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Blunt chest trauma (Swiss cheese sign)

Case contributed by Domenico Nicoletti
Diagnosis certain

Presentation

Road trauma. GCS15. Chest clinical examination: right breath sounds significantly reduced.

Patient Data

Age: 17 years
Gender: Male

Right pneumothorax secondary to rib fractures with contralateral mediastinal deviation. In the right upper lobe are three large parenchymal lacerations (pneumatocele) filled with blood; other small parenchymal lacerations are present in the right upper lobe and in the apical segment of the lower lobe of the same side (Swiss cheese sign).

Pulmonary contusions are seen in the right lung and in the apical segment of the lower lobe. Small right hemothorax.

Case Discussion

Usually pneumatoceles have a benign course. In the case of superinfection surgery may be indicated. 

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