Journal of Emergencies, Trauma, and Shock

ORIGINAL ARTICLE
Year
: 2015  |  Volume : 8  |  Issue : 3  |  Page : 140--143

DQOccultDQ rib fractures diagnosed on computed tomography scan only are still a risk factor for solid organ injury


Bishwajit Bhattacharya, Jennifer Fieber, Kevin Schuster, Kimberly Davis, Adrian Maung 
 Department of Surgery, Yale School of Medicine, Connecticut, USA

Correspondence Address:
Bishwajit Bhattacharya
Department of Surgery, Yale School of Medicine, Connecticut
USA

Introduction: Prior to the widespread use of computed tomography (CT) scan imaging, lower rib fractures diagnosed on chest X-rays (CXRs) were considered a risk factor for abdominal solid organ injury (ASOI). However, CXRs miss about 50% of the rib fractures that are detected on CT scans. We hypothesized that these DQoccultDQ rib fractures would not be predictive for ASOI. Materials and Methods: Retrospective review of a level I trauma centerSQs database identified all adult blunt trauma patients (n = 11,170) over a 5-year period. Data were abstracted for demographics, injury severity score, presence of ASOI, extremity, pelvic and spine fractures as well as presence and location of rib fractures. Results: Rib fractures correlated with the presence of ASOI, regardless of whether they were diagnosed by CXR or CT scan alone (P < 0.01). Middle (3-7) and lower (8-12) rib fractures, especially, correlated with the presence of ipsilateral ASOI (P < 0.0001). Discussion: Although CT scan detects more rib fractures than CXR, rib fractures remain a marker for increased likelihood of ASOI regardless of the modality by which they are diagnosed. Patients with rib fractures also have a greater incidence of spine and pelvic fractures. As the trauma community debates moving away from routine whole-body CT imaging towards a more selective approach, these results suggest that any clinical suspicion of rib fractures, despite a negative CXR, may warrant further investigation.


How to cite this article:
Bhattacharya B, Fieber J, Schuster K, Davis K, Maung A. "Occult" rib fractures diagnosed on computed tomography scan only are still a risk factor for solid organ injury.J Emerg Trauma Shock 2015;8:140-143


How to cite this URL:
Bhattacharya B, Fieber J, Schuster K, Davis K, Maung A. "Occult" rib fractures diagnosed on computed tomography scan only are still a risk factor for solid organ injury. J Emerg Trauma Shock [serial online] 2015 [cited 2020 Jul 10 ];8:140-143
Available from: http://www.onlinejets.org/article.asp?issn=0974-2700;year=2015;volume=8;issue=3;spage=140;epage=143;aulast=Bhattacharya;type=0