Chest Wall Diseases: Trauma and Neoplasia

Question 1

What % of animals with no evidence of external injuries following trauma show signs of thoracic trauma on chest radiographs?

Answer 1

72%

Question 2

What % of Thoracic trauma severe enough to result in rib fractures causes concurrent intrathoracic injury?

Answer 2

87-100%

Question 3

What is the survival rate following blunt trauma to the thorax?

Answer 3

30-88%

Question 4

For surgical exploration of a thoracic trauma, where should the approach be made?

Answer 4

Over the site of greatest injury and the soft tissues thoroughly explored, debrided and lavaged. Devitalised or irreparably damaged tissue (e.g., devitalised skin, devitalised rib fragments, or lung lobe laceration) should be removed.

Question 5

How are fractured ribs managed?

Answer 5

Conservatively:
Analgesia and Oxygen therapy

Question 6

If numerous intercostal wounds re apparent, how should sutures be placed?

Answer 6

Circumcostal basket weave fashion

Question 7

What are the reported thoracic wall tumours? (7)

Answer 7

chondrosarcoma
osteosarcoma
fibrosarcoma
mast cell tumour
haemangiosarcoma
peripheral nerve sheath tumour
mesothelioma.

Question 8

How lagre can a thoracic cavity defect be to be readily closed with local tissue?

Answer 8

Approx 4 ribs

Question 9

If a thoracic cavity defect cannot be closed routinely, what are the options?

Answer 9

Diaphragmatic advancement
Latissimus dorsi muscle flap
Omentalisation,
Prosthetics.

Question 10

What tends to be the reason for clinical signs with thoracic cavity neoplasia?

Answer 10

• Space occupying lesion
• Pleural effusion

Question 11

What are thoracic cavity tumours recommended margins?

Answer 11

3 cm (or greater) laterally, and one fascial plane deep,
Recommendations are to include at least one unaffected rib cranially and caudally within the en bloc excision.

Question 12

What are the post operative requirements following thoracic wall reconstruction? (6)

Answer 12

Frequent monitoring of vital parameters
Generous multimodal analgesia
Antibiosis as appropriate
Regular thoracic drainage
Oxygen supplementation
Nutritional support.

Question 13

What are the potential complications of thoracic wall reconstruction? (8)

Answer 13

Haemorrhage
Wound related complications
Pneumothorax
Pyothorax
Pleural effusion
Atelectasis
Hypoventilation
Hypothermia.

Question 14

Which thoracic wall tumour is most likely to metastasise? (2)

Answer 14

Osteosarc
Haemangiosarc