[Traumatic pneumothorax - diagnosis and treatment of 322 cases over a five-year period].

Introduction Retrospective analysis of a set of patients treated for traumatic pneumothorax in the Trauma Centre of Teaching Hospital in Pilsen over a period of five years. Method In total, 322 patients with traumatic pneumothorax were treated in the study period 20122016. The set included subjects whose injury fell within the definition of traumatic pneumothorax and who underwent either primary treatment or secondary transport to the Trauma Centre following basic treatment in another health facility on the day that the trauma occurred. The exclusion criterion was a pneumothorax Results The vast majority of traumatic pneumothoraces (94.1%) occurred as a result of blunt chest trauma, car accidents being the most common mechanism (about 28%). Closed pneumothoraces dominated (91.3%). Traumatic pneumothorax was part of a polytrauma in about one half of the injured. The average Injury Severity Score within the set was 20 points. Traumatic pneumothorax was diagnosed in more than three quarters of the patients based on clinical examination and computed tomography. The most common therapeutic procedure was drainage of the relevant pleural cavity (259 patients - 80.5%). Almost two thirds of surgical procedures were carried out within 1 hour of admission to the Trauma Centre. Complications associated with traumatic pneumothorax treatment were reported in 10.2% of the cases, and 33 reoperations were carried out. 15 patients (4.7%) in the set died, out of which 12 on the day of the trauma, all of them as a result of decompensated traumatic shock. Conclusion Traumatic pneumothorax is a relatively frequent type of chest trauma found in up to half of the patients with chest trauma as part of a polytrauma. It usually occurs as closed pneumothorax as a result of blunt chest trauma. The diagnostic process is based on clinical examination and chest radiogram. However, ultrasound examination could be an alternative to chest radiogram in emergency situations. Computed tomography is the method of first choice for more serious traumas and inconclusive findings. To manage this condition, proper drainage of the relevant pleural cavity is sufficient in the vast majority of the patients. With timely diagnosis and adequate therapeutic intervention, the prognosis for patients with traumatic pneumothorax is favourable.Key words: traumatic pneumothorax - diagnosis - chest drainage.