Chest contusion

Introduction Because the chest wall is directly subjected to violent impact or squeezing the chest wall, it is not enough to cause the ribs to fracture, or the chest muscles, fascia, intercostal nerves, blood vessels, etc. are damaged due to uncoordinated hands and heavy forces, causing local swelling, Pain, etc., cause soft tissue and periosteum in the chest wall, called chest contusion.

Cause

Because the chest wall is directly subjected to violent impact or squeezing, it is not enough to cause the ribs to fracture, or the chest muscles, fascia, intercostal nerves, blood vessels, etc. are damaged due to uncoordinated hands and heavy hands, causing local swelling and pain. Wait. Progressive hemothorax caused by organ tissue laceration is the main reason for the rapid progress of the injury and the death of the patient.

an examination

Related inspection

Chest flat chest B super

Local severe pain, finger touches the affected area, can touch the rib membrane thick blunt or linear peeling, the intercostal muscles are tight, sometimes can touch a rolling strip of intercostal muscle fiber stripping, tenderness is obvious.

Chest wall soft tissue injury refers to the mechanical damage caused by the external force of the skin, subcutaneous tissue, chest muscles and intercostal tissues of the chest wall, accounting for 40% to 60% of the chest injury. Superficial soft tissue injuries such as abrasions, contusions, etc., are generally not clinically important, but can cause serious effects if extensive lacerations or penetrating injuries occur. Chest wall soft tissue injury is divided into open and closed according to whether the skin is broken or not. Open injury is divided into penetrating and non-penetrating injuries according to whether the chest wall wound is in contact with the pleural cavity or with the mediastinum. Severe cases can cause respiratory and circulatory dysfunction. If not treated promptly, it can lead to rapid death.

Differential diagnosis

Differential diagnosis of chest contusion:

1. Thoracic schizophrenia: During the embryonic period, the sternal base forms the left and right sternum plates. At about the 9th to 10th week, the sternum plates on both sides merged at the midline to form the whole sternum. If the fusion is not completed during embryonic development, or only partially fused, a sternal fissure is formed. According to the location and extent of the fissure, it can be divided into the upper sternum fissure, the lower sternum fissure and the whole sternal fissure.

2, sternal tenderness: the most obvious part of the sternal tenderness of most patients in the lower part of the sternum, which is equivalent to the sternum of the fourth and fifth intercostal space.

3, lower sternal tenderness: tenderness of the lower sternum is one of the important signs of leukemia. In addition, it can also be seen in malignant lymphoma and myeloproliferative diseases, but the latter two are relatively rare. Leukemia, also known as blood cancer, is one of the most important signs when people suffer from leukemia, especially acute leukemia. According to clinical observations, the most obvious site of sternal tenderness in most patients is in the lower part of the sternum, which is equivalent to the sternum of the fourth and fifth intercostal spaces. Medical scientists believe that the cause of bone pain is mainly caused by the proliferation of leukemia cells in the bone marrow, the increase of the volume pressure of the bone marrow cavity, and the infiltration of the periosteum by the leukemia cells to stimulate the sensory nerve. From an anatomical point of view, the sternum plate is very thin, the skin covering this part is also very thin, and the periosteal sensory nerve is also rich, so it is sensitive to the touch pressure, and tends to produce obvious tenderness.

Local severe pain, finger touches the affected area, can touch the rib membrane thick blunt or linear peeling, the intercostal muscles are tight, sometimes can touch a rolling strip of intercostal muscle fiber stripping, tenderness is obvious.

Chest wall soft tissue injury refers to the mechanical damage caused by the external force of the skin, subcutaneous tissue, chest muscles and intercostal tissues of the chest wall, accounting for 40% to 60% of the chest injury. Superficial soft tissue injuries such as abrasions, contusions, etc., are generally not clinically important, but can cause serious effects if extensive lacerations or penetrating injuries occur. Chest wall soft tissue injury is divided into open and closed according to whether the skin is broken or not. Open injury is divided into penetrating and non-penetrating injuries according to whether the chest wall wound is in contact with the pleural cavity or with the mediastinum. Severe cases can cause respiratory and circulatory dysfunction. If not treated promptly, it can lead to rapid death.

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