PRIMARY AND SECONDARY DIAGNOSIS IN CHEST TRAUMA AND LUNG CONTUSION

In 212 patients after injury of the thorax (54 males, 158 females; pen etrating (15), blunt (197), multiple trauma (128)) 158 cases demonstra ted rib fractures and 103 radiological proven pneumo - or hematothorac es or sometimes both, 108 of 138 had to be drained. 96,5% of the effus ions and 98% of the pneumothoraces were clinical confirmed. 93,5% to 9 7 pulmonary contusions (79 unilateral, 18 bilateral) were detected by bronchoscopy within 10 h, 72% by x-ray. Caused by anatomical problems or for additional diagnosis 4 patients underwent thoracic CT. During I CU treatment 31 patients developed septic complications without detect ion in x-ray studies. In CT (n=64) we found: 5 empyema, 13 pleural eff usions, 4 pneumothoraces, 4 pneumocysts, 72 condensations of a lobe. A fter CT we performed: 9 resections of the lower lobe, 1 pneumectomy, 1 decortication, 7 thoracotomies with drainage, 8 drainages. To detect a septic focus under treatment the CT proved beeing an important diagn ostic tool in chest trauma and lung contusion.