CASE 545 Published on 24.10.2000

Blunt traumatic anterior flail chest

Section

Chest imaging

Case Type

Clinical Cases

Authors

M. Wintermark, P. Vock, P. Schnyder

Patient

71 years, female

Categories

No Area of Interest ; Imaging Technique CT

No Procedure ; No Special Focus ;

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Clinical History

Anterior paradoxical chest wall motion as part of a high-speed car accident

Imaging Findings

Belted 71-year-old female driver involved in a high-speed car crash and with an anterior paradoxical chest wall motion as part of her clinical presentation

Discussion

Flail chests usually affect one single hemithorax, but may exceptionally involve both hemithoraces when sternal and/or bilateral anterior chondro-costal fractures result in a complete disruption of the anterior thoracic wall

Differential Diagnosis List

Blunt traumatic anterior flail chest

Final Diagnosis

Blunt traumatic anterior flail chest

References

[1] Ciraulo DL, Elliott D, Mitchell KA, Rodriguez A.
Flail chest as a marker for significant injuries.
J Am Coll Surg. 1994 May;178(5):466-70. (PMID: 8167883)

[2] Freedland M, Wilson RF, Bender JS, Levison MA.
The management of flail chest injury: factors affecting outcome.
J Trauma. 1990 Dec;30(12):1460-8. (PMID: 2258956)

[3] Jackson A, Fields JM, Wong-You-Chong JJ.
The costal hook: an indicator of occult flail segment in chest trauma.
Eur J Radiol. 1991 Jul-Aug;13(1):69-71. (PMID: 1889434)

[4] Wintermark M, Schnyder P
Trauma of the chest wall. In Schnyder P, Wintermark M. Radiology of blunt trauma of the chest. Springer, Berlin Heidelberg New York, pp 9-27(2000).

Case information

URL:	https://eurorad.org/case/545
DOI:	10.1594/EURORAD/CASE.545
ISSN:	1563-4086

Figure 1

Blunt traumatic anterior flail chest

Spiral CT section (5-mm) displays an unusual anterior flail chest consecutive to left and right lateral chondro-costal dislocations (black arrows) and rib fractures (white arrows). A mediastinal hematoma and bilateral hemothoraces are also present.