Radiologic findings of thoracic trauma

Abstract

IntroductionChest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT) has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department.MethodsA total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included. Most of the patients were male (83.3%) and victims of a blunt chest trauma. The images were analyzed with respect to the presence of fractures of bony structures, hemothorax, pneumothorax, mediastinal organ injury, and pulmonary and vascular injuries.ResultsMDCT images of the 240 patients yielded a prevalence of 41.7% rib fractures, 11.2% scapular fractures, and 7.5% clavicle fractures. The prevalence of thoracic vertebral fracture was 13.8% and that of sternal fracture was 3.8%. The prevalence of hemothorax, pneumothorax, pneumomediastinum, and subcutaneous emphysema was 34.6%, 62.1%, 9.6%, and 35.4%, respectively. The prevalence of rib, clavicle, and thoracic vertebral fractures and pulmonary contusion was higher in the blunt trauma group, whereas the prevalence of hemothorax, subcutaneous emphysema, diaphragmatic injury, and other vascular lacerations was significantly higher in the penetrating trauma group than in the blunt trauma group (p<0.05).ConclusionMDCT images may yield a high prevalence of fracture of bony structures, soft tissue lacerations, and vascular lesions, which should be well understood by radiologists dealing with trauma.

Imaging findings of pulmonary contusions on multidetector CT: A retrospective study comparing adults and children

“…Most of PC were bilateral, what is in disagreement with previous studies, that evidence a slight [16,28] or vast [23,29] predominance of unilateral PC. Bilateral PC are more frequent in children who suffer traffic accidents compared to others injury mechanisms [26] and our data showed that falls generally were related to bilateral lesions and responsible for a significant percentage of PC.…”

“…[12] Therefore, CT can be assumed as a gold standard method. [13][14][15][16] The image pattern described in the literature is patchy or nonsegmental alveolar opacities, ranging from patchy ill-defined ground-glass opacities (GGO) to extensive areas of mixed lesions or consolidations. [2] Among the characteristics that can help to differentiate it from others airspace diseases are subpleural sparing, which is described as the noninvolvement of 1 to 2 mm of pulmonary parenchyma beneath the pleura [17] and their tendency to not respect anatomic limits, including pulmonary fissures, since they originate from the application of external forces on the pulmonary parenchyma.…”

Breaking point? An analysis of fatal stab wounds to the torso in Ireland between 2011 and 2018, examining the extent of rib fractures

“…Other studies have also concluded, perhaps in keeping with the finding that greater force is needed to penetrate cartilage and bone, that fractures to the ribs are not common in penetrating trauma [22].…”

“…Other studies have also concluded, perhaps in keeping with the finding that greater force is needed to penetrate cartilage and bone, that fractures to the ribs are not common in penetrating trauma [22]. One large cross‐sectional study, examining rib fractures in chest trauma, found that rib fractures occurred in just 32.7% of cases of penetrating trauma [23].…”

Role of chest CT scan in atypical cardiac trauma management: Left ventricle injury by a nail gun

“…Chest is the third most common anatomic region for trauma and considering penetrating mechanism, it has approximately 40% mortality. Although, according to previous studies, nail gun injury has less mortality rate (25%), its rarity makes its diagnosis crucial [ 1 , 3 , 4 ]. Therefore, early vigilant clinical assessment of the patients, and employment of imaging modalities among those with hemodynamic stability, can play a key role in the precise characterization of the injury especially considering rare causes like nail gun injury.…”