Original ArticlesPrevalence of Tension Pneumothorax in Fatally Wounded Combat CasualtiesMcPherson, John J. MS; Feigin, David S. MD; Bellamy, Ronald F. MD, FACSAuthor Information From the Departments of Military and Emergency Medicine (J.J.M.), Radiology and Radiological Sciences (D.S.F.), and Surgery (R.F.B.), Uniformed Services University of the Health Sciences, Bethesda, Maryland. Submitted for publication December 10, 2004. Accepted for publication May 19, 2005. The views expressed are those of the authors and do not necessarily reflect those of the authors' institutions, the Department of Defense, or the US government. Supported in part by an undergraduate research grant from the Uniformed Services University of the Health Sciences. An abstract based on the paper was presented at the 26th Annual Gary P. Wratten Army Surgical Symposium, April 19, 2004, Walter Reed Army Medical Center, Washington, DC. Address for reprints: Ronald F. Bellamy, MD, FACS, Borden Institute, Delano Hall, Building 11, Rm #1–117, Walter Reed Army Medical Center, 6900 Georgia Ave, NW, Washington, DC 20307-5001; email: [email protected]. The Journal of Trauma: Injury, Infection, and Critical Care: March 2006 - Volume 60 - Issue 3 - p 573-578 doi: 10.1097/01.ta.0000209179.79946.92 Buy Metrics Abstract Background: Tension pneumothorax is a potential cause of death in victims of penetrating chest trauma, but little is known about its actual prevalence. Methods: Data that are part of the Vietnam Wound Data and Munitions Effectiveness Team study were analyzed to address this question. Radiographs of 978 casualties were examined for evidence of tension pneumothorax using standard radiologic criteria such as pleural separation, displacement of the mediastinum and diaphragm, trachea deviation, and compression of the contralateral lung Results: Some or all of the radiographic changes were found in 198 casualties. Autopsy evidence indicated that 79 of these casualties died solely due to a chest wound. The fatal chest injury involved only the lungs in 55 casualties and caused a tension pneumothorax in 26. Fifteen of the 26 lived long enough to receive first aid from a medic or corpsman. Conclusion: Tension pneumothorax was the cause of death in 3 to 4% of fatally wounded combat casualties. Some may be temporarily helped by battlefield thoracentesis. © 2006 Lippincott Williams & Wilkins, Inc.