Hemothorax; Traumatic Clinical Trial
Official title:
Role of Pleural Fluid Attenuation Value Measurement on Computed Tomography as a Diagnostic Tool for Hemothorax in Traumatic Patients
To define the potential role of pleural fluid attenuation value determined on computed tomography (CT) for diagnosis of traumatic hemothorax and differentiate it from other pleural effusion.
Hemothorax is defined as blood accumulation in the pleural space. It is a consequence of
blunt trauma in 90% of cases. Hemothorax due to blunt trauma mechanisms e.g traffic
accidents,sport accidents and falls are among the commonest injuries of the chest. It is
manifested in 30-50% of chest trauma cases. In such cases, bleeding might be caused by damage
to pulmonary parenchyma or intercostal arteries associated with or without rib fractures and
other chest wall tissue injuries including parietal pleura or other thoracic structures.
Although other pleural effusion types may also manifest such as chylothorax in case of chest
trauma, however fluid detected in pleural space is usually considered blood unless proven not
to be. Despite the clinical and radiological findings provide important data about the
content of pleural cavity, however tube thoracostomy and diagnostic thoracocentesis are still
required to relieve pressure and characterize the fluid. Tube thoracostomy is an invasive
procedure which can lead to immediate procedural injuries, infections and pain which can
contribute to respiratory failure in patients with chest wall injury. Although needle
thoracocentesis is less invasive than tube thoracostomy, however it carries small but
definitive risks such as pneumothorax, bleeding and chest wall hematoma. Since hemothorax is
a potentially life threatening, it must be diagnosed quickly and accurately and all these
unnecessary complications should be avoided. Chest computed tomography [CT] has been accepted
as the gold standard imaging study for evaluating chest trauma and usually performed in
patients with grossly severe chest trauma, as it helps to detect even small hemothorax.
CT can also allow for more advanced characterization of pleural fluid and distinguish
hemothorax from any other types of effusion by means of scaling Hounsfield units as in
literature, any attenuation value for pleural fluid between 35 and 70 HU is considered
typically blood, so it can be considered as an important non-invasive diagnostic tool for
diagnosis of hemothorax in traumatic patients.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
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N/A | |
| Recruiting |
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|
N/A |