ROLE OF ULTRASOUND IN MANAGEMENT OF PATIENTS WITH HEMOTHORAX FOLLOWING BLUNT TRAUMA CHEST

Abstract

Aims: To study the Clinical and Ultrasonographic prole of patients presenting with blunt trauma chest and to compare these ndings in patients who underwent either tube thoracostomy or were managed conservatively. This prospect Settings and Design: ive study was carried out in the Departments of Surgery and Radiodiagnosis, Gobind Singh Medical College and Hospital, Faridkot(Punjab). The study was approved by the Institutional Ethics Committee. A total of 60 patients of Blunt Trauma Chest patient presenting to the Department of General Surgery,Guru Gobind Singh Medical College and Hospital,Faridkot were assessed and included in the study based on the Inclusion and Exclusion Criteria of the study. Methods and Material:The vitals,symptoms and signs of all patients were recorded. A Frontal Chest X-ray was performed on all patients after which thoracic ultrasound was done using Philips Afnity 70 and Clearview machines using 3.5-5MHz transducers.Based on the quantity of hemothorax,patients were divided into two groups-One group was managed conservatively and the other group with Tube Thoracostomy.Patients with volume of Hemothorax more than 500ml or with Hemothorax less than 500ml but had respiratory distress were managed by Tube Thoracostomy while rest of the patients were managed conservatively.Serial follow up Chest Xrays and Ultrasound examinations were done on days 3,5 and 7. The present study inferred that a total of 60 patients, out of which 41 Results: patients were managed conservatively and 19 patients were managed by Tube Thoracostomy . Majority of patients (68.33% in present study) with hemothorax following blunt trauma chest, even those with multiple rib fractures did not require tube thoracostomy and could be successfully managed conservatively. Availability of emergency ultrasound helps in diagnosis and quantication of Hemothorax volume, which aids in conservative management of patients who would have otherwise underwent Tube Thoracostomy. Ultrasound signicantly changes the managem Conclusions: ent of patients with Hemothorax following Blunt Trauma Chest.Thus,we recommend routine use of ultrasound thorax for assessment of Hemothorax volume in clinically stable patients.