Oblique chest X-ray: An alternative way to detect pneumothorax

Purpose: To identify occult pneumothorax with oblique chest X-ray (OCXR) in clinically suspected patients. Methods: In this retrospective study, we examined 1082 adult multitrauma patients who were admitted to our emergency service between January 2016 and January 2017. Clinical findings that suggest occult pneumothorax were rib fracture, flail chest, chest pain, subcutaneous emphysema, abrasion or ecchymosis and moderate to severe hypoxia in clinical parameters. All of these patients underwent anteroposterior chest X-ray (APCXR), but no pneumothorax could be detected. Upon this, OCXR was performed using mobile X-ray equipment. Results: Traumatic pneumothorax was observed in 421 (38.9%) of 1082 patients. We applied OCXR to 26 multitrauma patients. Occult pneumothorax was evaluated at 22 patients (2.03%) in 1082 multitrauma patients. The 22 patients who had multitrauma occult pneumothorax on OCXR were internated at intensive care unit (ICU) and follow-up was done using OCXR and APCXR. Conclusions: OCXR can be an alternative imaging technique to identify occult pneumo-thorax in some trauma patients at emergency room and also follow period at ICU. © 2018 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery