Ultrasonography in the Diagnosis of Traumatic Haemothorax
DOI:
https://doi.org/10.14738/bjhmr.101.13817Abstract
This study presents the authors' experience with ultrasonography in the diagnosis, follow-up and therapy of free and encapsulated haemorrhagic collections in polytrauma patients. Between August 2007 and September 2009, 107 patients with acute chest trauma were assessed for haemothorax with thoracic ultrasonography, supine chest radiography and computed tomography (CT); CT served as the reference standard and the sonographers were blinded to the other findings. Two intercostal oblique views took only minutes in supine patients. Haemothorax was present in 85 patients (79.43%). Against CT, ultrasonography gave 64 true positive, 9 true negative, 4 false positive and 8 false negative results, a sensitivity of 88.88%, specificity of 69.23%, accuracy of 85.88%, PPV of 94.11% and NPV of 52.94%. Fine-needle aspiration under imaging control was performed in 35 patients (32.71%) to specify the nature of the fluid and guide the choice between conservative treatment, drainage or thoracoscopy; sufficient fluid was obtained in 32 (91.42%), while aspiration failed in 3 (8.57%) because of thickened pleura. Most ultrasound results were available considerably earlier than the chest radiograph. The authors conclude that ultrasonography should be used as a primary method for the diagnosis and monitoring of haemothorax in major trauma patients, and that fine-needle aspiration under ultrasound or CT control should be the method of choice in cases that are difficult to differentiate.
Abstract prepared by the editorial office from the full text of the article; the authors did not supply one.
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