Diagnostic algorithm and lung laceration therapy

Overview

Lung laceration is one of the most serious nocsequences of both blunt, and penetrating trauma of the thorax. The authors described 16 cases diagnosed and surgically treated at their clinic over last five years. In about 80 % of cases, the laceration was a consequence of blunt trauma to the thorax, caused mainly by a traffic accident. In 12 patients lung laceration was part of serious polytrauma, and anatomic lung resection was necessary in one half of these cases. In contrast, all 3 cases of penetrating trauma could be treated only using sutures, or by wedgeshaped lung resection in one patient using a miniinvasive method. Postoperative complications in surviving patients were rare and operative revision was unnecessary. During or immediately after operation 4 male patients died (25 %), in all cases from multiple trauma incompatible with life. The extent of lung parenchyma damage in our group was proportional to the extent of force of the injury. Deep ruptures were in all cases a part of polytrauma. The optimal surgical method, especially in multiple and deep lacerations, seems to be various types of thoracotomy, indications for videothoracoscopy occur rarely. In the framework for the proper treatment of lung ruptures, saving procedures are preferred. Other aspects of diagnoses and therapy of lung lacerations are also discussed.

Key words:
lung laceration, thoracotomy.