MORPHOLOGICAL FEATURES OF HEMORRHAGES IN THE SOFT TISSUES OF INTERCOSTAL SPACES IN RIB FRACTURES

Practical knowledge allows us to note that hemorrhages from the area of rib fractures have a certain feature associated with the appearance in their area of hemorrhage of a cellular infiltrate, which may partially consist of bone marrow cells. This can lead to misperceptions and represent reactive changes of a certain severity. The results of a qualitative analysis of cases of chest trauma with hemorrhages in the soft tissues of the intercostal spaces from the area of rib fracture are presented. The study is based on the results of a retrospective analysis of 215 cases of death in people of both sexes, different age groups and causes of death. A histological method was used, including hematoxylin and eosin, Perls, van Gieson, orange-red-blue (MSB) staining, modified by D.D. Zerbino. The following microscopic signs were determined: edema (in the area of hemorrhage and perifocally), loss of fibrin threads, the presence of inflammatory infiltration both in the area of hemorrhage and in the perifocal area, activation and proliferation of macrophage and fibrohistiocytic cells, changes in the stroma, muscle fibers and walls vessels. The presence or absence of immature cellular elements of the bone marrow in hemorrhages was determined in the study groups. For qualitative variables, absolute (abs.) and relative (%) frequencies were calculated. In the studied groups (chest injuries as a result of resuscitation measures - in 11 (5.12/16.67%) cases; deaths at the scene - in 16 (7.44/1.52%) cases; with unknown time, from the moment of injury to the moment of death of the victim - in 26 (12.9/39.39%) cases, statistically significant indicators were identified (pU = 0.002). The presence of immature bone marrow cells in hemorrhages in soft tissues in the area of rib fractures is most likely directly related to the close proximity and structural features of the rib and its vascular system.