BACKGROUND: A major cause of morbidity and mortality after blunt chest trauma remains undetected injuries. This study evaluates the role of routine computed tomographic (CT) scan. METHODS: We studied 93 consecutive patients from January 1999 to July 2000: 73 (76.3%) after motor vehicle crash with crash speed > 10 mph, and 22 (23.7%) after fall from height > 5 ft. Simultaneous with initial clinical evaluation, anteroposterior chest radiograph and helical chest CT scan were obtained for all patients. RESULTS: Sixty-eight patients (73.1%) showed at least one pathologic sign on chest radiograph, and 25 patients (26.9%) had normal chest radiograph. In 13 (52.0%) of these 25 patients, the CT scan showed multiple injuries; among these were two aortic lacerations, three pleural effusions, and one pericardial effusion. CONCLUSION: Over 50% of patients with normal initial chest radiograph showed multiple injuries on the CT scan, among which were also two (8%) potentially fatal aortic lesions. We therefore recommend primary routine chest CT scan in all patients with major chest trauma.
BACKGROUND: A major cause of morbidity and mortality after blunt chest trauma remains undetected injuries. This study evaluates the role of routine computed tomographic (CT) scan. METHODS: We studied 93 consecutive patients from January 1999 to July 2000: 73 (76.3%) after motor vehicle crash with crash speed > 10 mph, and 22 (23.7%) after fall from height > 5 ft. Simultaneous with initial clinical evaluation, anteroposterior chest radiograph and helical chest CT scan were obtained for all patients. RESULTS: Sixty-eight patients (73.1%) showed at least one pathologic sign on chest radiograph, and 25 patients (26.9%) had normal chest radiograph. In 13 (52.0%) of these 25 patients, the CT scan showed multiple injuries; among these were two aortic lacerations, three pleural effusions, and one pericardial effusion. CONCLUSION: Over 50% of patients with normal initial chest radiograph showed multiple injuries on the CT scan, among which were also two (8%) potentially fatal aortic lesions. We therefore recommend primary routine chest CT scan in all patients with major chest trauma.
Authors: J P Kepros; R C Opreanu; R Samaraweera; A Briningstool; C A Morrison; B D Mosher; P Schneider; P Stevens Journal: Eur J Trauma Emerg Surg Date: 2012-07-12 Impact factor: 3.693
Authors: Guillermo P Sangster; Aldo González-Beicos; Alberto I Carbo; Maureen G Heldmann; Hassan Ibrahim; Patricia Carrascosa; Miguel Nazar; Horacio B D'Agostino Journal: Emerg Radiol Date: 2007-07-11
Authors: Monique Brink; Jaap Deunk; Helena M Dekker; Michael J R Edwards; Digna R Kool; Arie B van Vugt; Cornelis van Kuijk; Johan G Blickman Journal: Eur Radiol Date: 2009-09-17 Impact factor: 5.315