DIAGNOSTICS OF INFLAMMATORY INSIDE THE PLEURAL COMPLICATIONS OF THORACIC INJURY
The non-specificity of the clinical signs of posttraumatic purulent thoracic complications indicates the importance of instrumental diagnostic methods. There is no generally accepted algorithm for examining an injured person with a chest injury that would allow timely recognition of purulent complications in the posttraumatic period. The results of the examination of patients with intra-pleural complications of thoracic injury using the spiral computed tomography method, which in dynamics allows objectively documenting the dynamics of the pathological process, evaluating the effectiveness of treatment, timely diagnose secondary complications, are presented.
Тhe analysis of the results of the study indicates the need for a comprehensive examination of suspected post-traumatic intra pleural thoracic complications. In the presence of any manifestations of systemic inflammatory response in the posttraumatic period in patients with chest lesions, regardless of the results of the X-ray examination, ultrasound examination and computed tomography of the chest should be performed, which allows to detect the accumulation of pathological contents in the pleural and pericardial cavity, to assess the nature changes in the pulmonary tissue, mediastinum, thoracic wall and decide on the drainage of lesions fester. At the same time, for the correct interpretation of some changes in spiral computed tomography, including the lung abscess that developed in the background of pulmonary hemorrhages and mediastinitis against the background of hemorrhages in the mediastinum and pneumomediastinum, it is necessary to compare them with the baseline data. This testifies to the necessity of performing an early spiral computed tomographic examination in patients with chest lesions in the presence of any focal changes on the review X-ray. Spiral computer tomography of the chest in dynamics allows to objectively document the dynamics of the pathological process, evaluate the effectiveness of treatment, timely diagnose secondary complications. The application of this algorithm allows to diagnose the entire spectrum of intra-pleural complications in the early stages and to avoid diagnostic errors
Hadzhibaev A. N., Rakhmanov R. O., Sultanov P. K., Sharipova V. Kh. Diagnostics and surgical tactics for emergency conditions caused by trauma and diseases of the chest cavity organs. // General Resuscitation. 2016. – № 12 (4). – P. 57–67.
Agafonova N. V. Radiation methods for diagnosing traumatic injuries of the chest organs in patients with polytrauma, problems of diagnostics / N. V. Agafonova, S. V. Konev, A. G. Alekseeva // Proceedings of the XVIII All-Russian Scientific and Practical Conference «Multidisciplinary Hospital: the integration of specialties.» – Leninsk-Kuznetsky, 2014. – P. 57–58.
Granhed H. P. A feasibility study of 60 consecutive patients operated for unstable thoracic cage / H. P. Granhed, D. Pazooki // J Trauma Manag Outcomes. – 2014. – Vol. 8, № 1. – P. 20.
Chardoli M. Accuracy of chest radiography versus chest computed tomography in hemodynamically stable patients with blunt chest trauma / M. Chardoli, T. Hasan-Ghaliaee, H. Akbari, V. Rahimi-Movaghar // Chin J Traumatol. – 2013. – Vol. 16, № 6. – P. 351–354.
Bisenkov L. N. Emergency surgery of the chest and abdomen: a guide for doctors / L. N. Bisenkov, P. N. Zubarev, B. I. Ischenko, V. M. Trofimov, S. A. Shalaev. – SPb: SpetsLit, 2015. – P. 574. 6. Comprehensive treatment of lung abscesses and empyema in patients with severe thoracic injury / V. V. Boyko et al. // Klinicchna hirurgiya. – 2011. – № 3. – P.53–56.
Chung J. H. ACR appropriateness criteria blunt chest trauma / J. H. Chung, C. W. Cox, T. L. Mohammed, J. Kirsch, K. Brown, D. S. Dyer, M. E. Ginsburg, E. Heitkamp, J. P. Kanne, E. A. Kazerooni, L. H. Ketai, J. G. Ravenel, A. G. Saleh, R. D. Shah, R. M. Steiner, R. D. Suh // J Am Coll Radiol. – 2014. – Vol. 11, № 4. – P. 345–351.
Kochergaev O. V. Efficiency of spiral computed tomography in the detection of lung damage in severe mechanical combined chest injury / O. V. Kochergaev, A. A. Kopalin, V. I. Draznin, V. A. Kotkin // Togliatti Medical Consulium. – 2014. – № 5–6. – P. 59–66
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