Injuries of the pleural spaces

The presence of thoracic injuries in a multisystemic trauma can highly increase patient mortality; furthermore, injuries such as “flail chest,” lung contusion, hemothorax, and pneumothorax can complicate overall case management. Chest-X-Ray (CXR) is the first imaging step to perform in a thoracic trauma, to highlight a possible pneumothorax, hemothorax, and other life-threatening conditions. MultiSlice Computed Tomography (MDCT) is more accurate than CXR for the evaluation of pleural injuries, although it is to be performed in stable patients only. In this chapter, pleural abnormalities following blunt thoracic trauma and the role of CXR and MSCT will be discussed (pneumo-thorax, hemothorax), with a small digression about pleural drainages and the importance to recognize a possible dislocation to prevent severe complications.