Diagnostic Importance of Lung Ultrasonography in the Follow-up of Patients with Blunt Chest Trauma

Year 2023, Volume: 13 Issue: 1, 57 - 61, 26.04.2023

Güntuğ Batıhan

Abstract

Aim: Radiological follow-up of patients with blunt thoracic trauma is essential in providing a chance for early intervention for complications that may develop. The study aims to investigate lung ultrasound’s diagnostic value in patients with blunt thoracic trauma.
Material and Method: Patients of adult age who were treated for blunt chest trauma in the thoracic surgery clinic of our center between February 2022 and June 2022 were evaluated retrospectively. Among these patients, those who radiologically followed up with a combination of lung US and chest radiography were included in the study. Radiological data that indicates pneumothorax, hemothorax, and atelectasis were recorded.
Results: A total of 60 patients with blunt thoracic trauma were included in the study. Forty-nine of the patients were male, and 11 were female. The mean age was 45.7±17.8, and the median was 49 (range 18–74). While the perfect agreement was observed in the detection of hemothorax between the lung US and chest radiogram, substantial agreement was observed in the detection of pneumothorax and atelectasis.
Conclusion: In the follow-up of patients with blunt chest trauma, lung ultrasound is a good alternative to standard posterolateral chest X-ray with its similar diagnostic success, easy reproducibility, and the possibility to be applied at the bedside.

Keywords

atelectasis, chest trauma, hemothorax, lung ultrasound; pneumothorax

References

• 1. Dogrul BN, Kiliccalan I, Asci ES, Peker SC. Blunt trauma related chest wall and pulmonary injuries: An overview. Chin J Traumatol. 2020;23(3):125–138.
• 2. Milisavljevic S, Spasic M, Arsenijevic M. Thoracic trauma. In: Cagini L., editor. Current Concepts in General Thoracic Surgery. InTech; 2012.
• 3. Demirhan R, Onan B, Oz K. Comprehensive analysis of 4205 patients with chest trauma: a 10-year experience. Interact Cardiovasc Thorac Surg. 2009;9:450–453.
• 4. Berg RJ, Inaba K, Recinos G, Barmparas G, Teixeira PG, Georgiou C, et al. Prospective evaluation of early follow-up chest radiography after penetrating thoracic injury. World J Surg. 2013;37(6):1286–90.
• 5. Oikonomou A, Prassopoulos P. CT imaging of blunt chest trauma. Insights Imaging. 2011;2(3):281–295. doi:10.1007/ s13244-011-0072-9. Epub 2011 Feb 11.
• 6. Larson MM. Ultrasound of the thorax (noncardiac). Vet Clin North Am Small Anim Pract. 2009;39(4):733–45. doi:10.1016/j.cvsm.2009.04.006.
• 7. A. Ebrahimi, M. Yousefifard, H. Mohammad Kazemi, Rasouli HR, Asady H, Jafari AM, et al. Diagnostic accuracy of chest ultrasonography versus chest radiography for identification of pneumothorax: a systematic review and meta-analysis Tanaffos,. 2014;13:29–40.
• 8. Wilkerson RG, Stone MB. Sensitivity of bedside ultrasound and supine anteroposterior chest radiographs for the identification of pneumothorax after blunt trauma. Acad Emerg Med. 2010;17(1):11–7.
• 9. Heydari F, Esmailian M, Dehghanniri M. Diagnostic Accuracy of Ultrasonography in the Initial Evaluation of Patients with Penetrating Chest Trauma. Emergency. 2014;2(2):81–4.
• 10. Ding W, Shen Y, Yang J, He X, Zhang M. Diagnosis of pneumothorax by radiography and ultrasonography: a metaanalysis. Chest. 2011;140(4):859–66.
• 11. McEwan K, Thompson P. Ultrasound to detect haemothorax after chest injury. Emerg Med J. 2007;24(8):581–2.
• 12. Sabri YY, Hafez MAF, Kamel KM, Abbas DA. Evaluating the role of ultrasound in chest trauma: Common complications and computed tomography comparative evaluation. The Egyptian Journal of Radiology and Nuclear Medicine. 2018;49(4):986–92.
• 13. M. Hurley, G. Keye, S. Hamilton Is ultrasound really helpful in the detection of rib fractures? Injury. 2004;35(6):562–566.
• 14. S. Helmy, B. Beshay, M. Abdel Hady, A. Mansour Role of chest ultrasonography in the diagnosis of lung contusion Egypt J Chest Dis Tuberculosis. 2015;64(2):469–475.
• 15. Yang Jx, Zhang M, Liu Zh, Ba L, Gan J, Xu S. Detection of lung atelectasis/consolidation by ultrasound in multiple trauma patients with mechanical ventilation. Crit Ultrasound J. 2009;1:13–16.