Pneumothorax (PTX) in patients with penetrating thoracic trauma is routinely ruled out with serial chest radiographs (CXRs). This study examined the efficacy of a shortened time period between initial and follow-up radiographs. Patients with penetrating torso injuries treated at a Level-1 trauma center received a CXR during their initial evaluation. If no pneumothorax or hemothorax was noted, and the patient did not require immediate admission to the Intensive Care Unit or operating room, a repeat chest film was taken at 3 and 6 h. Findings were treated as clinically indicated, and patients were discharged home if the last radiograph revealed no evidence of pathology. Over a 15-month period, 116 patients were evaluated for penetrating thoracic injuries (93 stabbings, 23 gunshot wounds) and had no pneumothorax detected on initial CXR. Two patients had pneumothorax detectable only by computed tomography. One patient had a normal initial CXR, but developed a PTX on the 3-h film, requiring tube thoracostomy. No patients developed a PTX on the 6-h study that was not present on the initial or 3-h CXR. In conclusion, extending the time between initial and final CXRs to 6 h in patients with penetrating thoracic trauma provided no additional information that was not available on the 3-h film.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Emergency Medicine
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Clinical management of the apparently insignificant penetrating anterior chest wound.Chest. 1977; 72: 687
- Asymptomatic stab wounds of the chest.J Trauma. 1994; 36: 680-684
- Pneumothorax of late onset after chest stabbings.Injury. 1980; 11: 331-335
- Prospective trial of the six h rule in stab wounds of the chest.Surg Gynecol Obstet. 1989; 169: 223-225
- Role of three hour roentgenogram of the chest in penetrating and non-penetrating injuries of the chest.Surg Gynecol Obstet. 1992; 175: 249-253
- Management of non-penetrating stab and gunshot wounds of the chest.Surg Gynecol Obstet. 1981; 153: 395-397
- Management of asymptomatic patients following stab wounds to the chest.J Trauma. 1982; 22: 291-294
- Delayed pneumothorax and hemothorax following observation for stab wounds of the chest.Injury. 1985; 16: 247-248
- Tube thoracostomy for occult pneumothorax.J Trauma. 1993; 35: 726-729
- Treatment of occult pneumothoraces from blunt trauma.J Trauma. 1999; 46: 987-990
- Traumatic pneumothorax.J Accid Emerg Med. 1996; 13: 173-174
Accepted: November 15, 2000
Received in revised form: October 27, 2000
Received: June 16, 2000
© 2001 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.