Evaluation of Penetrating Trauma to Thorax using Multi–Detector Computed Tomography: A Prospective Study in 30 Patients

Manik Mahajan; Poonam Sharma

Volume : VIII, Issue : VI, June - 2019

Evaluation of Penetrating Trauma to Thorax using Multi–Detector Computed Tomography: A Prospective Study in 30 Patients

Manik Mahajan, Poonam Sharma

Abstract :

Introduction: Emergency practitioners and radiologists routinely encounter patients with penetrating thoracic trauma. Multi–Detector computed tomography is an accurate means of evaluating patients with penetrating trauma. MDCT is also accurate in identifying diaphragmatic rupture and thus predicting the need for operative intervention. Objectives/Aims: To evaluate usefulness of MDCT in detection of thoracic injury in patients with penetrating trauma and to evaluate CT findings for signs of diaphragmatic rupture. Materials and Methods: MDCT scans were obtained in 30 hemodynamically stable patients with penetrating injuries to thorax. All patients underwent MDCT of the thorax for any signs of injury. Positive findings included hemothorax, rib fractures, pneumothorax, diaphragmatic injury, lung contusions, lacerations and mediastinal haematoma. Nine patients with positive MDCT finding were operated including six patients with diaphragmatic injury and findings corroborated. Results: On MDCT, the most common injury was hemothorax (76.7%) followed by contusion (70.0%) and pneumothorax (53.3%). Diaphragmatic injury was seen in 30 % cases. Nine patients were operated upon, including 6 patients with diaphragmatic rupture. All these six patients had evidence of diaphragmatic injury on surgery. Two patients, one each with chest wall injury and thoracic aortic injury died. Sensitivity of MDCT in diagnosing diaphragmatic injuries was 100%. Conclusions: MDCT is the modality of choice for rapid assessment of emergency chest trauma patients and provides accurate assessment with respect to diaphragmatic injury.