ABSTRACT

Flail chest is anatomically defined as the presence of four consecutive, unilateral ribs each fractured in two or more places. Herein, we present a case who had no paradoxally movement of a chest wall segment but had flail chest pathophysiology between left thoracic cavity and gaint cavity in the chest wall occuring due to blast injury of a bullet. A 20-year-old man was admitted with bullet injury on the left chest. Chest x-ray revealed fractures in 4th and 5th ribs on the lateral side. The thorax computerized tomography revealed a giant cavity in the thoracic wall which was in combination with thoracic cavity. There was not significant contusion in lung parencyhma areas. However mechanical ventilation was performed for seven days, and then he was successfully extubated. The second thorax computerized tomography revealed obliteration of the cavity in the chest wall and parenchymal healing. We should consider in mind that a flail chest pathophysiology can occur when there is a giant cavity in the chest wall in combination with thoracic cavity occuring due to blast injury of a bullet.

Keywords: Blast injury, flail chest, mechanical ventilation, pathophysiology