For example, a hemodynamically stable patient with active arterial bleeding may be treated with an angioembolization procedure, whereas bleeding from a venous structure may result in supportive care [29,33]. MRI Chest, Abdomen, and Pelvis Without and With IV Contrast There is no relevant literature regarding the use of MRI chest, abdomen, and pelvis without and with IV contrast for initial evaluation of patients with penetrating torso trauma. MRI Chest, Abdomen, and Pelvis Without IV Contrast There is no relevant literature regarding the use of MRI chest, abdomen, and pelvis without IV contrast for initial evaluation of patients with penetrating torso trauma with hypotension. Radiography Trauma Series Chest radiographs can recognize contusions, pneumothorax, hemothorax, rib fractures, retained foreign bodies, and mediastinal injuries, which should be treated immediately. Radiographic evaluation can also help identify retained foreign bodies and suggest trajectory, which may direct initial surgical exploration. The limitations of radiography, particularly chest radiography, should be understood in the setting of nonballistic trauma. Nguyen et al [50] showed that greater than one-third of patients in their study had additional findings on CT after a normal screening chest radiograph. Variant 6: Adult. Nonballistic penetrating torso trauma, limited to chest, normotensive. Initial imaging. Injuries that are considered limited to the chest occur outside of the thoracoabdominal zone. Anatomical landmarks can include above the nipple line in men or above the fourth rib. Wounds occurring below these anatomical landmarks could involve abdominal structures given significant diaphragmatic excursion. FAST can help triage patients and direct initial bedside and surgical procedures. Hemopericardium, pneumothorax, and free intraperitoneal fluid discovered at FAST have significant implications on next steps in management of the patient.
Penetrating Torso Trauma. For example, a hemodynamically stable patient with active arterial bleeding may be treated with an angioembolization procedure, whereas bleeding from a venous structure may result in supportive care [29,33]. MRI Chest, Abdomen, and Pelvis Without and With IV Contrast There is no relevant literature regarding the use of MRI chest, abdomen, and pelvis without and with IV contrast for initial evaluation of patients with penetrating torso trauma. MRI Chest, Abdomen, and Pelvis Without IV Contrast There is no relevant literature regarding the use of MRI chest, abdomen, and pelvis without IV contrast for initial evaluation of patients with penetrating torso trauma with hypotension. Radiography Trauma Series Chest radiographs can recognize contusions, pneumothorax, hemothorax, rib fractures, retained foreign bodies, and mediastinal injuries, which should be treated immediately. Radiographic evaluation can also help identify retained foreign bodies and suggest trajectory, which may direct initial surgical exploration. The limitations of radiography, particularly chest radiography, should be understood in the setting of nonballistic trauma. Nguyen et al [50] showed that greater than one-third of patients in their study had additional findings on CT after a normal screening chest radiograph. Variant 6: Adult. Nonballistic penetrating torso trauma, limited to chest, normotensive. Initial imaging. Injuries that are considered limited to the chest occur outside of the thoracoabdominal zone. Anatomical landmarks can include above the nipple line in men or above the fourth rib. Wounds occurring below these anatomical landmarks could involve abdominal structures given significant diaphragmatic excursion. FAST can help triage patients and direct initial bedside and surgical procedures. Hemopericardium, pneumothorax, and free intraperitoneal fluid discovered at FAST have significant implications on next steps in management of the patient.