Ср, 20 апр 2016 Автор: врач АртёмShiman
Bruises in the daily practice of a traumatologist are found
everywhere.
Indeed, it is difficult to imagine a person who does not
I got a bruise for my life.
A bruise is an injury caused by excessive
physical (mechanical) effects on a particular tissue or
organ.
The main difference of this damage from partial or complete
fracture – preserving the integrity of the injured organ.
In addition, it should be noted that you can not hurt the bones.
Organs and soft tissues are bruised.
Fortunately, the vast majority of bruises do not carry any
significant risk to the patient’s life, however
accompanied by a mass of discomfort. So, sometimes pain
the syndrome with such injuries is so pronounced that the patient himself
Suspects serious injury.
Chest injuries stand in trauma practice far
not in the first place, but still make up an impressive proportion of cases.
Sometimes chest injuries occur with minimal
symptomatic complex, because people simply do not apply
to the doctor. Yet it is rather the exception and most often such injuries.
hard not to notice.
Chest injuries in general (bruises in particular) represent
extremely dangerous damage. To understand the reason, you need
turn to anatomy.
In the chest are vital organs, such as
heart and lungs. A blow to the region of the sternum (regardless of its strength)
always fraught with danger and can lead to unpredictable
the consequences. The medical literature describes cases of deferred
development of life-threatening symptoms, as well as urgent
conditions, up to cardiac arrest. That aggravates the situation
the fact that chest injuries are often accompanied by injuries
ribs (fractures, cracks).
It is clear that the described injury is not harmless. therefore
everyone must be knowledgeable about health
know what to do if such a nuisance has happened – to whom
address and how to minimize the consequences.
Contents
Chest injury: causes
According to medical statistics, chest injuries
are relatively rare (about 10-15% of all cases
appeals to a traumatologist with a bruise). This is understandable: causes of injury
although not specific, they also add up infrequently. Among them:
• Car accident (makes up the vast majority
cases, about 80%). Drivers suffer especially from injuries.
passenger transport: in a frontal collision there is a high risk of hitting
about the steering wheel.
• Brawl. A chest contusion is caused by a blow to the chest (as
usually with a blunt object or fist).
• Fall from a height (for one reason or another).
• Other domestic reasons. Meet a little less. Among them –
falls in domestic conditions, in sports, etc.
If we talk about the immediate cause of the injury, it is typical for
any injury. Chest injury results from
excessive mechanical stress on fabrics located in
this area (muscle).
Demographic differences between patients are not observed.
Dependence exists between the frequency of injury and occupational
activities. As mentioned, drivers are more likely to suffer.
Chest injury: symptoms
Symptomatic complex is strictly individual and
depends on two factors:
• The severity of the injury (the greater the injury, the faster
symptoms will appear and their course will be more intense).
• Prescription injury.
In addition, the symptoms are divided into general and local.
Symptoms of chest injury are specific and include
in itself the following manifestations:
• Pain at the site of injury. As a rule, the intensity of pain
sensations high. The pains are dull, aching, can be throbbing.
Throbbing pain after injury to the sternum is a warning sign,
as may indicate damage to nerve endings as well
and heart damage. Pain persists in the state
rest and amplified with movements. Also, the pain may become
stronger when breathing, coughing and even talking.
• Hematoma development. Hematoma forms at the site of injury.
soft tissue of the sternum. The appearance of a bruise is associated with destruction
surrounding capillaries and subsequent bleeding into the subcutaneous
fiber. Hematoma can spread to the area outside
damage.
• Swelling of the injury site. Any tissue damage is accompanied
fluid accumulation and increasing edema.
Both hematoma and edema begin to develop upon receipt
damage.
Unfortunately, rarely a chest contusion is an isolated injury.
The anatomical proximity of the lungs, pleura, heart causes high
риск их damage.
Mostly bruised sternum
accompany:
• Bruised ribs.
• Rib fractures (full and partial).
