Ability of a chest X-ray and an abdominal computed tomography scan to identify traumatic thoracic injury

Cristobal Barrios, Jacqueline Pham, Darren Malinoski, Matthew Dolich, Michael Lekawa, Marianne Cinat

    Research output: Contribution to journalArticle

    19 Scopus citations

    Abstract

    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.

    Original languageEnglish (US)
    Pages (from-to)741-745
    Number of pages5
    JournalAmerican journal of surgery
    Volume200
    Issue number6
    DOIs
    StatePublished - Dec 1 2010

    Keywords

    • Abdominal CT scan
    • Blunt chest trauma
    • Blunt thoracic trauma
    • Hemothorax
    • Occult thoracic injury
    • Pneumothorax
    • Pulmonary contusion
    • Rib fracture
    • Thoracic CT scan

    ASJC Scopus subject areas

    • Surgery

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