Tension pneumothorax

Case contributed by Andrew Taylor
Diagnosis certain

Presentation

Motorbike accident. Chest pain and shortness of breath.

Patient Data

Age: 60 years
Gender: Male
x-ray

The left lung is collapsed with mediastinal shift to the right in-keeping with a tension pneumothorax.

There are fractures of the left third, fourth, and fifth ribs posteriorly with associated subcutaneous emphysema.

Fracture of the mid third of the left clavicle.

Post-ICC insertion

x-ray

Left sided intercostal catheter (ICC) in situ. Left pneumothorax remains however the mediastinal shift has resolved.

No residual pneumothorax seen in the second image post repositioning of the ICC. 

Case Discussion

This case demonstrates the classic chest x-ray appearance of tension pneumothorax. Emergency decompression is required. 

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