Damage to Internal Organs

Title: Damage to Internal Organs

Injuries of the chest organs. With a closed injury, the reaction to pulmonary contusion is manifested by edema and hemorrhage into the alveoli. The course is asymptomatic, often dyspnea, moderate hemophthisis. X-ray - diffuse or local darkening of the lung tissue. Usually no special therapy is required. The post-concussion reaction disappears after 3-4 days. In severe cases with severe hypoxia, oxygen therapy is required through nasal catheters. The prognosis is favorable.

A closed injury such as chest compression can cause rupture of the trachea and/or bronchus. Signs of rupture include cyanosis, pain, hemorrhoids, cough, and shock. X-ray reveals pneumothorax, often mediastinal emphysema, the combination of which is pathognomonic. The diagnosis is confirmed bronchoscopically. Early surgical treatment is indicated. The prognosis is poor, with 30% of deaths occurring within the first hour.

Hemoineumothorax of traumatic origin is expressed by the accumulation of blood and air in the pleural cavity. The common symptom is respiratory failure. Diagnosis is based on a chest x-ray, which detects air and fluid. After a test diagnostic puncture, the pleural cavity is drained for aspiration of air and fluid, as well as diagnostic lavage (hemoglobin level!). If symptoms increase, surgery is indicated. The prognosis with timely treatment is favorable.

Rupture of the lung tissue during a closed injury leads to pneumothorax, accompanied by collapse of the lung tissue. With a collapse of 50% or more, a displacement of the mediastinal organs occurs, the signs of which are tachycardia, a drop in blood pressure, and respiratory failure. Tension valvular pneumothorax is especially dangerous. The diagnosis (see Spontaneous pneumothorax) is confirmed by x-ray examination. First aid is puncture of the pleural cavity in the third or fourth intercostal space along the midclavicular line with air aspiration, and, if necessary, drainage according to Bulau.

An open trauma to the chest cavity is always accompanied by an open pneumothorax, which occurs instantly or gradually (with oblique stab wounds). The task of first aid is to convert an open pneumothorax into a closed one by applying an occlusive, possibly adhesive, bandage. During dynamic observation, it is necessary to make sure that pneumothorax does not increase, which is possible with a combined injury of the chest wall and lung. With increasing pneumothorax, in addition to an occlusive bandage, puncture thoracentesis with a needle is necessary, on the pavilion of which a finger from a rubber glove with a cut off end is tightly fixed - a prototype of the Bulau valve.

Transport in an elevated position to the surgical department. The prognosis with adequate treatment is favorable.

Injuries to the abdominal organs can be open or closed. Open injuries are often gunshot or stab wounds, less often slash injuries. Along with the presence of a wound opening, there is severe pain, muscle tension and positive symptoms of peritoneal irritation. With a wide wound channel, intestinal contents and urine can flow from the wound. With a survey fluoroscopy of the abdominal cavity, a penetrating wound is confirmed by a crescent of gas under the diaphragm, but this sign is far from obligatory.

The clinical picture depends on the organ damaged by the injury - with damage to the liver and spleen, intestinal mesentery, profuse bleeding occurs with signs of acute blood loss; percussion can detect dullness in sloping areas of the abdomen. If a hollow organ (stomach, intestine) is damaged, the clinical picture of diffuse purulent or fecal peritonitis develops.

With closed injuries, there is no defect in the skin of the abdominal wall; usually such injuries occur in transport accidents, falls from a height, or strong blows to the abdominal wall. Diagnosis is difficult due to combined trauma of other organs and systems, the unconscious state of the patient