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The role of MDCT in the management of hemothorax in traumatized patients

Bruna Malta, Caterina Albieri, Stefano Tartari, Clorinda Montalto, Zairo Ferrante, Francesco Feletti, Andrea Aliverti, Giorgio Benea, Melchiore Giganti
European Respiratory Journal 2016 48: PA3815; DOI: 10.1183/13993003.congress-2016.PA3815
Bruna Malta
1Universitary Radiology Department, Sant'Anna Hospital, Cona, Ferrara (FE)Italy
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Caterina Albieri
2Radiology Department, Sant'Anna Hospital, Cona, Ferrara (FE)Italy
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Stefano Tartari
2Radiology Department, Sant'Anna Hospital, Cona, Ferrara (FE)Italy
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Clorinda Montalto
1Universitary Radiology Department, Sant'Anna Hospital, Cona, Ferrara (FE)Italy
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Zairo Ferrante
1Universitary Radiology Department, Sant'Anna Hospital, Cona, Ferrara (FE)Italy
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Francesco Feletti
3Radiology Department, Santa Maria delle Croci Hospital, Ravenna, Italy
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Andrea Aliverti
4Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
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Giorgio Benea
2Radiology Department, Sant'Anna Hospital, Cona, Ferrara (FE)Italy
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Melchiore Giganti
1Universitary Radiology Department, Sant'Anna Hospital, Cona, Ferrara (FE)Italy
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Abstract

PURPOSE: In polytraumatized patients with active bleeding, the improvement of survival depends on control/early stoppage of bleeding. The purpose of our study was to define the role of MDCT in patients with hemothorax.

MATERIALS AND METHODS: From January 2008 to December 2013, we performed thoraco-abdominal CT to 1352 patients with polytrauma or thoracic blunt trauma. We retrospectively reviewed CT of 93 patients (mean age 65 years) where MDCT showed hemothorax. Basing on CT findings, 12 patients have been treated with interventional radiology, 78 patients with surgical procedures (drainage tube, VATS, thoracotomy).

RESULTS: CT showed rib fractures in 85 patients; an active bleeding in arterial phase, with associated hematic pleural effusion in 12 patients;2 pseudoaneurysm in 2 patients. Two patients with flail chest showed bleeding a few days after traumatic event. Nine patients underwent to percutaneous treatment with technical success in 9/10 (90%).

CONCLUSIONS: MDCT demonstrates high value in the management of patients with thoracic blunt trauma, identifying and classifying the severity of injuries. It shows high accuracy in the diagnosis of active bleeding and precludes the occurrence of complications. In the detection of active bleeding CT allows correct selection and safe treatment planning. In polytraumatized patients the selective arteriography and transcatheter embolization provide a viable diagnostic and therapeutic alternative in the management of bleeding from arterial lesions.

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The role of MDCT in the management of hemothorax in traumatized patients
Bruna Malta, Caterina Albieri, Stefano Tartari, Clorinda Montalto, Zairo Ferrante, Francesco Feletti, Andrea Aliverti, Giorgio Benea, Melchiore Giganti
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3815; DOI: 10.1183/13993003.congress-2016.PA3815

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The role of MDCT in the management of hemothorax in traumatized patients
Bruna Malta, Caterina Albieri, Stefano Tartari, Clorinda Montalto, Zairo Ferrante, Francesco Feletti, Andrea Aliverti, Giorgio Benea, Melchiore Giganti
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3815; DOI: 10.1183/13993003.congress-2016.PA3815
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