Traumatic Diaphragmatic Rupture in An Elderly Patient With Polytrauma

Case presentation: We report a case of an 80-year-old woman presented to our hospital 2 hours after a traffic accident with multiple injuries: blunt chest injury, rib fractures, pulmonary laceration, right pneumothorax, pleural effusion, right lower lobe atelectasis, right diaphragmatic rupture causing intrathoracic intestinal herniation, blunt abdominal trauma, grade III liver rupture, spine injury with L1, L2 transverse process fractures. An emergency surgery was performed to drain the fluid and air in the pleural cavity, evacuate the hernia organs, and repair the diaphragmatic injury. The postoperative source was uneventful and she was discharged after 20 days. Conclusion Early diagnosis of diaphragmatic rupture in polytrauma requires the combination of clinical examination, chest X-ray, and CT scanner. Favorable outcomes can be achieved with early surgical interventions.

Trauma-Associated Pulmonary Laceration in Dogs—A Cross Sectional Study of 364 Dogs

In this study, we describe the computed tomography (CT) features of pulmonary laceration in a study population, which included 364 client-owned dogs that underwent CT examination for thoracic trauma, and compared the characteristics and outcomes of dogs with and without CT evidence of pulmonary laceration. Lung laceration occurred in 46/364 dogs with thoracic trauma (prevalence 12.6%). Dogs with lung laceration were significantly younger than dogs in the control group (median 42 months (interquartile range (IQR) 52.3) and 62 months (IQR 86.1), respectively; p = 0.02). Dogs with lung laceration were significantly heavier than dogs without laceration (median 20.8 kg (IQR 23.3) and median 8.7 kg (IQR 12.4 kg), respectively p < 0.0001). When comparing groups of dogs with thoracic trauma with and without lung laceration, the frequency of high-energy motor vehicle accident trauma was more elevated in dogs with lung laceration than in the control group. No significant differences were observed between groups regarding tge frequency and length of hospitalization and 30-day mortality. Similar to the human classification scheme, four CT patterns are described in dogs in this study: Type 1, large pulmonary laceration located deeply in the pulmonary parenchyma or around an interlobar fissure; Type 2, laceration occurring in the paraspinal lung parenchyma, not associated with vertebral fracture; Type 3, subpleural lung laceration intimately associated with an adjacent rib or vertebral fracture; Type 4, subpleural lesions not associated with rib fractures. Complications were seen in 2/46 dogs and included lung abscess and collapse.

Injuries to the Chest Part 1

Thoracic injury is common and is associated with significant morbidity and mortality. Injuries to the chest are responsible for 25% of blunt trauma fatalities and contribute to an additional 50% of deaths in this population.1 Fortunately, the majority of thoracic injuries can be treated effectively, and often definitively, by relatively simple maneuvers that can be learned and performed by most physicians involved in early trauma care. Only 5 to 10% will require operative intervention.2 These extremes in injury severity are unique to the chest and require treatment by a surgeon with a correspondingly broad range of knowledge and skills. This article will address the following procedures and injuries: tube thoracostomy, thoracotomy, emergency department resuscitative thoracotomy, video-assisted thoracoscopy, chest wall injuries including rib fractures and flail chest, pneumothorax, hemothorax, empyema, pulmonary contusion and laceration, and tracheobronchial injury. This review 6 figures, 1 table, and 49 references. Keywords: Tube thoracoscopy, emergency department resuscitative thoracotomy (EDRT), rib fractures, flail chest, pneumothorax, hemothorax, empyema, pulmonary contusion, pulmonary laceration, tracheobronchial injury

Injuries to the Chest Part 1

Thoracic injury is common and is associated with significant morbidity and mortality. Injuries to the chest are responsible for 25% of blunt trauma fatalities and contribute to an additional 50% of deaths in this population.1 Fortunately, the majority of thoracic injuries can be treated effectively, and often definitively, by relatively simple maneuvers that can be learned and performed by most physicians involved in early trauma care. Only 5 to 10% will require operative intervention.2 These extremes in injury severity are unique to the chest and require treatment by a surgeon with a correspondingly broad range of knowledge and skills. This article will address the following procedures and injuries: tube thoracostomy, thoracotomy, emergency department resuscitative thoracotomy, video-assisted thoracoscopy, chest wall injuries including rib fractures and flail chest, pneumothorax, hemothorax, empyema, pulmonary contusion and laceration, and tracheobronchial injury. This review 6 figures, 1 table, and 49 references. Keywords: Tube thoracoscopy, emergency department resuscitative thoracotomy (EDRT), rib fractures, flail chest, pneumothorax, hemothorax, empyema, pulmonary contusion, pulmonary laceration, tracheobronchial injury

Pericardial flap to repair a pulmonary laceration in a cat with pyothorax

Case summary A 2-year-old female neutered domestic shorthair cat was presented for investigation of acute onset tachypnoea and dyspnoea. Pyothorax was diagnosed based on thoracic radiographs and fluid analysis. Medical treatment consisted of bilateral thoracostomy tube placement, antibiotic therapy and thoracic lavage. After 12 days of medical management infection was still present, warranting exploratory thoracotomy. At surgery, encapsulated abscesses were found in the left lung, right cranial and right middle lobes. The right caudal lobe was the only macroscopically non-abscessated lobe, and appeared to have a parenchymal laceration 8 mm long over the dorsolateral surface. Following partial pericardiectomy, mediastinectomy and debridement of abscesses, a pericardial flap was reflected caudolaterally and apposed over the laceration to seal the affected lung lobe. This flap was sutured to a rim of fibrinous adhesion that was partially covering this lobe. After 8 days the cat was discharged with antibiotic therapy for 3 more weeks. Follow-up assessment at 19 and 38 weeks postoperatively confirmed the cat to have good exercise tolerance. Thoracic radiographs at 19 weeks revealed good bilateral aeration of the pulmonary parenchyma without pleural effusion. Relevance and novel information Lung lobe laceration can be treated by lung lobectomy or direct suturing of the lung parenchyma. This is the first report using a pericardial flap to repair a lung laceration. Pericardial flap was successfully used to treat this lung laceration where lobectomy was contraindicated. Encouraging results were present at 8 months postoperatively.

The performance of multi-slice spiral CT in pulmonary laceration and its application value

Benzoxazine resin, a new type of phenolic resin, has many advantages such as strong molecular design, no small With the continuous development of social information and modernization, the deepening of medical technology in the social status and role is also more and more important. The digitization and visualization of medical science and technology provide great convenience for the reading and access of clinical information. At the same time, it also improves the efficiency and accuracy of information reading and access. In addition, as China's population continues to proliferate, various traffic accidents are appalling, and serious consequences such as chest trauma and head trauma are also common in hospital emergency cases. Patients with pulmonary laceration need CT timely diagnosis and repair of the pulmonary pleural rupture, if not timely and accurate judgments will seriously endanger the safety of patients. To explore the performance of multi-slice spiral CT in pulmonary laceration and its application value, aim to improve the accuracy of CT dynamic observation of disease changes, improve the medical diagnosis technology and reduce the mortality rate of patients. For patients with pulmonary laceration, the diagnosis of rapid and effective, review, you can avoid missed or misdiagnosed, rest assured. And multi-slice spiral CT in the early diagnosis, multi-slice spiral CT used in clinical examination or diagnosis, the effect of great reference value, it is worth promoting the use.