| Chest injury | |
|---|---|
| Other names | Chest trauma, Commotio thoracis |
 | |
| Achest X-ray of a right sided pulmonary contusion associated with flail chest andsubcutaneous emphysema | |
| Specialty | Emergency medicine  |
Achest injury, also known aschest trauma, is any form of physicalinjury to thechest including theribs,heart andlungs. Chest injuries account for 25% of all deaths from traumatic injury.[1] Typically chest injuries are caused by blunt mechanisms such as direct, indirect, compression, contusion, deceleration, or blasts[2] caused bymotor vehicle collisions or penetrating mechanisms such asstabbings.[3]
Chest injuries can be classified asblunt orpenetrating. Blunt and penetrating injuries have differentpathophysiologies and clinical courses.
Specific types of injuries include:
Most blunt injuries are managed with relatively simple interventions liketracheal intubation andmechanical ventilation andchest tube insertion. Diagnosis of blunt injuries may be more difficult and require additional investigations such asCT scanning. Penetrating injuries often requiresurgery, and complex investigations are usually not needed to come to a diagnosis. Patients with penetrating trauma may deteriorate rapidly, but may also recover much faster than patients with blunt injury.
Chest trauma outcomes depend on the severity of the chest injury as well as associated injuries (such as head or spinal trauma) and the patient’s general health condition.
Early management in specialist centres offers better survival. Management is a mixture of medical (eg pain relief, respiratory support, chest drainage and antibiotics), non-medical (physiotherapy and rehabilitation) and surgical (fixation of rib fractures if appropriate and operative treatment of cardiac, lung, airway, diaphragm and oesophageal injuries).
Those who survive chest trauma and are discharged from hospital have a long-term survival comparable to the general population.[4]