1Trauma group, Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, P O Box 18532, Al-Ain, United Arab Emirates.
Department of Radiology, Al Rahba Hospital, Abu Dhabi, United Arab Emirates.
World J Emerg Surg. 2019 Sep 2;14:44. doi: 10.1186/s13017-019-0263-0. eCollection 2019.
Bedside diagnostic ultrasound for traumatic pneumothorax is easy and reliable. However, the thoracic anatomical locations to be examined are debateable. We aimed to study the anatomical locations of blunt traumatic pneumothoraces as defined by chest CT scan to identify the areas that should be scanned while performing bedside diagnostic ultrasound.
This is a retrospective analysis of a data collected for a previous study in blunt trauma patients at our hospital during a 4-year-period with CT confirmed pneumothoraces. The anatomical distribution of the pneumothoraces and their volume were analyzed. Advanced statistical analysis was performed using repeated measures logistic regression models.
Seven hundred three patients had a CT scan of the chest. Seventy-four patients (10.5%) were confirmed to have a pneumothorax. Only 64 were included in the study as they did not have a chest tube inserted before the CT scan. Twelve (18.8%) patients had bilateral pneumothorax. Seventy-six pneumothoraces were identified for which 41 patients had a right-sided pneumothorax and 35 patients had a left-sided pneumothorax. 95.1 % of the pneumothoraces detected on the right side were in the whole parasternal area with 75.6% seen in the lower parasternal region only. Similarly, 97.1 % of the pneumothoraces on the left side were seen in the whole parasternal area with 80% seen in the lower parasternal region only.
The current study showed that air pockets of blunt traumatic pneumothoraces are mainly located at the parasternal regions especially in pneumothorax with small volume. We recommend a quick ultrasound scanning of the parasternal regions on both sides of the chest from proximal to distal as the appropriate technique for the detection of pneumothoraces in blunt trauma setting.
创伤性气胸的床边诊断超声既简单又可靠。然而，需要检查的胸部解剖部位仍存在争议。我们旨在通过胸部 CT 扫描研究钝性创伤性气胸的解剖部位，以确定在进行床边诊断性超声检查时应扫描的区域。
这是对我院 4 年来因钝性创伤而进行 CT 证实气胸的患者数据进行的回顾性分析。分析了气胸的解剖分布及其体积。使用重复测量逻辑回归模型进行了高级统计分析。
703 例患者进行了胸部 CT 扫描。74 例（10.5%）患者被证实患有气胸。只有 64 例患者被纳入研究，因为他们在 CT 扫描前没有插入胸腔引流管。12 例（18.8%）患者存在双侧气胸。共发现 76 例气胸，其中 41 例为右侧气胸，35 例为左侧气胸。右侧检测到的气胸 95.1%位于整个胸骨旁区，仅 75.6%位于胸骨旁下区。同样，左侧的气胸 97.1%位于整个胸骨旁区，仅 80%位于胸骨旁下区。
本研究表明，钝性创伤性气胸的气袋主要位于胸骨旁区，尤其是在气胸量较小的情况下。我们建议在钝性创伤情况下，对胸部两侧的胸骨旁区从近端到远端进行快速超声扫描，作为检测气胸的适当技术。
