Pertinent Chest x-ray Findings in the Trauma Patient ...

Pertinent Chest x-ray Findings in the Trauma Patient and Implications

Respiratory distress without x-ray findings - Central nervous system (CNS) injury, aspiration, traumatic asphyxia

Any rib fracture - Pneumothorax, pulmonary contusion

Fracture of first three ribs or sternoclavicular fracture-dislocation - Airway or great vessel injury

Fracture of lower ribs 9 to 12 - Abdominal injury

Two or more rib fractures in two or more places - Flail chest, pulmonary contusion

Scapular fracture - Great vessel injury, pulmonary contusion, brachial plexus injury

Mediastinal widening - Great vessel injury, sternal fracture, thoracic spine injury

Persistent large pneumothorax or air leak after chest tube insertion - Bronchial tear

Mediastinal air - Esophageal disruption, tracheal injury, pneumoperitoneum

Gastrointestinal (GI) gas pattern in the chest (loculated air) - Diaphragmatic rupture

NG tube in the chest - Diaphragmatic rupture or ruptured esophagus

Air fluid level in the chest - Hemopneumothorax or diaphragmatic rupture

Disrupted diaphragm - Abdominal visceral injury

Free air under the diaphragm - Ruptured hollow abdominal viscus

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