Should Computed Tomography be Performed in All Chest Trauma Patients

Document Type : Original Article

Authors

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.

Keywords

The Egyptian Journal of Hospital Medicine
Volume 87, Issue 1
April 2022
Pages 1843-1847

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