Lecture52_Chest Trauma, Cardiac Tamponade & Tension Pneumothorax - Impact on Circulation

Haematoma diaphragmatic rupture 3 of chest trauma

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Unformatted text preview: eft subclavian artery Aortic Shear Injury: Subadventitial haematoma Diaphragmatic Rupture 3% of chest trauma patients Early diagnosis difficult, 30% have delayed diagnosis – usually on left side because liver buffers injury on right side Mechanism n n Transmission of abdominal pressure through diaphragm Liver acts as buffer … thus more left sided traumatic hernias Diaphragmatic Rupture Diagnosis n n n n Decreased breath sounds Basilar dullness Dyspnea Bowel sounds in chest CXR n n Blurred diaphragm Bowel seen in chest Treatment n n NG tube surgery Esophageal Rupture Penetrating trauma >> blunt trauma 75% iatrogenic (usually around cricoid) Boerhaave’s = rupture following protracted vomiting tearing oesophagus, often excessive alcohol Dx n n n n Pain radiates to back, shoulders, either side of chest, abdomen Dyspnea Subcutaneous emphysema CXR – pneumomediastinum, pneumothorax, pleural effusion, atelectasis Tx: 100% mortality without surgery Cardiac Tamponade and Tension Pneumothorax Definitions Cardiac Tamponade: A condition characterized by a decrease in cardiac output due to the accumulation of fluid (blood, serous fluid, pus, etc) within the pericardial sac sufficient to restrict the filling of the ventricles Definitions Tension Pneumothorax: A condition characterized by decreased cardiac output and respiratory function due to the accumulation of air under pressure within the pleural cavity sufficient to cause kinking of vena caval return to the right atrium and ventricle, leading eventually to impairment of left ventric...
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