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Abstract: A 45-year-old Mr. Li fell accidentally while repairing an air conditioning duct on the second floor, and was diagnosed with traumatic pneumothorax by examination and chest CT. He was firstly treated by fixing the fracture end with chest cloth and administered oxygen, followed by intravenous injection of ceftriaxone sodium and oral diclofenac sodium extended-release tablets, and was discharged for recuperation after 2 weeks of hospitalization with good recovery, and fully recovered after 6 months of re-examination.
Basic information】Male, 45 years old
Disease Type】Traumatic pneumothorax
Hospital】Wuhan University People’s Hospital
Consultation time】May 2020
Treatment plan】Physical therapy (chest cloth fixation of fracture end, oxygen inhalation) + intravenous injection (intravenous ceftriaxone sodium for injection) + oral medication (diclofenac sodium extended-release tablets)
Treatment period】2 weeks of inpatient treatment, regular review
Treatment effect】Symptoms improved, no other discomfort
I. Initial consultation
Mr. Li fell down accidentally while repairing air conditioning ducts on the second floor, and felt uncomfortable after landing, especially the severe pain in the right rib cage. When I saw Mr. Li, he was sweating profusely, his face showed a painful color, and his face was pale and he was moaning in pain. By asking Mr. Li’s workmates, I learned that Mr. Li had a history of “chronic bronchitis” in the past.
II. Treatment process
After the chest CT examination, Mr. Li was found to have a right hemopneumothorax, bilateral pleural thickening, fluid in the right pleural cavity, and a fracture of the right 3 and 4 ribs, which was clearly a traumatic hemopneumothorax caused by rib fracture. I explained to Mr. Li that he was now filled with blood and gas in the chest cavity and needed timely treatment, such as closed chest drainage to drain the blood and gas in the chest cavity, but because Mr. Li’s symptoms were relatively mild and the ribs were not displaced, he could also undergo oxygen therapy to relieve the total pleural capillary gas pressure and promote the absorption of blood and gas in the chest cavity. Mr. Li chose the second treatment option.
After fixing the fracture end by chest cloth, Mr. Li was treated with oxygen, and was given intravenous ceftriaxone sodium to prevent infection and oral diclofenac sodium extended-release tablets to relieve pain symptoms.
III. Treatment effect
After the treatment with oxygen and medication and the fixation of the short end of the fracture with chest cloth, Mr. Li’s pain symptoms were relieved. 1 week later, a chest CT examination revealed that some of the blood and gas in the chest cavity had been absorbed and the pneumothorax symptoms were relieved, indicating that the treatment plan was effective and could be continued. 2 weeks later, the patient reported that the pain was mild and there were no symptoms such as chest tightness, and another chest CT examination revealed that the pneumothorax had disappeared. The fracture was not fully recovered, but the patient could be discharged from the hospital for recuperation. 1 month later, the patient was found to be in good condition and no recurrence of pneumothorax was observed at the follow-up examination. The fracture was completely healed in the following 6 months, and no more symptoms such as chest pain and chest tightness occurred.
IV. Notes
We are glad that Mr. Li is gradually recovering, but since his rib fracture is not completely healed, he needs to continue to use chest cloth to fix the short end of the fracture after discharge, and he should take more rest and refrain from lifting heavy objects on a daily basis to avoid re-injuring his ribs and affecting the healing process. In addition, Mr. Li needs to pay attention to proper exercise activities with the help of his family to restore the function of his lungs. He should also pay attention to eating foods rich in calcium and protein, such as shrimp, seafood, milk, etc., which are good for promoting the growth of the fracture site.
V. Personal insight
Mr. Li, 45 years old, suffered a rib fracture due to an accidental fall and a traumatic pneumothorax, which fortunately was treated in time and finally did not have a big impact on Mr. Li’s life. However, it is still necessary to pay attention to safety in life, no matter what you do, you should pay attention to good safety measures to reduce the occurrence of accidents, because in serious cases, death may occur without waiting for treatment. In addition, for the treatment of traumatic pneumothorax, if the symptoms are more serious, it is recommended to actively carry out chest drainage treatment, which can better help patients recover.