Incidental Pulmonary Nodule

Abstract

Trauma is still one of the leading causes of death among teenagers and a major cause of morbidity and mortality among the elderly (DeGrauw et al., J Safety Res 56:105–109, 2016). Advances in technology have allowed more affordable and easily accessible imaging modalities. Modern trauma centers rely heavily on imaging for assessment of suspected injuries (Andrawes et al., Trauma Surg Acute Care Open 2(1):e0001012, 2017). In addition to providing information on acute injuries, however, imaging modalities have also been shown to reveal chest pathologies not related to trauma called “incidental findings” which may or may not require further investigation (Salim et al., Arch Surg 141:468–473, 2006; Sampson et al., Clin Radiol 61:365–369, 2006; Seah et al., Injury 47:691–694, 2016). In the acute setting when a patient is too unstable for immediate imaging, there is potential for discovery of incidental findings intraoperatively. Lung nodules or masses can originate from many different etiologies. Very few of these need to be directly addressed in the acute care surgery setting. The acute care surgeon’s role is often to identify the incidental finding and set the patient up for the appropriate work up and specialty follow-up. The diagnosis and correct treatment of these incidental findings could have a major impact on the patient’s future health and survival. The list of potential incidental findings is extensive. In this chapter, we will briefly cover some common incidental findings as well as discuss recommended work-up and potential treatment.