Pathogenesis (development of disease)
Thoracic trauma (chest injury) is differentiated by cause as follows:
- Blunt thoracic trauma (without bony involvement) – caused by impact or collision (e.g., traffic or work accidents; ski collision); approximately 90% of cases
- Thoracic contusion (Commotio thoraci) – without bony involvement.
- Thoracic contusion (contusio thoracis) – involvement of intrathoracic organs (organs located in the thoracic cavity).
- Open (penetrating/into the chest wall) thoracic trauma – due to stabbing, gunshot or impalement injuries; about 10% of cases.
In blunt thoracic trauma, some of the kinetic energy is absorbed by the chest wall. The rest is transmitted intrathoracically (inside the chest). In younger people, the thorax is more elastic and consequently more deformable than in older people, so more energy hits the thoracic viscera. In older accident victims, on the other hand, the thoracic skeleton breaks. This results in serial rib fractures (rib fractures; at least three adjacent ribs are affected) and/or sternal fracture (sternum fracture).
Thoracic trauma can also be iatrogenic, meaning caused by the physician. Chest injuries may occur during the following procedures:
- Tracheotomy (tracheotomy) – tracheobronchial (belonging to the trachea and bronchi) ruptures (“tears”).
- Intubation (insertion of a tube (a hollow probe) into the trachea).
Etiology (causes)
Injuries, poisonings, and other consequences of external causes (S00-T98).
- Impact trauma – blunt force trauma caused by impact, e.g., to a car seat belt or steering wheel (traffic accident)
- Deceleration trauma (sudden interruption of a rapid body movement) – e.g. in falls from a greater height.
- Entrapment
- Iatrogenic (caused by the doctor) in the context of surgical procedures.
- Stabbing, gunshot or impalement injuries.
- Kicks/blows to the thorax
- Rollover trauma
- Burial
