[Utility of digital thoracotomy in chest trauma].

BACKGROUND: toracostomy in thoracic trauma is a good opportunity for the digital exploration of pleural cavity.

OBJECTIVES: To evaluate the utility of digital exploration during chest tube insertion in thoracic trauma.

SETTING: Hospital de Urgencias. Córdoba.

PATIENTS AND METHODS: patients with blunt and penetrating chest trauma by stab wound, who need chest tube insertion and treated by only one surgeon, were evaluated from July 10 to December 31st 2000. Previously to the thoracostomy with 24 french tube in 5th intercostal space, at the affected side, a digital exploration of pleural cavity was done, attempting to find intrathoracic injuries.

RESULTS: in a six months period, 36 thoracostomy tubes were placed, due thoracic trauma (11 blunt trauma and 25 penetrating, by stab wound). Three patients had positive findings in the digital exploration, which forced to do another diagnostic or therapeutic procedures.

CONCLUSIONS: digital thoracotomy is not considered a formal procedure, but as a part of a technique, in which, the previous exploration with the finger before chest tube insertion, allows to reach a diagnosis of the pleural space situation, to confirm suspicions, to modify a conduct, and to avoid greater morbidity to patients.