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 journalArticlepeer-review

20 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
Externally publishedYes

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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