Journal of Emergencies, Trauma, and Shock
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Year : 2008  |  Volume : 1  |  Issue : 1  |  Page : 19-20
Ultrasound diagnosis of traumatic pneumothorax


Department of Emergency Medicine, SUNY Downstate, 450 Clarkson Avenue Box 1228, Brooklyn, NY 11203, USA

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How to cite this article:
Stone MB. Ultrasound diagnosis of traumatic pneumothorax. J Emerg Trauma Shock 2008;1:19-20

How to cite this URL:
Stone MB. Ultrasound diagnosis of traumatic pneumothorax. J Emerg Trauma Shock [serial online] 2008 [cited 2019 Jul 23];1:19-20. Available from: http://www.onlinejets.org/text.asp?2008/1/1/19/41788



   Case History Top


A 36-year-old man presented to our emergency department complaining of right-sided chest pain after a motor vehicle collision. Physical examination revealed bilateral breath sounds and a supine chest radiograph was unremarkable. A 10-5 MHz linear transducer (SonoSite MicroMaxx, Bothell, WA, USA) was used to obtain ultrasound images at the patient's left anterior chest wall [Figure 1], right anterior chest wall [Figure 2] and right lateral chest wall [Figure 3].


   Discussion Top


Traumatic pneumothorax . Shortly after the primary survey the patient developed dyspnea, tachycardia, and hypoxia. A rush of air was encountered upon entering the right pleural space and a 36-French thoracostomy tube was inserted. The patient's symptoms improved and he was admitted to the Trauma service for further management.

Supine chest radiography has low sensitivity for traumatic pneumothorax. [1] Several studies have demonstrated high sensitivity and specificity for thoracic ultrasound for the detection of occult pneumothorax in critical care, [2] and trauma patients. [3] Absent lung sliding suggests pneumothorax, but can occur in the presence of multiple other conditions such as mainstem intubation, acute respiratory distress syndrome, or pleural adhesions. The lung point is an ultrasound sign with 100% specificity for pneumothorax, [4] and can be used to determine the size of the pneumothorax. [5]

 
   References Top

1.Rowan K, Kirkpatrick A, Liu D, Forkheim KE, Mayo JR, Nicolaou S. Traumatic pneumothorax detection with thoracic US: Correlation with chest radiography and CT - initial experience. Radiology 2002;225:210-4.  Back to cited text no. 1    
2.Lichtenstein DA, Meziθre G, Lascola N, Biderman P, Courret JP, Gepner A, et al . Ultrasound diagnosis of occult pneumothorax. Crit Care Med 2005;33:1231-8.  Back to cited text no. 2    
3.Blaivas M, Lyon M, Duggal S. A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax. Acad Emerg Med 2005;12:844-9.  Back to cited text no. 3  [PUBMED]  
4.Lichtenstein D, Meziere G, Biderman P, Gepner A. The "lung point": An ultrasound sign specific to pneumothorax. Intensive Care Med 2000;26:1434-40.  Back to cited text no. 4    
5.Soldati G, Testa A, Sher S, Pignataro G, La Sala M, Silveri NG. Occult traumatic pneumothorax: Diagnostic accuracy of lung ultrasonography in the emergency department. Chest 2008;133:204-11.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]

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Correspondence Address:
Michael B Stone
Department of Emergency Medicine, SUNY Downstate, 450 Clarkson Avenue Box 1228, Brooklyn, NY 11203
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2700.41788

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    Figures

  [Figure 1], [Figure 2], [Figure 3]

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