Clinical aspect of lungs

Flail chest

Causes

  • Crushing injuries especially which is extensive and causes indentation.

  • Direct violence

  • Involves many ribs which break at the anterior and posterior angles.

  • The fracture unit remains a different unit from others and there is paradoxical breathing.

  • Extensive flaccid instability of chest wall

Diagnosis

  • History: War or RTA with direct violence.Condition is painful and may involve stability of chest. Paradoxical breathing occurs with difficulty in breathing. It always has indentation of chest wall.

  • General examination: Crepitus and localized tenderness.

X-ray:

Treatment

  • Artificial respiration

  • Tracheostomy cures the condition.

  • Analgesics for pain.

  • Intercostal nerve block may be used for persistent pain.

  • Surgical intervention to elevate the depressed chest wall

Stove-in-chest

Causes and features

  • Crushing injuries especially which is extensive and causes indentation.

  • Direct violence

  • Involves many ribs which break at the anterior and posterior angles.

  • The fracture unit may remain a different unit from others and there is paradoxical breathing.

  • It is found in three places usually- anterior (involving sternum) and lateral (subscapular).

Diagnosis

  • History: War or RTA with direct violence. Condition is painful and may involve stability of chest. Paradoxical breathing occurs with difficulty in breathing. It always has indentation of chest wall.

  • General examination: Crepitus and localized tenderness.

  • X-ray:

Treatment

  • Artificial respiration

  • Tracheostomy

  • Analgesics for pain.

  • Intercostal nerve block may be used for persistent pain.

  • Surgical intervention to elevate the depressed chest wall

  • Recurrence requires fixation of ribs with wires

 

 

 

 

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Creator: Oluwole Ogunranti