The increasing use of thoracic computed tomography (CT) has led to the recognition of intrapleural blood and air not initially evident on admission plain chest x-ray, defining the presence of occult hemopneumothorax. The clinical significance of occult hemopneumothorax, specifically the role of tube thoracostomy, is not clearly defined.To identify those patients with occult hemopneumothorax who can be safely managed without chest tube insertion.Methods:During the recent 24 month period ending July 2010, comprehensive data on 73 blunt chest trauma patients with occult hemopneumothorax were recorded to determine whether tube thoracostomy was needed and, if not, to define the consequences of non-drainage. Pneumothorax and hemothorax were quantified by computed tomography (CT). Data included demographics, injury mechanism and severity, chest injuries, need for mechanical ventilation, indications for tube thoracostomy, hospital length of stay, complications and outcome.
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