Occult pneumothorax in patients with blunted polytrauma: an experience of Tanta University Hospitals

Abstract

Aims
The objective of this study was to retrospectively evaluate the incidence, management, and outcome of occult pneumothorax (OPTX) in patients with blunt chest trauma (BCT).


Settings and design
A retrospective observational study was performed.


Patients and methods
Over 9 years, cases with BCT were identified retrospectively from the database between 2012 and 2021. Data were evaluated and compared based on the first management (conservative vs. intercostal tube).


Results
Of the 2113 cases, 51 (2.4%) admitted with BCT during the study period were found to have OPTX. The mean age of patients was 37 ± 6.58 years, and there was a male predominance (78.43%). Intercostal tube intervention was done in 29 (53.8%) cases, and conservative management was done in 22 (43.13%) cases. Cases that needed tube thoracostomy had significantly higher rates of lung and chest contusions and high Abbreviated Injury Scale compared with those who were treated conservatively. However, pneumonia, rib fracture, hospital length of stay, and ventilatory days were insignificantly different between both groups. Overall mortality was 9.8%.


Conclusions
In cases with BCT that did not require major interventions or needed to be mechanically ventilated, their OPTX can be safely managed conservatively.