Chest injury in children with blunt abdominal trauma: evaluation with CT

Chest trauma is one of the main causes of death in children older than one year of age. It is critical to provide fast diagnosis of injuries in the thoracic region (between the base of the neck and the diaphragm) because delay severely hinders chances for survival. Diagnosis of thoracic injury in children is difficult, however, due to the lack of identifiable symptoms. Images provided by portable X-ray, the imaging technique often used in these types of cases, has not been a satisfactory means of assessment. The study evaluated the use of computed tomography (CT) scanning compared to portable chest X-ray in 62 cases of blunt abdominal trauma in children. Twenty-four hours after the injury, assessment of cardiopulmonary (heart-lung) damage should be made. Cardiopulmonary involvement in cases of blunt chest trauma is not normally evident until 24 hours has elapsed, particularly in young children who have a soft, flexible thorax which permits internal injury to occur without skeletal injury. X-ray imaging underestimated more than 33 percent of chest injuries that were subsequently viewed on CT scans. CT scans were able to demonstrate abnormality not depicted on chest X-ray images. The research found that CT scanning of the chest performed in conjunction with CT scanning of the upper abdomen is helpful in the early recognition of thoracic injuries that may not be symptomatic during the first 24 hours following trauma to the chest.