Chest X-ray as a screening tool for blunt thoracic trauma in children

Abstrak. Trauma tumpul toraks memiliki insiden yang sangat tinggi pada populasi dewasa, 20 – 50 % dari kasus dapat mengakibatkan kematian. Cedera pada struktur pembuluh darah dari bagian dada atas, terutama pembuluh darah arteri subklavia kiri, sangat jarang ditemukan dan biasanya disertai dengan “hematotoraks massif”. Observasi ketat dari tanda- tanda vital dan foto toraks serial sangatlah penting. Kami paparkan sebuah kasus jarang dari seorang pasien yang mengalami cedera traumatik arteri subklavia kiri. Tidak ditemukan gambaran klinis dari hematoma di supra klavikula, pulsasi arteri radialis kiri tidak teraba, dan tidak ditemukan pelebaran dari mediastinum pada foto toraks. Tetapi didapatkan hematotoraks massif kiri. Dilakukan posterolateral torakotomi kiri, dijumpai sumber perdarahan dari bagian apex paru kiri, dicurigai terdapatnya robekan dari pembuluh darah arteri subklavia kiri. Tindakan dilanjutkan dengan insisi median sternotomy yang diperluas ke arah supraklavikula kiri, ditemukan rupture total dari arteri subklavia kiri dengan jarak 1,5 cm proksimal dari arkus aorta. Tindakan repair (perbaikan) arteri secara primer (end to end anastomosis) dilakukan dengan hasil baik. (JKS 2017; 2: 105-114)Kata kunci : Trauma tumpul toraks, hematotoraks massif, cedera arteri subklavia kiriAbstract. Blunt thoracic trauma highest incidence is in adult, 20% to 50 % of the trauma cause death. Injuries to the vascular structures of the thoracic outlet, especially left subclavian artery, are rare and typically accompanied by massive hemorrhage. Close observation of vital sign and serial chest x-ray are very important. We describe an unusual presentation of a patient who suffered traumatic rupture of left subclavian artery. No clinical presentation of supraclavicular hematoma, unilateral absence of radial artery pulse and mediastinal widening in chest x-ray was found, but there is a massive hemothorax. Left posterolateral thoracotomy was performed, the source of bleeding was found in the apex of the lung, suspected a rupture of the left subclavian artery. The procedure continued with median sternotomy extended to left supraclavicular incision, a rupture was found in the left subclavian artery, 1,5 cm proximal to aortic arch. Primary repair was done with a good result. (JKS 2017; 2: 105-114)Key Words : Blunt thoracic trauma, massive hemothorax, left subclavian artery rupture

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The combined utility of extended focused assessment with sonography for trauma and chest x-ray in blunt thoracic trauma

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0000000000001868 ◽

2018 ◽

Vol 85 (1) ◽

pp. 113-117 ◽

Cited By ~ 4

Author(s):

Morgan Schellenberg ◽

Kenji Inaba ◽

James M. Bardes ◽

Nicholas Orozco ◽

Jessica Chen ◽

...

Keyword(s):

Thoracic Trauma ◽

Blunt Thoracic Trauma ◽

X Ray ◽

Chest X Ray

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LEFT SUBCLAVIAN ARTERY RUPTURE DUE TO BLUNT THORACIC TRAUMA: A CASE REPORT

Jurnal Kedokteran Syiah Kuala ◽

10.24815/jks.v18i2.17999 ◽

2018 ◽

Vol 18 (2) ◽

pp. 93-100

Author(s):

Yopie Afriandi Habibie ◽

Ign Wuryantoro

Keyword(s):

Subclavian Artery ◽

Thoracic Trauma ◽

Left Subclavian Artery ◽

Primary Repair ◽

Median Sternotomy ◽

Traumatic Rupture ◽

Blunt Thoracic Trauma ◽

X Ray ◽

Massive Hemothorax ◽

Chest X Ray

Abstract. Blunt thoracic trauma highest incidence is in adult, 20% to 50 % of the trauma cause death. Injuries to the vascular structures of the thoracic outlet, especially left subclavian artery, are rare and typically accompanied by massive hemorrhage. Close observation of vital sign and serial chest x-ray are very important. We describe an unusual presentation of a patient who suffered traumatic rupture ofleft subclavian artery. No clinical presentation of supraclavicular hematoma, unilateral absence of radial artery pulse and mediastinal widening in chest x-ray was found, but there is a massive hemothorax. Left posterolateral thoracotomy was performed, the source of bleeding was found in the apex of the lung, suspected a rupture of the left subclavian artery. The procedure continued with median sternotomy extended to left supraclavicular incision, a rupture was found in the left subclavian artery, 1,5 cm proximal to aortic arch. Primary repair was done with a good result. Key Words : Blunt thoracic trauma, massive hemothorax, left subclavian artery rupture

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Accuracy and Incremental Yield of the Chest X-Ray in Screening for Tuberculosis in Uganda: A Cross-Sectional Study

Tuberculosis Research and Treatment ◽

10.1155/2021/6622809 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Joanitah Nalunjogi ◽

Frank Mugabe ◽

Irene Najjingo ◽

Pastan Lusiba ◽

Francis Olweny ◽

...

