Treatment of occult pneumothoraces from blunt trauma

Karen J. Brasel, Renae E. Stafford, John A. Weigelt, Jane E. Tenquist, David C. Borgstrom

Research output: Contribution to journalArticlepeer-review

118 Scopus citations


Background: Occult pneumothoraces (OPTXs) are seen on abdominal computed tomographic (CT) scans but not on routine chest x-ray films. Optimal treatment for blunt trauma OPTXs has not been defined. We hypothesized that OPTXs could be safely observed without need for a chest tube (CT). Methods: A prospective trial randomized blunt trauma patients with OPTXs to CT scan or observation. Patients were not excluded for positive pressure ventilation. Primary outcome measures were respiratory distress and pneumothoraces progression. Results: Thirty-nine patients with 44 pneumothoraces were enrolled. Eighteen patients received a CT scan, and 21 patients were observed. Nine patients in each group received positive pressure ventilation. There was no difference in overall complication rate. No patient had respiratory distress related to the OPTX or required emergent CT scan. Conclusions: Observation of OPTX is not associated with an increased incidence of pneumothorax progression or respiratory distress. These pneumothoraces can be safely observed in patients with blunt trauma injury regardless of the need for positive pressure ventilation.

Original languageEnglish (US)
Pages (from-to)987-991
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number6
StatePublished - Jun 1999
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine


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