What Trauma Surgeons Are Looking For in a Chest CT
In every episode of Grey’s Anatomy, you’ve heard one of the trauma surgeons yell “get a chest CT, STAT!” Or, as is commonplace in grandiose Hollywood, they forgo the medical imaging altogether and scoot the patient into the operating room as quickly as possible and open them up to correct the problem without having confirmation — confidence is key. But, had they waited around for the scan results, there are a variety of things they were looking for, and a plethora of things that can be revealed. Join us as we review some of the traumatic findings that a trauma surgeon is looking for in a chest CT.
A pneumothorax and/or a hemothorax are all fairly common in any type of chest trauma event. The area known as the thoracic cavity is the place inside the chest caged by the ribs that hold the most vital of organs — heart and lungs. The lungs are very large and therefore have a high propensity for injury. A pneumothorax happens when there is a break in the pleural space that allows air to accumulate around the lung, but not escape. This is a real problem because the chest acts as a giant vacuum, pressure allows the lungs to fill and then pushes the air out when we exhale. When this closed system is compromised, the air can fill the space around the lung which prevents the lung from expanding, and if not corrected, will lead to death — for Hollywood’s (accurate) rendition of this, reference the movie “Three Kings.” A hemothorax is a condition of the same mechanics, but instead of air, the chest cavity fills with blood. These phenomena may not be readily visible upon inspection or assessment if the chest has not been penetrated. However, if a rib is broken, it can easily puncture the pleural sac without breaking the skin.
There are a variety of signs and symptoms that will lead a medical provider to believe that they are dealing with a pneumo/hemothorax, and will likely order diagnostic imaging to confirm. A standard x-ray will show where there is something in the pleural space that should not be, but a CT scan will reveal, in greater detail, all the components that have caused the problem and allow them to perform accurate interventions.
Cardiac tamponade is a condition that is caused by damage or insult to the pericardial sac — the lining around the heart. Similarly to a pneumothorax, when the protective sac around the heart is compromised, it causes blood to accumulate in the space. Identically to a hemothorax, this prevents the organ — in this case, the heart — from being able to properly fill and pump. As you can very well imagine, this condition causes a quick fatality if not corrected rapidly. To identify a cardiac tamponade, a number of diagnostic tests may be performed including an electrocardiogram (EKG), an ultrasound, an x-ray, and/or a CT scan. It is important to run a medical imaging test to differentiate between an actual cardiac tamponade versus a tension pneumothorax or heart failure. These differing diagnosis can cause similar symptoms, but the procedure to correct a cardiac tamponade, if performed on a patient who does not have a tamponade, can create one.
Medical imaging is a powerful diagnostic tool that is used in a variety of settings reveal a lot of different problems. Medical imaging technology can even help guide the corrective interventions and then be used to monitor for effectiveness after surgical intervention is performed. At Touchstone Imaging, we understand what important tools x-rays, MRIs, CT scans, and ultrasounds can be. We are proud to offer an option for meeting the medical imaging needs of patients across the nation. For all of your non-emergent imaging needs, trust the imaging experts at Touchstone Imaging. Contact us to schedule your appointment today!