Keyword(s):

Screening Tool ◽

Screening Method ◽

Cross Sectional Study ◽

Case Detection ◽

Sectional Study ◽

Cross Sectional ◽

X Ray ◽

Number Needed To Screen ◽

Screening Algorithm ◽

Chest X Ray

The WHO END TB strategy requires ≥90% case detection to combat tuberculosis (TB). Increased TB case detection requires a more sensitive and specific screening tool. Currently, the symptoms recommended for screening TB have been found to be suboptimal since up to 44% of individuals with TB are asymptomatic. The chest X-ray (CXR) as a screening tool for pulmonary TB was evaluated in this study, as well as its incremental yield in TB diagnosis using a cross-sectional study involving secondary analysis of data of 4512 consented/assented participants ≥15 years who participated in the Uganda National TB prevalence survey between 2014 and 2015. Participants with a cough ≥2 weeks, fever, weight loss, and night sweats screened positive for TB using the symptoms screening method, while participants with a TB defining abnormality on CXR screened positive for TB by the CXR screening method. The Löwenstein-Jensen (LJ) culture was used as a gold standard for TB diagnosis. The CXR had 93% sensitivity and 65% specificity compared to LJ culture results, while symptoms had 76% sensitivity and 31% specificity. The screening algorithm involving the CXR in addition to symptoms led to a 38% increment in the yield of diagnosed tuberculosis. The number needed to screen using the CXR and symptoms screening algorithm was 32 compared to 45 when the symptoms are used alone. Therefore, the CXR in combination with symptoms is a good TB screening tool and increases the yield of diagnosed TB.

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The utility of chest X-ray as a screening tool for blunt thoracic aortic injury

Injury ◽

10.1016/j.injury.2015.08.003 ◽

2016 ◽

Vol 47 (1) ◽

pp. 32-36 ◽

Cited By ~ 15

Author(s):

Adam Gutierrez ◽

Kenji Inaba ◽

Stefano Siboni ◽

Zachary Effron ◽

Tobias Haltmeier ◽

...

Keyword(s):

Screening Tool ◽

Aortic Injury ◽

X Ray ◽

Blunt Thoracic Aortic Injury ◽

Thoracic Aortic Injury ◽

Chest X Ray

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Thoracic Trauma

10.2310/em.4352 ◽

2020 ◽

Author(s):

William E. Baker ◽

Ron Medzon

Keyword(s):

Blunt Trauma ◽

Thoracic Trauma ◽

Flail Chest ◽

Penetrating Trauma ◽

Pulmonary Contusion ◽

X Ray ◽

Computed Tomographic ◽

Computed Tomographic Scan ◽

Chest X Ray ◽

Lung Point

More than 85% of blunt and penetrating trauma to the thorax results in injury to the lungs or ribs. Among civilians, blunt trauma is the most common mechanism, while penetrating trauma is the most common among military sectors. This review describes the assessment and stabilization, diagnosis, treatment and disposition, and outcomes of thoracic trauma. Videos shows the “lung point” sign on M-mode and two-dimensional ultrasonography, and a transthoracic echocardiogram clip of pericardial clot and tamponade due to a gunshot wound. Figures show a sonogram showing the “lung point sign”, a chest x-ray and computed tomographic scan demonstrating right-sided hemothorax in a patient with a right chest stab wound, and a three-dimensional computed tomographic scan and chest x-ray of a blunt trauma patient with displaced fractures of the left lateral sixth to ninth ribs. Tables list types of injuries, NEXUS chest decision instrument imaging criteria, level 2 evidence-based recommendations for the management of pulmonary contusion and flail chest by the Eastern Association for the Surgery of Trauma, Eastern Association for the Surgery of Trauma practice guidelines for managing issues with pulmonary contusion and flail chest, and the Vancouver simplified and University of Washington grading systems for blunt aortic injury. This review contains 2 videos, 4 highly rendered figures, 10 tables, and 94 references.

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