Presentation
Breathless and left sided chest pain, following a 'popping' sensation in his chest the previous day.
Patient Data
Large left sided pneumothorax, with tracheal deviation and mediastinal shift to the right. Flattening of the left hemidiaphragm. Appearances in keeping with left tension pneumothorax.
Improved appearances following needle aspiration and left intercostal chest drain insertion. Small residual apical pneumothorax on the left. Left basal atelectasis.
The trachea/mediastinum is no longer deviated to the right.
Case Discussion
A left sided tension pneumothorax, arguably the patient should have never had this X-ray! Thankfully, he underwent needle aspiration immediately after this radiograph was taken and following this, insertion of intercostal chest drain.