摘要:

The most important lung alterations associated with blunt trauma are contusion, laceration, and diffuse alveolar damage. The first two are the direct consequences of injury to the chest, while the third is the indirect result of thoracic or nonthoracic trauma. In addition to these three conditions, there are a number of epiphenomena and less common posttrauma abnormalities that are important to the radiologist involved in the care of injured patients.

ISSN:0883-5993    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The clinical fat embolism syndrome consisting of progressive pulmonary insufficiency, cerebral disfunction, and petechiae is rare. Following severe skeletal trauma, fat droplets appear in the circulating blood and embolize the capillaries of the lungs and other organs. Whether fat droplets are of mechanical or chemical origin remains controversial. These fat droplets cause mechanical occlusion of lung capillaries followed by chemical changes associated with hydrolysis of the neutral fat to free fatty acids. The free fatty acids produce a toxic and inflammatory reaction resulting in pulmonary edema, hemorrhage, and micro-atelectasis. The clinical and radiographic abnormalities appear after an initial latent period of 12 to 72 hours. The chest radiographic findings are nonspecific and consist of bilateral patchy or diffuse alveolar and interstitial lung densities. With aggressive management the survival has markedly improved, and mortality is now rare.

ISSN:0883-5993    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

With more sophisticated medical procedures and treatment for the critically ill patient, iatrogenic damage to the thorax has become increasingly common. But simple radiologic procedures, such as chest radiography and fluoroscopy, permit diagnosis of unsuspected and clinically silent complications. A very important iatrogenic trauma to the lung depends on the increasing use of overpressure ventilation. Experimental evidence shows that the lung can be damaged with interstitial emphysema at peak pressures as low as 40 cm H2O. The chest radiograph may show an early pathognomonic finding of perivascular air collections. The respirator treatment should then be modified to avoid pneumomediastinum and pneumothorax. The placement of catheters, chest tubes, endotracheal tubes, and feeding tubes as well as pacemaker electrodes and counterpulsation balloons may cause serious complications. Follow-up chest radiography after these procedures is therefore important.

ISSN:0883-5993    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Trauma is the third leading cause of death in the United States and the leading cause for persons under 40 years of age; chest trauma accounts for more than 25% of these deaths.1Rates of trauma to the chest— both blunt and penetrating—are rising because of the continuing development of high-speed transportation and because of increasing inner-city violence combined with ready availability of handguns.2But treatment has improved; even injury to the heart is no longer considered invariably lethal. This review describes the spectrum of injuries to the pericardium, heart, aorta, and thoracic arteries and veins, exclusive of iatrogenic trauma and high-velocity gun shot injuries caused by military weapons. The role of imaging is described.

ISSN:0883-5993    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

While most injuries to the chest can be diagnosed by a portable supine radiograph, computed tomography (CT) adds significant findings that will influence patient management. In addition to requested CT chest examinations, we routinely obtain a limited chest CT during the initial work-up of traumatized patients referred to our radiology department for other CT examinations. The major categories of new information provided by CT are: occult pneumothorax, malposition of chest tubes, inadequately drained pleural collections, differentiating between posttraumatic abscess and empyema, noninvasive diagnosis of tracheal rupture, and cause of mediastinal widening.

ISSN:0883-5993    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Blunt and penetrating chest trauma in children results from many causes but the major cause is motor vehicle accidents. The trauma induces a variety of injuries to the bony thorax, the pulmonary parenchyma, and mediastinal structures. In recent years, a disturbing increase in iatrogenic chest trauma has occurred in patients, particularly small infants, receiving intensive hospital care. Radiologic evaluation plays an important role in documenting and diagnosing these traumatic and iatrogenic injuries. The various radiologic manifestations of these injuries are described and discussed.

ISSN:0883-5993    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

While some degree of injury to normal, non-tumor-bearing, intrathoracic structures always occurs following irradiation for cure or palliation of neoplastic disease, clinical expression of this injury is uncommon. However, under certain circumstances, clinical manifestations may be severe and life threatening. Acute radiographic manifestations of pulmonary injury usually appear either synchronous with or, more typically, seven to ten days after the onset of the clinical syndrome. The acute signs of edema and slight volume loss within the irradiated zone are nonspecific except for their temporal and spatial relationship to the irradiation of the patient. Resolution of the acute changes is followed by pulmonary cicatrization, which is almost always stable within one year after completion of therapy. Change in postirradiation scarring following stabilization of the reaction must always be assumed to be due to some other process. While the radiograph primarily reveals pulmonary injury, all tissues, including the heart and major vessels, are susceptible, and the radiologist must recognize that any change within the thorax of a patient who has undergone thoracic irradiation may be a complication of that treatment. Differentiation of irradiation injury from residual or recurrent tumor, drug reaction, or opportunistic infection may be difficult and at times impossible.

ISSN:0883-5993    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Radiologically guided aspiration and drainage of thoracic fluid collections is an improvement on standard “blind” techniques for chest-tube insertion. Specific indications for radiologic drainage are broadening, and instead of failed surgical cases only, patients now are commonly referred for drainage. Most of these procedures are effective and the complication rate vis-à-vis alternatives is acceptable. Soft 12-F catheters suffice in most cases and are relatively comfortable compared to large-bore tubes.

ISSN:0883-5993    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

A case of pneumomediastinum following inhalation of cocaine alkaloid (free-base) is reported. This is the third reported case in the literature. The presumed mechanism is barotrauma secondary to vigorous inhalation for valsalva maneuvers.

ISSN:0883-5993    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0883-5993    

出版商:OVID    

年代:1987

数据来源: OVID