[Thoracic trauma: an analysis of 521 patients]. / Gögüs travmalari: 521 olgunun degerlendirilmesi.

BACKGROUND: We evaluated thoracic trauma cases with regard to etiologic causes, treatment methods, outcome, and factors affecting the results in the light of our experience and relevant literature data. METHODS: A retrospective evaluation was made of 521 patients (399 males, 122 females; mean age 42 years; range 4 to 93 years) who were treated for thoracic trauma from September 1997 to August 2002. RESULTS: Isolated thoracic trauma and multisystem trauma were found in 348 (67%) and 173 (33%) patients, respectively. Blunt injuries accounted for 87%, the most common cause being traffic accidents (62%), and penetrating injuries accounted for 13%. The most frequent thoracic pathologies included multiple (56%) and single (24%) rib fractures, and flail chest (8.4%). Extrathoracic injuries were seen in 33.2%, the extremities (41%) and the skull (40%) being the most commonly involved. Treatment consisted of symptomatic treatment in 159 patients (30.5%), tube thoracostomy in 337 patients (64.6%), and thoracotomy in 15 patients (2.9%). In isolated thoracic trauma and multisystem trauma, morbidity rates were 3.4% and 22%, and mortality rates were 2.5% and 16.2%, respectively. The overall mortality was 7.1% (37 patients). The mean length of hospital stay was 7.1 days (range 1 to 64 days). CONCLUSION: A great majority of thoracic trauma patients can be treated with conservative methods or tube thoracostomy. Accompanying multisystem traumas are associated with dramatic increases in morbidity and mortality rates.

Endobronchial lipoma: a rare cause of bronchial occlusion.

Benign neoplasms of the endobronchial tree are uncommon, and among them lipomas are the most uncommon. Endobronchial lipoma is histologically benign in character but may cause bronchial obstruction. We describe a 47-year-old woman with an endobronchial lipoma arising from the right main bronchus which was treated as asthma for 4 years.