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Thoraxtrauma

Teil II: Management von spezifischen Verletzungen

Chest injury

Part II: Management of specific injuries

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Zusammenfassung

Wichtige Verletzungen des Thorax betreffen Pneumothorax, Rippenfrakturen, Lungenkontusion, Herzkontusion, Aortenruptur, Zwerchfellruptur und die sehr seltenen Verletzungen des Tracheobronchialbaums und des Ösophagus. Das Spektrum der chirurgischen Interventionen umfasst die Thoraxdrainage, Perikardpunktion sowie die Thorakoskopie und die Thorakoskopie, deren Indikationen bekannt sein müssen. Interventionelle Methoden finden bei den Läsionen großer Gefäße zunehmend Verbreitung. Bei der überwiegenden Mehrzahl der Patienten mit Thoraxtrauma sind keine operativen Interventionen erforderlich, allerdings ist in 10–15% der Fälle das Einlegen einer Thoraxdrainage oder – wesentlich seltener – eine Perikardpunktion oder eine Thorakotomie erforderlich.

Abstract

Significant injuries to the thorax comprise pneumothorax, rib fractures, lung contusion, cardiac contusion, aortic laceration, ruptured diaphragm, and the very rare injuries to the tracheo-bronchial tree and the esophagus. A surgeon dealing with chest trauma patients needs to be familiar with the indications for and execution of chest tube insertion for thoracic drainage, pericardial puncture, and thoracoscopy and thoracotomy. Interventional techniques are gaining increasing acceptance in the management of major vascular injuries. The vast majority of patients with chest injury do not need an operative intervention, but it is necessary to place a thoracic drain in 10–15% of cases or to perform in a much lower proportion a pericardial puncture or a thoracotomy.

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  1. Klinik für Unfallchirurgie, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen, Deutschland

    C. Waydhas & D. Nast-Kolb

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  1. C. Waydhas
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  2. D. Nast-Kolb
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Correspondence to C. Waydhas.

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Waydhas, C., Nast-Kolb, D. Thoraxtrauma. Unfallchirurg 109, 881–894 (2006). https://doi.org/10.1007/s00113-006-1150-1

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