Rizwan Aziz Memon, Jawaid Ahmed, Naveed Ali Khan, Amjad Siraj Memon, Ata-ur Rehman.
Blunt chest trauma, not to be underestimated.
Pak J Surg Jan ;30(4):310-4.

Objectives: To understand the patt ern, presentation, management strategies and outcome associated with blunt chest trauma patients. Study design: Retrospective analytical Patients & methods: Th e study was conducted at cardiothoracic surgery department of Liaquat national hospital, Karachi and Surgical unit 5 Dow University of health sciences - Civil hospital Karachi from the period of April 2009 to March2014. A total of 290 patients were identifi ed and analyzed, who were admitt ed with history of Blunt Chest trauma. Results: Th e most common age group involved was between the ages of 20-50 years with male: female ratio of 7:1. Road traffi c accident was the most common mode of injury and motor bike was the most commonly involved vehicle. Multiple rib fracture with haemothorax and or pneumothorax was the most common presentation. 39% of all patients were victim of multiple trauma (thoracic plus extra thoracic), where limb, abdominal and head & neck were the most common associated injuries. Out of 290 patients, 56 (19%) patients were managed conservatively while 223 (77%) patients required intercostal tube thoracostomy and supportive therapy while only 11(4%) patient required thoracotomy aft er intercostals tube thoracostomy. During this period 11 patients (4%) required thoracotomy, 2 in emergency, 5 urgent while 4 were elective and eight patients required Laparotomy. Ventilatory support (12%) was required only in multiple trauma patients, patients with fl ail chest and post thoracotomy patients. Th e overall mortality was 11(4%), mostly in multiple trauma patients, only one patient with isolated chest injury did not survive due to extensive pneumonia/ARDS following thoracotomy for empyema. Conclusion: Th e vast majority of blunt chest trauma patients (>90%) require either no invasive therapy or at most a tube thoracostomy with excellent outcome and prognosis. A high index of suspicion and close follow up is vital to avoid preventable morbidity and mortality especially in multiple trauma patients.

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