FAILURE OF CHEST X-RAYS TO DIAGNOSE PNEUMOTHORACES AFTER BLUNT TRAUMA

We report four cases of occult pneumothorax in patients who had suffer ed blunt trauma. In each case supine chest X-rays failed to diagnose a n anterior pneumothorax. Subsequent spiral computerised tomography sca ns of the chest showed anterior pneumothoraces in all cases. In two of the cases anterior pneumothoraces were present in spite of a chest dr ain having been placed in the pleural cavity. We recommend the inserti on of anteriorly positioned chest drains to relieve pneumothoraces in severely injured trauma patients.