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The X-ray was done immediately after his arrival in the ER.
The left atelectasis/pleural effusion is replaced with an extensive pneumothorax involving the entire white lung, which extends through a left costal defect. The mediastinum is in a normal position. The posterior sixth rib is transversely fractured and inferiorly displaced.
The findings are highly suspicious of a bronchopleural fistula in this postoperative patient.