The Efficacy of Emergency Computed Tomography in Patients with Chest Trauma

Woo,  Keun Hwa; Kim,  Won Yul; Kim,  Kyung Hwan; Kim,  Hong Yong; Lee,  Ghi Jai

J Korean Soc Emerg Med > Volume 10(1); 1999 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 1999;10(1): 91-96.

The Efficacy of Emergency Computed Tomography in Patients with Chest Trauma

Keun Hwa Woo, Won Yul Kim, Kyung Hwan Kim, Hong Yong Kim, Ghi Jai Lee

ABSTRACT

BACKGROUND: Trauma is the third leading cause of death, irrespective of age, and the leading cause of death in persons under 40 years of age. Computed tomography (CT) is an effective technique in the initial emergent evaluation of the abdomen and head following blunt trauma. Most chest indies are not seen on conventional chest radiography, or may be underestimated. But routine use of CT in the initial emergent evaluation of chest trauma is controversial. CT, however, has been shown to be useful in the diagnosis of unsuspected chest injuries and in directing therapeutic interventions. This review discusses the efficacy of emergent CT in patients with blunt trauma on the chest.
METHODS:
To evaluate the efficacy of CT of the thorax, a retrospective study comparing early thoracic CT scanning with initial chest roentgenogram(CXR) was carried out on 121 patients with blunt trauma on the chest. The interval between CXR and CT was less than 1 hour.
RESULTS:
Among 121 patients, 42 patients had normal initial chest roentgenogram in whom 19 patients showed normal CT findings. Sensitivities of diagnosing pneumothorax and pleural effusion by CXR were low (49.3%and 45.1%respectively), whereas 65.7% (44/67) of patients had thoracostomy only by CXR. CONCLUSIONS : Although sometimes abused in patients with chest trauma, CT of the thorax is an effective method of detecting thoracic injuries and provides accurate information regarding their pattern and extent in the initial emergent diagnosis.