Abstract
The management of chest injuries begins with knowledge of what happened to the patient at the time of the traumatic incident and converting this information into possible diagnoses. The various organs of the chest cavity are discussed emphasizing the controversies that attend the management or diagnosis of each one.
Résumé
Le traitement des lésions thoraciques commence par la compréhension du type du traumatisme et la discussion diagnostiques possibles. Les organes de la cavité thoracique pouvant être lésés sont énumérés et les controverses entourant leur diagnostic ou leu traitement sont discutés une par une.
Resumen
El trauma torácico constituye entre el 20 y el 30% de todas las muertes por trauma en los Estados Unidos; sin embargo, sólo 15% de los pacientes con trauma torácico requieren intervención quirúrgica. La mayoría de los casos pueden ser exitosamente manejados manteniendo oxigenación y perfusión adecuadas. La estabilidad de la pared torácica, el control de neumotórax y de hemotórax masivo y el mantenimiento de buen gasto cardiaco aseguran la oxigenación tisular que previene el metabolismo anaeróbico. La hemorragia, que generalmente se origina en la pared torácica o en los vasos pulmonares, con frecuencia es autolimitante. Las lesiones de la aorta que resultan en pérdida de continuidad de la luz vascular y las lesiones cerradas del corazón deben ser manejadas como entidades independientes, aunque hacen parte del complejo patológico que se conoce como trauma torácico. Las lesiones del esófago son poco comunes pero requieren reparación en la misma forma que en cualquiera otra parte del tracto gastrointestinal. La presente revisión de las lesions torácicas comprende: 1) lesiones de la pared torácica; 2) lesiones de los pulmones y bronquios, incluyendo los vasos pulmonares; 3) lesiones del corazón; 4) lesiones de la aorta, y 5) lesiones del esófago. Se hace énfasis sobre las controversias que suscitan el manejo y el diagnóstico de estas lesiones.
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McSwain, N.E. Blunt and penetrating chest injuries. World J. Surg. 16, 924–929 (1992). https://doi.org/10.1007/BF02066993
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DOI: https://doi.org/10.1007/BF02066993