DIAGNOSTICS OF INFLAMMATORY INSIDE THE PLEURAL COMPLICATIONS OF THORACIC INJURY
Abstract
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
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