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穿透性胸部创伤的断层扫描表现:火器及其他武器所致损伤

Tomographic aspects of penetrating thoracic trauma: injuries from firearms and other weapons.

作者信息

de Melo Alessandro Severo Alves, Moreira Luiza Beatriz Melo, Pessoa Fernanda Miraldi Clemente, Saint-Martin Nara, Ancilotti Filho Roger, Souza Arthur Soares, Marchiori Edson

机构信息

PhD, MD, Radiologist, Adjunct Professor at the Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil.

MD, Radiologist at the Hospital Universitário Antônio Pedro da Universidade Federal Fluminense (HUAP-UFF), Niterói, RJ, Brazil.

出版信息

Radiol Bras. 2017 Nov-Dec;50(6):372-377. doi: 10.1590/0100-3984.2016.0167.

Abstract

OBJECTIVE

The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions.

MATERIAL AND METHODS

We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon.

RESULTS

Pulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2.5%) and hematomas in 1 (2.5%). Hemothorax was seen in 31 cases (77.5%), and pneumothorax was seen in 22 cases (55%). Mediastinal lesions were observed in 8 cases (20%), including mediastinal hematoma in 3 cases (7.5%), hemopericardium in 3 (7.5%), and pneumomediastinum in 2 (5%). Diaphragmatic rupture was seen in 2 cases (5%).

CONCLUSION

In patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach.

摘要

目的

本研究旨在分析穿透性胸部创伤的各种计算机断层扫描结果,以及确定病变的频率和范围。

材料与方法

我们研究了40例穿透性胸部创伤的计算机断层扫描结果,其中35例(85.8%)为枪伤,5例(14.2%)由其他类型武器所致。

结果

39例(97.5%)发现肺部病变,其中34例(85%)表现为挫伤,8例(20%)为肺不张,1例(2.5%)为撕裂伤,1例(2.5%)为血肿。31例(77.5%)出现血胸,22例(55%)出现气胸。8例(20%)观察到纵隔病变,包括3例(7.5%)纵隔血肿、3例(7.5%)心包积血和2例(5%)纵隔气肿。2例(5%)出现膈肌破裂。

结论

对于穿透性胸部创伤患者,胸部计算机断层扫描是一种重要工具,可用于明确受影响器官、评估损伤路径以及病变的严重程度和范围。所获得的图像在估计死亡风险和确定最佳治疗方法方面也很有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/131c/5746881/3261ebfcd438/rb-50-06-0372-g01.jpg

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