Ability of a chest X-ray and an abdominal computed tomography scan to identify traumatic thoracic injury - 20/08/11
, Jacqueline Pham, B.S., Darren Malinoski, M.D., Matthew Dolich, M.D., Michael Lekawa, M.D., Marianne Cinat, M.D.
Corresponding author. Tel.: +1-714-456-6048; fax: +1-714-456-8359Abstract |
Objective |
Our objective was to show that a chest X-ray (CXR) and an abdominal computed tomography (CT) scan are sufficient to identify most clinically significant thoracic injuries in trauma patients, rendering the thoracic CT scan useful in only a subset of patients.
Methods |
A retrospective study identified thoracic injuries in 374 trauma patients evaluated with a CXR, a thoracic CT scan, and an abdominal CT scan. Injuries seen on the initial CXR versus those seen on a CT scan only (occult) were identified and assessed for clinical relevance.
Results |
An abdominal CT scan identified 65% (15/23) of occult pneumothoraces, 100% (25/25) of occult hemothoraces, 64% (18/28) of occult pulmonary contusions, and 58% (18/31) of occult rib fractures. No occult pneumothoraces seen on the thoracic CT scan alone required tube thoracostomy.
Conclusions |
Our pilot study suggests that a CXR and an abdominal CT scan will identify most occult intrathoracic injuries. Reserving a thoracic CT scan for patients with an abnormal CXR or high-risk mechanism could safely reduce cost and radiation exposure while still diagnosing significant thoracic injuries.
Le texte complet de cet article est disponible en PDF.Keywords : Blunt chest trauma, Blunt thoracic trauma, Occult thoracic injury, Pneumothorax, Hemothorax, Rib fracture, Pulmonary contusion, Thoracic CT scan, Abdominal CT scan
Plan
Vol 200 - N° 6
P. 741-745 - décembre 2010 Retour au numéro
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