ElDerie, A., Elsorogy, H., Sanad, M., Saleh, M., Awad, G. (2022). Should Computed Tomography be Performed in All Chest Trauma Patients. The Egyptian Journal of Hospital Medicine, 87(1), 1843-1847. doi: 10.21608/ejhm.2022.231632
Ahmad ElDerie; Hatem Abdelmoneim Elsorogy; Mohammed AbdelFattah Sanad; Mohammed Elshabrawy Saleh; Gehad Ibrahim Awad. "Should Computed Tomography be Performed in All Chest Trauma Patients". The Egyptian Journal of Hospital Medicine, 87, 1, 2022, 1843-1847. doi: 10.21608/ejhm.2022.231632
ElDerie, A., Elsorogy, H., Sanad, M., Saleh, M., Awad, G. (2022). 'Should Computed Tomography be Performed in All Chest Trauma Patients', The Egyptian Journal of Hospital Medicine, 87(1), pp. 1843-1847. doi: 10.21608/ejhm.2022.231632
ElDerie, A., Elsorogy, H., Sanad, M., Saleh, M., Awad, G. Should Computed Tomography be Performed in All Chest Trauma Patients. The Egyptian Journal of Hospital Medicine, 2022; 87(1): 1843-1847. doi: 10.21608/ejhm.2022.231632
Should Computed Tomography be Performed in All Chest Trauma Patients
Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Abstract
Background: Occult hemothorax is detected by Computed Tomography (CT) chest but missed initially by chest X-ray. Supine position, presence of less than 300 ml of blood, and intrapleural adhesions are all causes of missed hemothorax on initial chest x-ray. Patients and methods: In this retrospective study, we revised 864 patients who had blunt chest trauma at Mansoura Emergency Center from January 2016 to January 2020 and for them chest X-ray and CT chest were done. Patients having hemothorax (320) were divided into occult and non-occult. The outcomes included patients’ demographic data, number of patients in each group, associated injuries, and lines of management. Results: Chest X-ray helped diagnosis of 143 cases (44.68%) (Non-occult hemothorax). There were significant statistical differences between the two groups as regard chest tube drainage (686+456 ml Vs 871+603 ml), hospital stays (3-5 Vs 5-6 days), conservatively managed cases (33 (18.64%) Vs 3 (2,1%)), and surgical exploration for significant bleeding (2 (1.13%) Vs 18 (12.58%)). On the other hand, there was no significant statistical deference as regard age group, patient’s gender, mortality, chest tube insertion, and exploration for associated injuries. Conclusion: CT chest is the gold standard imaging tool for victims of chest trauma as it helps patient’s evaluation and diagnose occult cases of hemothorax who were missed in initial chest X-ray.