pneumothorax. Semin Respir Crit Care Med 2010;31:769-80.
  • [2] Matsumoto S, Kishikawa M, Hayakawa K, Narumi A, Matsunami K, Kitano M. A method to detect occult pneumothorax with chest radiography. Ann Emerg Med 2011;57:378-81.
  • [3] Sangster G, Gonzales-Beicos A, Carbo A, Heldmann M, Ibrahim H, Carrascosa P, et al. Blunt traumatic injuries of the lung parenchyma, pleura, thoracic wall and intrathoracic airways: multidetector computer tomography imaging findings. Emerg Radiol 2007;14:297-30.
  • [4] Henry M, Arnold T, Harvey J. Pleural Diseases Group, Standards of Care Comittee, British Thoracic Society. BTS guidelines for the management of spontaneous pnneumothorax. Thorax 2003;58:39-52.
  • [5] Baumann M, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, et al. Management of spontaneus pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest 2001;119:590-602.
  • [6] Cai W, Lee JG, Fikry K, Yoshida H, Novelline R, Moya M. MDCT quantification is the dominant parameter in decision-making regarding chest tube drainage for stable patients with traumatic pneumothorax. Comp Med Imag 2012;36:375-86.
  • [7] Richardson JD, Miller FB, Carrillo EH, Spain DA. Complex thoracic injuries. Surg Clin North Am 1996;76:725-58.
  • [8] Yladom MY, Platz E, Brown DF, Nadel ES. Pneumothorax in a blunt trauma patient. J Emerg Med 2008;35:199-203.
  • [9] Chad GB, Kirkpatrick AW, Feliciano DV. The occult pneumothorax: What have we learned? Can J Surg 2009;52:173-9.
  • [10] Reddy VS. Minimally invasive techniques in thoracic trauma. Semin Thorac Cardiovasc Surg 2008;20:72-7.
  • [11] Ball CG, Kirkpatrick AW, Laupland KB, Fox DL, Litvinchuk S, Dyer DM. Factors related to the failure of radiographic recognition of occult posttraumatic pneumothoraces. Am J Surg 2005;189:541-46.
  • [12] Kesieme EB, Dongo A, Ezemba N, Irekpita E, Jebbin N, Kesieme C. Tube thoracostomy: complications and its management. Pulm Med 2012;25:68-78.
  • [13] Lin YC, Tu CY, Liang SJ. Pigtail catheter for the management of pneumothorax in mechanically ventilated patients. Am J Emerg Med 2010;28:466-71.
  • [14] Fabbrucci P, Nocentini L, Secci S, Manzoli D, Bruscino A, Fedi M. Video-assisted thoracoscopy in the early diagnosis and management of post-traumatic pneumothorax and hemothorax. Surg Endosc 2008;22:1227-31.
Year 2019, Volume: 5 Issue: 2, 306 - 310, 04.03.2019
https://doi.org/10.18621/eurj.375947

Abstract

References

  • [1] Haynes D, Baumann M. Management of pneumothorax. Semin Respir Crit Care Med 2010;31:769-80.
  • [2] Matsumoto S, Kishikawa M, Hayakawa K, Narumi A, Matsunami K, Kitano M. A method to detect occult pneumothorax with chest radiography. Ann Emerg Med 2011;57:378-81.
  • [3] Sangster G, Gonzales-Beicos A, Carbo A, Heldmann M, Ibrahim H, Carrascosa P, et al. Blunt traumatic injuries of the lung parenchyma, pleura, thoracic wall and intrathoracic airways: multidetector computer tomography imaging findings. Emerg Radiol 2007;14:297-30.
  • [4] Henry M, Arnold T, Harvey J. Pleural Diseases Group, Standards of Care Comittee, British Thoracic Society. BTS guidelines for the management of spontaneous pnneumothorax. Thorax 2003;58:39-52.
  • [5] Baumann M, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, et al. Management of spontaneus pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest 2001;119:590-602.
  • [6] Cai W, Lee JG, Fikry K, Yoshida H, Novelline R, Moya M. MDCT quantification is the dominant parameter in decision-making regarding chest tube drainage for stable patients with traumatic pneumothorax. Comp Med Imag 2012;36:375-86.
  • [7] Richardson JD, Miller FB, Carrillo EH, Spain DA. Complex thoracic injuries. Surg Clin North Am 1996;76:725-58.
  • [8] Yladom MY, Platz E, Brown DF, Nadel ES. Pneumothorax in a blunt trauma patient. J Emerg Med 2008;35:199-203.
  • [9] Chad GB, Kirkpatrick AW, Feliciano DV. The occult pneumothorax: What have we learned? Can J Surg 2009;52:173-9.
  • [10] Reddy VS. Minimally invasive techniques in thoracic trauma. Semin Thorac Cardiovasc Surg 2008;20:72-7.
  • [11] Ball CG, Kirkpatrick AW, Laupland KB, Fox DL, Litvinchuk S, Dyer DM. Factors related to the failure of radiographic recognition of occult posttraumatic pneumothoraces. Am J Surg 2005;189:541-46.
  • [12] Kesieme EB, Dongo A, Ezemba N, Irekpita E, Jebbin N, Kesieme C. Tube thoracostomy: complications and its management. Pulm Med 2012;25:68-78.
  • [13] Lin YC, Tu CY, Liang SJ. Pigtail catheter for the management of pneumothorax in mechanically ventilated patients. Am J Emerg Med 2010;28:466-71.
  • [14] Fabbrucci P, Nocentini L, Secci S, Manzoli D, Bruscino A, Fedi M. Video-assisted thoracoscopy in the early diagnosis and management of post-traumatic pneumothorax and hemothorax. Surg Endosc 2008;22:1227-31.
There are 14 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Murat Sarıçam 0000-0003-3469-5798

Berker Özkan 0000-0003-2157-4778

Yaşar Türk 0000-0001-6728-3664

Publication Date March 4, 2019
Submission Date January 8, 2018
Acceptance Date February 15, 2018
Published in Issue Year 2019 Volume: 5 Issue: 2

Cite

AMA Sarıçam M, Özkan B, Türk Y. Management of traumatic pneumothorax in isolated blunt chest trauma. Eur Res J. March 2019;5(2):306-310. doi:10.18621/eurj.375947

e-ISSN: 2149-3189 


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