Management of asymptomatic patients following stab wounds to the chest

A patient with stab wounds to the chest may have negative physical findings, and normal radiologic examinations and still develop delayed pneumothorax or hemothorax. The frequency and time intervals of these complications have not been established. One hundred ten asymptomatic patients with chest stab wounds were prospectively studied. All patients had normal chest radiographs on initial evaluation. Ten patients (9%) developed a delayed pneumothorax or hemothorax. Careful radiologic examination using inspiratory and expiratory chest films revealed all positive findings by 6 hours postadmission. Asymptomatic patients with chest stab wounds can be safely managed without hospitalization.