We have located links that may give you full text access.
Mediastinal evaluation utilizing the reverse Trendelenburg radiograph.
American Surgeon 1999 May
When thoracic aortic rupture is suspected, a 45-degree reverse Trendelenburg (RT) anteroposterior (AP) chest radiograph should place the mediastinal structures in a more appropriate position and allow a more accurate evaluation than a supine AP radiograph. One hundred ninety-one consecutive hemodynamically stable adult patients with major blunt thoracic trauma were initially evaluated for mediastinal abnormalities associated with aortic disruption by both supine AP chest radiograph and an AP chest radiograph with the patient in 45-degree RT position. One hundred four patients underwent contrast aortography based on mediastinal abnormalities detected on the supine AP chest radiograph. Twenty of these patients had abnormal aortograms demonstrating traumatic aortic disruption confirmed at surgery. Supine and RT chest radiographs were retrospectively compared in a blinded fashion to evaluate their specificity and positive predictive value for detection of traumatic thoracic aortic rupture. If RT chest radiographic findings had been used to determine the need for further assessment, 29 angiograms (26%) would have been eliminated, specificity would have increased from 52 per cent to 69 per cent, and positive predictive value would have increased from 19 per cent to 27 per cent. Both supine and RT chest radiographs demonstrated mediastinal widening in all 20 patients with abnormal aortograms, with no missed thoracic aortic disruptions (100% sensitivity). This study indicated that the RT chest radiograph may be used instead of the standard supine radiograph as the initial screen for mediastinal evaluation, maintaining a high sensitivity and eliminating the cost and morbidity of many unnecessary aortograms.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app