Occult Pneumothorax in Patients with Abdominal Trauma

Wolfman, Neil T.; Gilpin, J W; Bechtold, Robert E.; Meredith, J. Wayne; Ditesheim, Jeff A.

doi:10.1097/00004728-199301000-00009

Cited by 38 publications

(16 citation statements)

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“…traumatic pneu mothoraces into three groups according to size and location. and we postulated that this classifi cation might help to guide management of these pneumothoraces [9]. In the present study.…”

Section: Discussionmentioning

confidence: 73%

“…We previously reported a retrospective study in which we proposed a system for grouping occult pneumothoraces into three categorieson the basisof size and location [9]. We postulatedthat this classificationmight help to guide appropriate management of oc cult pneumothoraces, in particular by avoiding unnecessary tube thoracostomy in many pa tients with occult pneumothorax.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Validity of CT classification on management of occult pneumothorax: a prospective study.

Wolfman¹,

W²,

Glauser³

et al. 1998

American Journal of Roentgenology

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Section: Discussionmentioning

confidence: 73%

mentioning

confidence: 99%

Validity of CT classification on management of occult pneumothorax: a prospective study.

Wolfman¹,

W²,

Glauser³

et al. 1998

American Journal of Roentgenology

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“…CT is more sensitive for detecting pneumothorax than radiography, particularly in the supine patient. Pneumothoraces that are not apparent on the supine chest radiograph have been shown on CT in 10% to 50% of patients with head and blunt abdominal trauma (Wolfman et al, 1993). It is generally safe to observe a stable patient with an occult pneumothorax, the situation is more controversial when the patient udergoes PPV.…”

Section: Pleural Space Injuriesmentioning

confidence: 99%

Routine CT- Chest in Primary Evaluation of the Major Blunt Trauma Patients; Pros and Cons

Hamad¹

2011

CT Scanning - Techniques and Applications

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“…This situation is increasingly common with the increased use of CT. The incidence appears to approximate 5% in injured populations presenting to hospital [45,[47][48][49][50][51][52], with CT revealing at least twice as many PTXs as suspected on plain radiographs [43,47,50,[52][53][54][55][56].…”

Section: The Condition: Occult Pneumothoracesmentioning

confidence: 99%

Opening Pandora’s box: the potential benefit of the expanded FAST exam is partially confounded by the unknowns regarding the significance of the occult pneumothorax

et al. 2010

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Introduction Point of care (POC) ultrasound brings another powerful dimension to the physical examination of the critically ill. A contemporary challenge for all care providers, however, is how to best incorporate ultrasound into contemporary algorithms of care. When POC ultrasound corroborates pre-examination clinical suspicion, incorporation of the findings into decision-making is easier. When POC ultrasound generates new or unexpected findings, decision-making may be more difficult, especially with conditions that were previously not appreciated with older diagnostic technologies. Pneumothoraces (PTXs), previously seen only on computed tomography and not on supine chest radiographs known as occult pneumothoraces (OPTXs), which are now increasingly appreciated on POC ultrasound, are such an example.Methods The relevant literature concerning POC ultrasound and PTXs was reviewed after an electronic search using PubMed supplemented by ongoing research by the Canadian Trauma Trials Collaborative of the Trauma Association of Canada. Results OPTXs are frequently encountered in the critically injured who often require mechanical ventilation with positive pressure breathing (PPB). Standard recommendations for post-traumatic PTXs and the setting of PPB mandate chest drainage, recognizing a significant rate of complications related to this procedure itself. Whether these standard recommendations generated in response to obvious overt PTXs apply to these more subtle OPTXs is currently unknown, and evidence-based recommendations regarding appropriate therapy are impossible due to the lack of clinical studies. Conclusions OPTXs are a condition that illustrates how incorporation of POC ultrasound findings brings further responsibilities to critically appraise the significance of these findings in terms of patient outcomes and overall care. Adequately powered and adequately followed-up clinical trials addressing the treatment are required.Keywords Point of care ultrasound Á Critical ultrasound Á Pneumothorax Á Occult pneumothorax Á Critical care Á Mechanical ventilation Electronic supplementary material The online version of this article (

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Occult Pneumothorax in Patients with Abdominal Trauma

Cited by 38 publications

References 0 publications

Validity of CT classification on management of occult pneumothorax: a prospective study.

Validity of CT classification on management of occult pneumothorax: a prospective study.

Routine CT- Chest in Primary Evaluation of the Major Blunt Trauma Patients; Pros and Cons

Opening Pandora’s box: the potential benefit of the expanded FAST exam is partially confounded by the unknowns regarding the significance of the occult pneumothorax

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