Keywords:
Thorax, Emergency, Trauma, CT, Diagnostic procedure
Authors:
I. Turkalj, K. Petrovic; Novi Sad/RS
DOI:
10.1594/ecr2013/C-0040
Purpose
The clinical presentation of thoracic trauma ranges from a minimum of pain to a state of shock,
and about a third of thoracic injuries require hospital treatment (1).
Two thirds of patients with multiple blunt injuries have a chest injury,
whereas severe chest injuries are associated with other injuries in 70-90% of the patients (2).
It depends on the clinical findings whether the patient was in immediate danger and if radiological examinations can be made safely (3).
After an initial clinical evaluation and the stabilisation of traumatised patients,
radiological methods play an important role in the evaluation of the injury (4).
The initial diagnostic approach to chest trauma is typically based on chest X-ray at the time of admission.
With respect to its limits,
chest X-ray (CXR) can be a valuable diagnostic tool providing a wide range of information.
However,
it is well-known that information provided by standard CXR could be insufficient in diagnosing both vascular and non-vascular thoracic injuries (3,
5-8).
Computerised tomography (CT) was primarily used for thoracic aortic injuries,
but numerous studies found that CT is more sensitive to other thoracic injuries (2,
4,
9-11).
Due to the lack of time and in order to avoid unnecessary radiation,
chest CT is often performed in injured patients when a CT examination of the abdomen or head has already been indicated,
because of the frequent association between thoracic and extrathoracic injuries (4,
12).
Multidetector computerised tomography (MDCT),
a new valuable tool in modern medicine that is characterised by speed and precision,
is increasingly accessible in emergency wards.
However,
regardless of the growing application of MDCT examinations in emergency departments,
it should be borne in mind that MDCT examination should not delay necessary surgery (13).
The aim of our study was to determine what kind of injuries of the chest region were the most common,
with which extrathoracic injuries they were associated,
and what the outcome of the treatment was.