head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2021, vol. 27, issue1
Subject Area: Medicine
DOI: 10.5272/jimab.2021271.3611
Published online: 17 March 2021

Original article

J of IMAB. 2021 Jan-Mar;27(1):3611-3614
Konstantin KostovORCID logo Corresponding Autoremail,
Department of General, Visceral and Emergency Surgery, UMHATEM "N. I. Pirogov" – Sofia, Bulgaria.

Purpose: The purpose of the study is to analyze the diagnosis and treatment of patients with traumatic chest injuries and traumatic hemopneumothorax in UMHATEM "N. I. Pirogov ".
Material and Methods: Data on 113 patients with thoracic trauma were processed within a retrospective clinical analysis for the period of 1.1. 2016 to 1.1. 2018 in the General, Visceral and Emergency Surgery Section of the UMHATEM "Pirogov. Of the hospitalized women are 38 (33.63%), men 75 (66.37%). The age in this retrospective analysis varied from 18 to 83 years (average 57.4 years).
Results: In our study, among 113 patients, 43 patients had a pneumothorax, 29 patients were with hemothorax, 18 patients with hemopneumothorax, 2 patients had tension pneumothorax and others 21 had only rib fractures. Associated injuries were confirmed in 43 patients (38.05%). From all patients group, 21 patients were managed conservatively, 89 patients with chest tube insertion and only 3 with thoracotomy.
Conclusions: The majority of the patients with a thoracic injury can be performed in emergency surgery by conservative management or by mini-intervention- thoracic chest tube. Tube thoracostomy was evaluated to be important for pleural collections from blunt or penetrating trauma. Therefore it was recommended as a first-line therapeutic approach.

Keywords: thoracic injury, hemothorax, pneumothorax, chest tube, management,

pdf - Download FULL TEXT /PDF 493 KB/
Please cite this article as: Kostov K. Diagnosis and treatment of thoracic injuries and traumatic hemopneumothoraxr. J of IMAB. 2021 Jan-Mar;27(1):3611-3614. DOI: 10.5272/jimab.2021271.3611

Corresponding AutorCorrespondence to: Konstantin Kostov, MD, PhD, Surgical Clinic, UMHATEM "N. I. Pirogov"; 21, Totleben Blvd., 1606 Sofia, Bulgaria; E-mail: dr.k.kostov@gmail.com

1. Hoyt DB, Coimba R, Engthelhaardt S, Hansbrough JF, Steele RJC, Moosa AR, (ed). Essential surgical practice. 4th ed. London: Arnold; 2002. p: 5-15.
2. Dalal S, Nityasha VM, Vashisht M, Dahiya R. Prevalance of chest trauma at an Apex institute of North India. A retrospective study. Internet J Surg. 2008;18(1):1-5.
3. Vigar VS, Solanki MI. Analytic study of chest injury. IJSS Journal of Surgery. 2015;1(1):5-9.
4. May AK, Patterson MA, Rue LW 3rd, Schiller HJ, Rotondo MF, Schwab CW. Combined blunt cardiac and pericardial rupture: review of the literature and report of a new diagnostic algorithm. Am Surg. 1999 Jun;65(6):568-74. [PubMed]
5. Sugarbaker DJ, Bueno R, Krasna MJ, Mentzer SJ, Zellos L, editors. Adult Chest Surgery. 1st ed. New York: McGraw-Hill; 2009.
6. Karmy-Jones R, Jurkovich GJ.  Blunt chest trauma. CurrProbl Surg. 2004 Mar;41(3): 223-380. [PubMed]
7. Richardson JD, Miller FB, Carrillo EH, Spain DA. Complex thoracic injuries. SurgClin North Am1996 Aug;76(4):725-48. [PubMed]
8. Bastos R, Baisden CE, Harker L, Calhoon JH. Penetrating thoracic trauma. SeminThoracCardiovasc Surg. Spring 2008;20(1):19-25. [PubMed]
9. Robison PD, Harman PK, Trinkle JK, Grover FL. Management of Penetrating Lung Injuries in Civilian Practice. J Thorac Cardiovasc Surg. 1988 Feb;95(2):184-90. [PubMed]
10. Unsworth A, Curtis K, Asha SE. Treatments for blunt chest trauma and their impact on patient outcomes and health service delivery. Scand J Trauma ResuscEmerg Med. 2015 Feb 8;23:17. [PubMed]
11. Knottenbelt JD, van der Spuy JW. Traumatic pneumothorax: a scheme for rapid patient turnover. Injury. 1990 Mar;21(2):77-80. [PubMed]
12. Feenstra TM, Dickhoff C, Deunk J. Systematic review and meta-analysis of tube thoracostomy following traumatic chest injury; suction versus water seal.  Eur J Trauma Emerg Surg. 2018 Dec;44(6): 819–827 [PubMed]
13. Çakmak M, Kandemir MN. Study of 433 Operated Cases of Thoracic Trauma. Indian J Surg. 2016 Dec; 78(6): 477–481 [PubMed]
14. Yazgan C, Aksu NM. Imaging features of blast injuries: experience from 2015 Ankara bombing in Turkey. Br J Radiol. June 2016; 89(1062): 20160063. [PubMed]
15.Avcı A, Saraç EO, Eren TS, Onat S, Ülkü R, Özçelik C. Risk factors affecting post-traumatic acute respiratory distress syndrome development in thoracic trauma patients. Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Oct; 27(4): 540–549. [PubMed].

Received: 04 May 2020
Published online: 17 March 2021

back to Online Journal