Journal of thoracic imaging
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Blunt and penetrating chest trauma in children results from many causes but the major cause is motor vehicle accidents. The trauma induces a variety of injuries to the bony thorax, the pulmonary parenchyma, and mediastinal structures. ⋯ Radiologic evaluation plays an important role in documenting and diagnosing these traumatic and iatrogenic injuries. The various radiologic manifestations of these injuries are described and discussed.
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The most important lung alterations associated with blunt trauma are contusion, laceration, and diffuse alveolar damage. The first two are the direct consequences of injury to the chest, while the third is the indirect result of thoracic or nonthoracic trauma. In addition to these three conditions, there are a number of epiphenomena and less common posttrauma abnormalities that are important to the radiologist involved in the care of injured patients.
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While most injuries to the chest can be diagnosed by a portable supine radiograph, computed tomography (CT) adds significant findings that will influence patient management. In addition to requested CT chest examinations, we routinely obtain a limited chest CT during the initial work-up of traumatized patients referred to our radiology department for other CT examinations. The major categories of new information provided by CT are: occult pneumothorax, malpositon of chest tubes, inadequately drained pleural collections, differentiating between posttraumatic abscess and empyema, noninvasive diagnosis of tracheal rupture, and cause of mediastinal widening.