Asymptomatic non-occult pneumothorax in pediatric blunt chest trauma: Chest tube versus observation.

Document Type

Article

Publication Date

12-2021

Identifier

DOI: 10.1016/j.jpedsurg.2021.02.003

Abstract

BACKGROUND: The treatment of asymptomatic non-occult pneumothoraces (ANOPTX) secondary to blunt chest trauma (BCT) has not been well delineated. We sought to analyze our experience with ANOPTX in pediatric trauma patients and determine if a chest tube (CT) is mandatory.

METHODS: A retrospective chart review of patients < 17 years old with ANOPTX from BCT who presented to a level 1 trauma children's hospital, between January 2000 and June 2015 was performed. Demographics, vitals, trauma scores, imaging, interventions, hospital expenses and outcomes were analyzed.

RESULTS: Of the 77 patients who had ANOPTX, 48 (62.3%) were managed with observation only, while 29 (37.7%) underwent CT placement. The median length of stay for patients who had CT placement was 7 days (IQR, 4, 12) and 2 days (IQR, 1, 4) in those observed (p < 0.01). All patients who were observed had complete resolution of the pneumothorax without recurrence or the need for CT placement. Patients who had CT placement had more imaging performed and more hospital expenditure compared to those who were observed.

CONCLUSIONS: CT is not mandatory in all pediatric patients with ANOPTX from BCT and observation has been found to be safe and cost effective.

Journal Title

Journal of pediatric surgery

Volume

56

Issue

12

First Page

2333

Last Page

2336

MeSH Keywords

Adolescent; Chest Tubes; Child; Hospitals, Pediatric; Humans; Pneumothorax; Retrospective Studies; Thoracic Injuries; Tomography, X-Ray Computed; Wounds, Nonpenetrating

Keywords

Asymptomatic non-occult pneumothoraces; Blunt chest trauma; Chest tube; Observation; Pediatric trauma

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