OAK: Chest CT indications

Indications for Chest CT in Pediatric Trauma

Scenario

Recommendation

Routine Chest CT in pediatric blunt trauma

Rarely useful; reserve for injuries requiring intervention.

Abnormal mediastinum on CXR with high-energy trauma

Perform CTA of the chest.

Suspected sternoclavicular dislocation

Perform portal venous phase chest CT.

Child abuse (for rib fracture assessment)

Perform low-dose non-contrast chest CT.

Isolated pneumothorax, hemothorax, or fractures

Not an indication for chest CT.

Symptoms after chest drain placement

Consider CT for operative targets at surgeon discretion.

Blunt esophageal injury (rare)

Consider CT for large pneumomediastinum with torso injury.

Thoracoabdominal penetrating trauma

Use CT at trauma surgeon’s discretion.

Unstable penetrating thoracoabdominal trauma

Skip CT; proceed to OR for hemorrhage control.

 

Keywords: Chest, CT