¿Está indicado realizar una tomografía computarizada torácica urgente en el traumatismo leve-moderado? / Is it adequate to carry out a chest-CT in patients with mild-moderate chest trauma?

Se considera un traumatismo leve-moderado aquel que se encuentra fuera del contexto de politraumatismo, no presenta un mecanismo de alta energía, no es penetrante y se acompaña de contusión de la pared torácica o de fracturas costales sin asociar una lesión torácica que amenace de forma inmediata la vida del paciente. Es un motivo de consulta frecuente en los servicios de urgencias. La radiología convencional de tórax y la tomografía computarizada (TC) son las técnicas diagnósticas radiológicas realizadas habitualmente, considerándose la TC torácica como el estándar de referencia diagnóstico. Sin embargo, no existen guías clínico-radiológicas de actuación actualizadas que establezcan indicaciones de cuándo hay que solicitar una TC en este motivo de consulta. Por ello buscamos las recomendaciones basadas en la evidencia para mejorar la adecuación de la solicitud de pruebas radiológicas urgentes con el objetivo de disminuir costes y evitar radiación innecesaria

Mild-moderate blunt chest trauma is defined as a blunt chest trauma that is not caused by a high-energy mechanism, causing thoracic tenderness with or without rib fractures and that has no immediate life-threatening consequences for the patient. It is a frequent clinical situation in the emergency department. The most common radiological techniques that are used in this context are chest X-ray and thoracic computed tomography (CT). The CT scan is set as the gold standard. However, there are no current clinical-radiological guidelines that establish the adequacy of the requests of the CT scan. Therefore, we decided to search for evidence-based recommendations to improve the adequacy of the chest X-ray and CT scan in our daily practice in order to reduce the costs and avoid unnecessary radiation exposure

Is it adequate to carry out a chest-CT in patients with mild-moderate chest trauma? / ¿Está indicado realizar una tomografía computarizada torácica urgente en el traumatismo leve-moderado?

Mild-moderate blunt chest trauma is defined as a blunt chest trauma that is not caused by a high-energy mechanism, causing thoracic tenderness with or without rib fractures and that has no immediate life-threatening consequences for the patient. It is a frequent clinical situation in the emergency department. The most common radiological techniques that are used in this context are chest X-ray and thoracic computed tomography (CT). The CT scan is set as the gold standard. However, there are no current clinical-radiological guidelines that establish the adequacy of the requests of the CT scan. Therefore, we decided to search for evidence-based recommendations to improve the adequacy of the chest X-ray and CT scan in our daily practice in order to reduce the costs and avoid unnecessary radiation exposure.

[Traumatic sectioning of the isthmus in a case of renal fusion]. / Sección traumática del istmo en un caso de fusió renal.

In this paper, we present a case of traumatic sectioning of the isthmus in a patient with multiple injuries, suffering from a horse-shoe-shaped kidney, which is extremely rare, according to the review of the literature which we have carried out. In view of the scanty incidence of kidney fusions and the difficulty sometimes involved in classifying them and in their surgical treatment, we shortly comment on the consequences which traumatisms may have on this kind of kidney malformation.