The Treatment Results of Pneumothorax in Blunt Chest Trauma

Background: Blunt chest trauma is one of the leading causes of post-traumatic death in both developed and developing countries. Pneumothorax is a common injury after blunt chest trauma. It occurs when there are signs of air remaining in the pleural cavity after injury, even though the pleural cavity does not communicate with the outside environment. Diagnosis is based on signs and symptoms, including chest pain, shortness of breath, hyperresonant to percussion, decreased breath sounds, decreased tactile fremitus. Chest X-rays are essential for diagnosis, and chest computed tomography can provide more accurate results. Treatment methods vary but often involve pleural drainage as a primary and important step, in addition to options such as conservative treatment or surgery. Objectives: To study the clinical, imaging features, and treatment results of pneumothorax in blunt chest trauma. Materials and methods: All patients with pneumothorax in blunt chest trauma were treated at Can Tho Central General Hospital from April 2022 to April 2023. Results: The average age was 45.95 ± 18.16 years. Men constituted 89% of the patient population, and traffic accidents were the cause in 86% of cases. Chest pain and dyspnea were two common symptoms of pneumothorax after blunt chest trauma, accounting for 91.9% and 40.5%, respectively. The incidence of rib fractures is quite high, accounting for 83.8% of cases. Out of 37 cases, one case was managed conservatively, while pleural drainage was performed in 36 cases (97.3%). Among the cases requiring pleural drainage, three cases (8.3%) required thoracotomy. The overall treatment success rate was 100%, with an average hospital stay of 8.3 ± 3.5 days. The presence of more or fewer rib fractures can impact the treatment duration for the patient, as 78.6% of patients with more than 4 broken ribs had a hospital stay of at least 8 days. Conclusion: Pneumothorax is a common injury following blunt chest trauma, and it occurs more frequently in men than women. The prevalent clinical features include chest pain, dyspnea, decreased breath sounds, and subcutaneous emphysema. The age of the patient and the number of fractures also impact the time required for treatment of this condition.