Chest crush injury

Case contributed by Dr Andrew Dixon

Presentation

Severe crush injury to chest.

Patient Data

Age: 50
Gender: Male

This case featured in our 2016 Trauma Radiology Course which is now available to view online.

Trauma Series

X-ray

Chest x-ray #1 - Many bilateral displaced rib fractures, bilateral pneumothoraces, bilateral chest wall subcutaneous emphysema. Left lower lobe collapse / consolidation with air brochograms projected behind the heart. Attempted left pneumocath. ETT and NGT appropriately positioned. 

Chest x-ray #2 - Bilateral intercostal catheters have been inserted. The left catheter is kinked at the level of the side hole and required repositioning to allow drainage. 

Chest x-ray #3 - The left ICC has been repositioned and is no longer kinked. 

Chest CT

CT

Multiple displaced bilateral rib fractures. Many ribs are fractured in two places (flail segment). Bilateral small residual anterobasal pneumothoraces. Bilateral lower lobe collapse / consildation, left greater than right. Chest wall subcutaneous emphysema. Trace right hemothorax. 

Post operative

X-ray

Bilateral rib internal fixation has been performed. Extra-pleural hematoma / swelling is seen in association with the fractures. Left lower lobe atelectasis is present. 

Case Discussion

This case demonstrates crush injury to the chest with multiple displaced rib fractures, pneumothoraces and subcutaneous emphysema. Internal fixation of the rib fractures was performed. 

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