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Basal pneumothorax

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Intercostal nerve block yesterday. Prior pectus excavatum repair. Pneumothorax concern

Patient Data

Age: 30 years
Gender: Female

One year earlier

x-ray

Nuss repair.

Heart size normal.  Lungs clear.

x-ray

Nuss repair of pectus excavatum.

Lucent at the left base with a deep costophrenic sulcus.

Heart size normal.  Right lung clear.

Case Discussion

One could miss this pneumothorax with the distraction from the extensive and to many unfamiliar Nuss repair of a pectus excavatum chest deformity as well as its purely based location.

The radiograph from one year prior is for reference to appreciate the then normal left costophrenic recess.

Also a pretty nice fellowship viva radiograph for observation and discussion of several topics.

With thanks to Dr Heather Harris, Chesterfield Royal, UK.

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