What is the role of ultrasonography in the workup of hemothorax?

Updated: Jul 13, 2020
  • Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: Jeffrey C Milliken, MD  more...
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Answer

Trauma ultrasonography is used at some trauma centers in the initial evaluation of patients for hemothorax. Even with the use of chest radiography and helical CT, some injuries can remain undetected. In particular, patients with penetrating chest injuries may harbor serious cardiac injury and a pericardial effusion that may be clinically difficult to determine. Bedside echocardiography can provide immediate, accurate information regarding the pericardium and the need for immediate surgery. It can also improve patient outcome. [33]

One drawback of ultrasonography for the identification of traumatic hemothorax is that associated injuries readily seen on chest radiographs in the trauma patient, such as bony injuries, widened mediastinum, and pneumothorax, are not readily identifiable on chest ultrasonograms. Ultrasonography more likely plays a complementary role in specific cases where the chest x-ray findings of hemothorax are equivocal.


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