List Archives

Fri Nov 21 20:13:12 GMT 2008

I have several suggestions:   

1.    Loss of aortic knob contour on a chest X-ray  following trauma
2.    Loss of perivertebral stripe
3.    "Apparent" widened mediastinum

should all lead to another screening test or an  arteriogram.    

Another screening test could be a CT and CTA.   I do not believe  that the CT 
and CTA should be definitive test, it is only a  screen.    If there is 
concern on the three tests above or the CT  or CTA, then go to aortogram.  

k

In a message dated 11/21/2008 2:10:00 P.M. Central Standard Time,  
pbjorn at emh.org writes:

I'm  disappointed that your interesting question hasn't found a reply.
My long  experience as a member and admirer of the Trauma List leaves me
thinking  that there simply isn't a good answer.  

That said, and assuming  you're looking for an aortic injury, I think the
incidence among  pre-adolescents is almost exactly zero.  Isn't it?  So
in  practical terms you're talking about a small handful of teenagers,
for whom  the 8-cm rule (and a whole lot of clinical context) should
suffice.   

Points for trying?

Pret Bjorn, RN
Bangor, ME  USA

-----Original Message-----
From:  trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On  Behalf Of moore677 at aol.com
Sent: Wednesday, November 19, 2008 2:01  PM
To: trauma-list at trauma.org
Subject: WIDE MEDIASTINUM IN  CHILDREN

We have defined a wide mediastinum in an adult trauma  patient as >8cm.?
Can anyone tell me how we define a pediatric patient  with a wide
mediastinum?

Forrest "Dell" Moore, MD,  FACS
Trauma Critical Care Surgery
St. Joseph's Hospital and Medical  Center
Phoenix, AZ
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WIDE MEDIASTINUM IN CHILDREN