Injuries to Chest and Abdomen

What is a chest wall injury?

Injuries to the chest wall include fractured ribs, fractured sternum (breastbone) and/or bruising to the lungs. They normally occur following an impact trauma to the chest, such as falling from a height, a road traffic accident or during impact sports.

Problems with your chest and lungs

Your lungs are surrounded by a membrane that folds back onto itself to create something called pleural cavity.  This cavity usually contains a small amount of fluid.  The membrane (pleurae) is attached on the one side to the chest wall which is the ribcage and the other side to the lungs.  This membrane is attached to different blood vessels and nerves.  

During an accident, some of the blood vessels connected to the membrane and lung can get damaged and cause bleeding.  A variety of names are used to explain what fluid is in the lungs or in the membrane around the lungs.  Below is a description of some of these:

Pleural Effusion

A pleural effusion means that there is a build-up of fluid between a lung and the chest wall.  Please refer to this leaflet for more information. 

Haemothorax

This means that there is some blood in between the two membranes that surround the lungs.

Pneumothorax

This is a collection of air in-between the membrane around the lungs and the ribcage. The illustration below shows a right pneumothorax. Please refer to this leaflet for more information.

Haemopneumothorax

This is a collection of blood and air in the chest cavity or in the pleural space- between the lungs and the rib cage.  This often happens if the ribcage gets puncture. 

Chest Drain

A chest drain is a plastic tube inserted into the chest to drain off fluid or air that might be collecting there after an operation or accident or as a result of disease.  Please refer to this leaflet and this leaflet for more information.

Problems with your Abdomen 

Laparotomy

This is a surgical procedure where the doctors make a long vertical cut in your abdomen to enable them to look inside your tummy. This is often a procedure used to explore or investigate if there is any damage in your tummy after an accident such as blood or damaged organs (spleen, kidney, liver etc). If the doctors find any damage then they can repair what is needed or perform the surgery required to address the problem.

Laparotomies cuts through strong abdominal muscles and requires several weeks to heal. It is thus advisable to avoid lifting anything heavy (>500grams) for at least 6 weeks after the operation and also avoid contact sport. Click here for more information:

Thoracotomy

A thoracotomy is a very big operation often carried out in an emergency and is a large horizontal cut across your chest. The purpose of this operation is for doctors to get quick access to your heart and lungs only for those people that are very unwell after an accident. In the majority of cases a chest tube will be inserted after this type of surgery to drain any excess blood and fluid out of your chest cavity. It can take a long time to recover from this surgery and there is always a risk of infection. Advice is similar to that of laparotomies but as your heart and lungs may have been injured in the accident which required this surgery, further advice needs to be sought form your doctor.

Stoma

In some patients, especially those with severe pelvic fractures, the doctors may decide that a stoma is required.  This involves an ostomy which is a surgically made opening from the inside of an organ to the outside.  This procedure is often done because of intestinal damage of your duodenum or your bowels.  This procedure involves making an opening from the large intestine to the abdominal wall so faeces bypass the anal canal and are collected in a bag on your tummy called a stoma bagFor more information, please refer to this leaflet