THE INVESTIGATION OF DELAYED TRAUMATIC PNEUMOTHORAX DUE TO BLUNT INJURY

Abstract

　　Defining "delayed traumatic pneumothorax (DTPTX) " as traumatic pneumothorax (TPTX) diagnosed by film examination after admission that was not detected by computed tomography at admission, we retrospectively evaluated 159 patients with TPTX due to blunt trauma. Five patients met the criteria for DTPTX. All patients had multiple upper or middle rib fractures, and three also had clavicle fracture. DTPTX was diagnosed on day 2 (80%) or 3 (20%). Emergency thoracic drainage just after the diagnosis was required for 3 of 5 (60%), and 1 of the remaining 2 patients underwent drainage just before elective surgery under general anesthesia. The thoracic drainage duration was 6 (3-11) days and DTPTX in the remaining patient who did not receive drainage did not deteriorate ; therefore, all 5 patients survived. Although DTPTX is rare, as some patients require immediate thoracic drainage, chest trauma patients with multiple upper or middle rib fractures and clavicle fracture should be observed carefully.