• Bruises to the lungs.
If the injury to the sternum is complicated by other lesions, symptoms
will be expressed brighter. In this case, the following are observed:
• pain high intensity when inhaling, palpating and even light
by touch.
• Breathing problems (may indicate problems with
light or accompany himself bruised chest or ribs:
pain syndrome is so pronounced that the patient cannot do
full breath).
Bruises are even harder, which are accompanied by damage
lungs or pleura. They are fraught with the development of severe complications, among
which:
• Pneumothorax.
• Hemothorax.
If as a result of the injury, large
blood vessels of the sternum, abdomen or lungs, is formed
dangerous hematoma: blood is poured into the pleural cavity and, not
finding a way, thickens. Such a condition in medical practice
called hemothorax. Hemothorax is accompanied by serious
increasing respiratory disorders, as well as severe general
symptoms: headache, weakness, etc.
With pneumothorax a large amount penetrates into the chest cavity
air, resulting in compression of the lung and its
�”Shrinking”. Pneumothorax is accompanied by characteristic
manifestations:
• Serious breathing problems.
• Increased blood pressure, reduced heart rate
cuts.
• Development of subcutaneous emphysema (due to penetration
air into the subcutaneous tissue).
• Overall Severe.
Both of these conditions are extremely dangerous and require immediate
medical intervention.
If the volume of blood lost is large, the patient develops
signs of anemia.
Chest injury: diagnosis
If a chest contusion was sustained, refer to
traumatologist or surgeon.
Diagnosis of bruise of the chest is not difficult. Where
more important to exclude the presence of concomitant damage to the ribs and organs
chest: it can be life-threatening conditions.
During the initial visit to a specialist standard
Diagnostic strategy includes:
• Collecting anamnesis. The doctor asks the patient a question about his general
condition, conditions of injury, after which it may be
general impression of the injury.
• Inspection. Visually assess the condition of the chest: form
and size, confirmed or excluded deformation
(usually observed with rib injuries), hematoma size.
• Palpation. Conducted with caution because painful
bruise syndrome is pronounced. Allows you to assess the presence of fractures
ribs.
• Radiography of the chest cavity. Used to assess bone
structures of the chest cavity.
• MRI. Assigned and administered when damage is suspected.
organs of the thoracic cavity. MRI provides an opportunity to visually assess
soft tissue and blood vessels, exclude or confirm
internal hematomas.
• CT. Assigned to a more subtle assessment of bone structures, if
after radiography, questions remain.
The specific list of diagnostic measures is determined by
a doctor.
Chest injury: treatment
Treatment of the chest injury itself
conservative, however, to approach him “sloppy” in no way
case is impossible. With severe bruising, accompanied by the development
hematomas and pain syndrome should be mandatory
обратиться to the doctor.
The fact is that dangerous symptoms (respiratory disorders, up to
its stopping, disturbance of cardiac activity) may be
delayed and manifest after 1-2 days.
The essence of the treatment is to relieve pain and
inflammation. Usually, a combination is enough.
painkiller (analgesic drugs) and anti-inflammatory
drugs.
Used drugs such as:
• Baralgin.
• Ketorol.
• Nise.
Removal of the acute period takes from 7 to 14 days.
At the end of treatment, physiotherapy is prescribed.
(electrophoresis, magnet).
Injury complicated by hemothorax or pneumothorax is treated
only surgically. The task of surgical treatment of complications
chest injury includes removal of blood or removal
accumulated in the chest cavity air. In both cases, the treatment
should be held as soon as possible: there is a risk
irreversible lung changes.
Thus, it is impossible to call chest contusion with the lungs. AT
In most cases, this is a serious injury that requires serious injury.
relations, because its consequences may be the most
unpredictable. ATо всех случаях рекомендуется обратиться к
a specialist. He will select the necessary complex diagnostic
measures and determine the treatment strategy. Self-medication in this
case is dangerous to deal with.
