Learning objectives
1.
Demonstration of the variety of common and more unusual chest injuries in the setting of major trauma.
2.
Emphasise the importance of accurate detection and prompt reporting of such imaging findings in the acute setting.
Background
Chest injuries are one of the commonest injuries seen on imaging in the setting of polytrauma.
Such injuries are associated with both high morbidity and mortality rates1,
accounting for approximately 25% of trauma related deaths,
second only to head trauma2.
The extent and severity of thoracic injuries are often difficult to evaluate clinically.
Imaging plays a central role in early,
accurate diagnosis,allowing early intervention and appropriate management.
Ours is a large teaching hospital and was designated one of the UKs major trauma centres in April...
Imaging findings OR Procedure details
Lung parenchymal injuries:
1.
Pulmonary Laceration
Case 1: A 45-year male was brought to emergency department following a stab injury to the left chest.
A CT was performed and selected axial (Fig 1) and coronal images (Fig 2) show abnormal appearances of a collapsed left lower lobe with a circular laceration (arrows) containing gas and soft tissue.
There is also haemo-pneumothorax.
Case 2: This patient presented following a fall from a ladder,
having fallen approximately 15 feet landing on hard ground. Trauma CT showed a...
Conclusion
Our pictorial review demonstrates the spectrum and severity of injuries that can be seen on thoracic CT in the setting of Polytrauma.
Accurate clinical information is paramount to optimise scan protocols.
Although,
as we have shown,
the severity of injuries may not always match the initial clinical presentation.
The reporting radiologist will review a large number of images per case and potentially several cases in a short period of time.
It is vital to have a systemic approach for each case or,
like at our...
References
1.
Wanek S,
Mayberry JC.
Blunt thoracic trauma: flail chest,
pulmonary contusion,
and blast injury.
Crit Care Clin.
2004 Jan;20(1):7181
2.
Oikonomou A,
Prassopoulos P.
CT imaging of blunt chest trauma.
Insights into Imaging 2011;2(3):281295.
doi:10.1007/s1324401100729