Introduction:

Chest trauma has a high incidence, and pneumothorax is the most frequent finding. The literature is limited about what to do with asymptomatic patients with pneumothorax due to penetrating chest trauma. The objective of this study was to evaluate the findings of control follow-up chest x-ray in patients with penetrating chest trauma who are not initially taken to surgery and its usefulness in determining the need for additional management.

Methods:

A retrospective cohort study was conducted, including patients older than 15 years who were admitted for penetrating chest trauma between January 2015 and December 2017 and who did not require initial surgical management. The results of the chest x-ray, the timing of it and the management according to the findings in the patients initially left under observation were analyzed.

Results:

1,554 patients were included; whose average age was 30 years, 92.5% were males and 97% sustained a gunshot wound; 361 patients were left under observation with control x-ray, of which 186 (51,5%) had no findings on their initial radiograph, 142 had pneumothorax less than 30% and 33 had pneumothorax greater than 30%, hemoneumotorax or hemothorax. Closed thoracostomy was required as final management in 78 cases, sternotomy or thoracotomy in 2 cases and discharge in 281.

Conclusion:

In asymptomatic patients with small or moderate pneumothorax and without other significant injuries, longer observation times, x-rays and closed thoracostomy may be unnecessary.

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