Thoracic Trauma

Thoracic trauma is a significant cause of morbidity and mortality in both adults and children. It is a leading cause of death in approximately 25% of multiple trauma patients and, when associated with other injuries, it causes death in additional 50% of multiple trauma patients, usually as a result of hypoxia and hypovolemia. When cardiac trauma is not involved, mortality from isolated penetrating chest injury is low (<1%), but if cardiac trauma is present, mortality rises to about 20%. The most important issue with thoracic trauma is to prevent lethal outcomes, because many of these wounds are fatal shortly after the injury or a few hours afterwards. Thoracic injury may occur in isolation (isolated thoracic trauma), or in the presence of polytrauma. According to etiology, thoracic injuries are divided into: blunt traumas and penetrating chest wounds. Specific injuries are: pulmonary barotraumas, burns of the tracheobronchial tree resulted from aspiration, blast lung injury, parenchymal lung damage from aspiration, and iatrogenic injury. Fractures associated with the chest wall may be caused by a direct force, and the tissues and organs of the chest may be damaged including contusions, lacerations or rupture. In addition, traumatic forces can act indirectly; in such cases the effect of a traumatic force is manifested after the disintegration of the tissue (air embolism resulting from the entrance of air into the pulmonary veins after lung laceration).[1]