Chest Trauma : What should we know

Jayarasti Kusumanegara, M Nuralim Mallapasi, Rosie

Surgery Department
Faculty of Medicine, Hasanuddin University

Chest trauma is a significant cause of morbidity and mortality in both adults and children. It is a
leading cause of death in approximately 25% of multiple trauma patients. Life-threatening
injuries can be remembered as the deadly dozen — six (airway obstruction, tension
pneumothorax, open pneumothorax, massive haemothorax, flail chest, cardiac tamponade) are
immediately life threatening and should be sought during the primary survey and six (aortic
disruption), lung contusion, myocardial contusion, diaphragmatic rupture, tracheobronchial
injury, oesophageal injury) are potentially life threatening and should be detected during the
secondary survey.

Although some of these injuries (most of them cardiac) require emergency surgical intervention,
most injuries to the lungs and pleura can be treated nonoperatively by applying certain
fundamental principles of initial trauma management, which can substantially reduce morbidity
and mortality related to these injuries. A knowledge of the pathophysiology of cardiac and
pleuropulmonary injuries is of utmost importance for optimal treatment.