Traumatic chest lesions in patients with severe head trauma: a comparative study with computed tomography and conventional chest roentgenograms.

Détails

ID Serval
serval:BIB_090D53C370EA
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Traumatic chest lesions in patients with severe head trauma: a comparative study with computed tomography and conventional chest roentgenograms.
Périodique
Journal of Trauma
Auteur(s)
Karaaslan T., Meuli R., Androux R., Duvoisin B., Hessler C., Schnyder P.
ISSN
0022-5282
Statut éditorial
Publié
Date de publication
12/1995
Peer-reviewed
Oui
Volume
39
Numéro
6
Pages
1081-1086
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article
Résumé
In patients with severe craniocerebral trauma, who need a continuous positive-pressure breathing, the detection of pulmonary and mediastinal traumatic lesions, especially pneumothorax, may alter the management. The aim of this study is to evaluate the efficiency and accuracy of conventional supine chest roentgenograms to detect the associated traumatic chest lesions in severe craniocerebral trauma and to compare their value as a diagnostic method for the identification of unsuspected lesions with a limited chest computed tomographic (CT) examination. Forty-seven consecutive patients with severe craniocerebral trauma underwent head CT and a prospective limited CT examination of the thorax in the same session. Nine patients (19.1%) presented a pneumothorax, bilateral in one case. Six pneumothoraces (60%) were identified both on conventional chest roentgenograms and CT, whereas in four cases (40%), the lesion was only detectable on CT. The CT study also showed 31 areas of pulmonary parenchymal contusions in 19 subjects (40%), whereas the conventional chest roentgenograms demonstrated 17 areas of contusions in 11 (23%) subjects. One thoracic aorta and one right diaphragm rupture were detected on CT study. On the conventional chest roentgenograms the mediastinal vascular injury was overlooked, whereas the right diaphragmatic rupture was highly suspected. The limited chest CT examination supplied additional information in 30% of patients. In 12.7% of patients, this information was clinically significant enough to alter the management. In patients with severe craniocerebral trauma evaluation of associated chest trauma by a supplementary limited chest CT, examination provides more and precise information about the size and severity of mediastinal and pulmonary lesions with a superior detectability of pneumothorax.
Mots-clé
Adolescent, Adult, Aged, Brain Injuries/radiography, Child, Child, Preschool, Contusions/radiography, Craniocerebral Trauma/complications, Craniocerebral Trauma/radiography, False Positive Reactions, Female, Humans, Lung/radiography, Lung Injury, Male, Middle Aged, Pneumothorax/etiology, Pneumothorax/radiography, Pulmonary Atelectasis/etiology, Pulmonary Atelectasis/radiography, Radiography, Thoracic, Sensitivity and Specificity, Thoracic Injuries/complications, Thoracic Injuries/radiography, Tomography, X-Ray Computed
Pubmed
Web of science
Création de la notice
11/04/2008 12:40
Dernière modification de la notice
03/03/2018 13:31
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