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Ann Thorac Surg 2004;77:754-755
© 2004 The Society of Thoracic Surgeons

Correspondence

Blunt chest trauma and tube thoracostomy

Atike Tekeli, MD

Department of Cardiovascular Surgery, Marmara University School of Medicine, Barbaros mah. Mutevelli Cesme, Sok No: 17 D:15 Uskudar, Istanbul, Turkey

Serdar Akgun, MD

Yakut 15, 16, Atasehir, 81120, Istanbul, Turkey

e-mail: atikemd{at}yahoo.com
e-mail: serdarak{at}turk.net

To the Editor:

We read with great interest the case report by Janson and colleagues [1]. It helps all of us to better understand the importance of blunt thoracic trauma and pericardial rupture.

Closed tube thoracostomy is a common and very useful procedure in the therapy for acute thoracic injury [2]. However, it is not without risk. The indications for, placement of, and management of chest tubes are clear [3]. In the interesting report by Janson and associates, there were multiple rib fractures on the right side with a lung contusion, but there was no hemothorax or pneumothorax. The chest roentgenogram does not provide enough information about the left side. As we understand from the text, the left side of the chest was normal without rib fracture, hemothorax, or pneumothorax. The point about which we are confused is the decision to place chest tubes prophylactically in both sides of thorax. Also, we could not determine whether or not there was any drainage or air leakage from the left chest tube. How do the authors explain the bilateral tube thoracostomies if the left side of the thorax was normal.

References

  1. Janson J.T., Harris D.G., Pretorius J., Rossouw G.J. Pericardial rupture and cardiac herniation after blunt chest trauma. Ann Thorac Surg 2003;75:581-582.[Abstract/Free Full Text]
  2. Millikan J.S., Moore E.E., Steiner E., Aragon G.E., Van Way C.W., III Complications of tube thoracostomy for acute trauma. Am J Surg 1980;140:738-741.[Medline]
  3. Iberti T.J., Stern P.M. Chest tube thoracostomy. Crit Care Clin 1992;8:879-895.[Medline]




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