TY - JOUR
T1 - The unreliability of CT scans and initial chest radiographs in evaluating blunt trauma induced diaphragmatic rupture
AU - Shapiro, M. J.
AU - Heiberg, E.
AU - Durham, R. M.
AU - Luchtefeld, W.
AU - Mazuski, J. E.
PY - 1996
Y1 - 1996
N2 - Objective, There is no gold standard for early and reliable diagnosis of traumatic diaphragmatic rupture (TDR). The purpose of this study is to correlate CT scans, chest radiographs, and intubation on the ability to diagnosis traumatic diaphragmatic rupture. Materials and methods. Twenty patients with blunt trauma induced diaphragmatic rupture were identified from a five year review of a Level 1 Trauma Registry Results. Ten of the 20 (50%) patients had TDR on initial chest X-ray, all on the left side, Twelve patients had both chest X-rays and a chest and abdominal CT scan; however, only five (42%) of the CT scans were diagnostic. Of the 12 patients initially intubated, TDR was diagnosed in only four (33%) patients on initial chest X-ray and in one (14%) of seven patients having chest and abdominal CT scans and being intubated. Conclusion. The early diagnosis of blunt traumatic diaphragmatic rupture, especially in intubated patients, continues to be a diagnostic dilemma. There is a significantly better possibility of identifying left over right-sided TDR (P ≤ 0.05). Diagnosing TDR is also facilitated by extubation. If the suspicion exists, a post extubation chest radiograph should be performed to evaluate for TDR.
AB - Objective, There is no gold standard for early and reliable diagnosis of traumatic diaphragmatic rupture (TDR). The purpose of this study is to correlate CT scans, chest radiographs, and intubation on the ability to diagnosis traumatic diaphragmatic rupture. Materials and methods. Twenty patients with blunt trauma induced diaphragmatic rupture were identified from a five year review of a Level 1 Trauma Registry Results. Ten of the 20 (50%) patients had TDR on initial chest X-ray, all on the left side, Twelve patients had both chest X-rays and a chest and abdominal CT scan; however, only five (42%) of the CT scans were diagnostic. Of the 12 patients initially intubated, TDR was diagnosed in only four (33%) patients on initial chest X-ray and in one (14%) of seven patients having chest and abdominal CT scans and being intubated. Conclusion. The early diagnosis of blunt traumatic diaphragmatic rupture, especially in intubated patients, continues to be a diagnostic dilemma. There is a significantly better possibility of identifying left over right-sided TDR (P ≤ 0.05). Diagnosing TDR is also facilitated by extubation. If the suspicion exists, a post extubation chest radiograph should be performed to evaluate for TDR.
UR - http://www.scopus.com/inward/record.url?scp=0030028032&partnerID=8YFLogxK
U2 - 10.1016/S0009-9260(96)80214-5
DO - 10.1016/S0009-9260(96)80214-5
M3 - Article
C2 - 8549043
AN - SCOPUS:0030028032
VL - 51
SP - 27
EP - 30
JO - Clinical Radiology
JF - Clinical Radiology
SN - 0009-9260
IS - 1
ER -