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Is Routine Spiral CT-Chest Justified in Evaluation of the Major Blunt Trauma Patients?

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Study:

New generation spiral CT scanners permit multiple consecutive CT examinations on the same trauma patient in a short period of time. The purpose of this study was to evaluate the diagnostic role and therapeutic impact of routine spiral CT chest in multiply injured patients or patients with a suspicious mechanism of injury.

Patients and Methods:

This prospective study included 443 patients with blunt chest trauma. All patients underwent a spiral CT chest as part of their routine evaluation. Radiological interpretation of chest x-rays, CT scan findings, and changes in management plan guided by these findings were recorded.

Results:

The mechanism of injury was road traffic accidents in 422 patients (95.26%). Out of the 167 patients with normal chest radiograph, 136 (81.43%) were found to have an abnormality on chest CT. The management was changed in the form of additional investigations or unplanned intervention in 92 patients (20.76%). Additional investigations included transoesophageal echocardiography (n = 7), bronchoscopy (n = 13), transfer to higher center for aortography (n = 2). Intercostal tubes (n = 55), thoracotomies (n = 4), fixation of sternal fracture (n = 9), laparotomy (n = 1) and spinalfixation (n = 1) were performed following the CT scan.

Conclusion:

Although the incidence of significant injuries identified by the chest CT scan was low, it did prompt immediate intervention in a significant number of patients; some of them had potentially life-threatening injuries. Routine use of CT scanning is warranted in early evaluation of polytrauma patients or patients with severe blunt chest trauma.

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Authors and Affiliations

  1. Thoracic Surgery Division, Padova University Hospital, Padova, Italy

    Abdel-Mohsen M. Hammad MD

  2. Cardiothoracic Surgery Department, King Fahd Specialist Hospital, Buraidah, Al Qassim, Saudi Arabia

    Mohamed A. Regal

  3. Thoracic Surgery Division, Padova University Hospital, via Giustiniani 2, 35128, Padova, Italy

    Abdel-Mohsen M. Hammad MD

Authors
  1. Abdel-Mohsen M. Hammad MD
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  2. Mohamed A. Regal
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Correspondence to Abdel-Mohsen M. Hammad MD.

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Hammad, AM.M., Regal, M.A. Is Routine Spiral CT-Chest Justified in Evaluation of the Major Blunt Trauma Patients?. Eur J Trauma Emerg Surg 35, 31–34 (2009). https://doi.org/10.1007/s00068-008-8025-9

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  • DOI: https://doi.org/10.1007/s00068-008-8025-9

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