Use of Chest Computed Tomography for Blunt Pediatric Chest Trauma: Does It Change Clinical Course?

Elizabeth M. Holl, Ashley P. Marek, Rachel M. Nygaard, Chad J. Richardson, Donavon J. Hess

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


INTRODUCTION: Given the concern for radiation-induced malignancy in children and the fact that risk of severe chest injury in children is low, the risk/benefit ratio must be considered in each child when ordering a computed tomography (CT) scan after blunt chest trauma.

METHODS: The study included pediatric blunt trauma patients (age, <15 years) with chest radiograph (CR) before chest CT on admission to our adult and pediatric level I trauma center. Surgeons were asked to view the blinded images and reads and indicate if they felt CT was warranted based on CR findings, if their clinical management change based on additional findings on chest CT, and how they might change management.

RESULTS: Of the 127 patients identified, 64.6% had no discrepancy between their initial CR and chest CT and 35.4% of the children's imaging contained a discrepancy. The majority of the pediatric and general trauma surgeons felt CT was indicated in 6 of 45 patients based on CR. In 87% of patients with a discrepancy in findings on CR and CT, the majority of surgeons agreed that their management would not change based on the additional information. In the 6 patients in which the CT was considered indicated, 4 of the 6 would have triggered a management change.

CONCLUSIONS: Our study suggests that chest CT scans frequently serve as confirmatory diagnostic tools and in the pediatric blunt chest trauma patient and can be withheld in many cases without hindering the management of an injured child.

Original languageEnglish (US)
Pages (from-to)81-86
Number of pages6
JournalPediatric Emergency Care
Issue number2
StatePublished - Feb 1 2020

Bibliographical note

Publisher Copyright:
© 2020 Wolters Kluwer Health, Inc. All rights reserved.


  • CT
  • blunt trauma
  • chest injury
  • pediatric trauma
  • radiation
  • Neoplasms, Radiation-Induced/prevention & control
  • Radiography, Thoracic/methods
  • Tomography, X-Ray Computed/methods
  • Humans
  • Radiation Exposure/adverse effects
  • Risk Factors
  • Child, Preschool
  • Trauma Centers
  • Infant
  • Male
  • Wounds, Nonpenetrating/diagnostic imaging
  • Thorax/diagnostic imaging
  • Adolescent
  • Surgeons
  • Female
  • Surveys and Questionnaires
  • Thoracic Injuries/diagnostic imaging
  • Retrospective Studies
  • Child

PubMed: MeSH publication types

  • Journal Article


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