Presentation
Fall from 3 stories.
Patient Data
Left pneumothorax with deep sulcus sign on the left, despite ICC, consistent with a persistent pneumothorax.
Bilateral moderate pneumothoraces, with bilateral intercostal catheters in situ.
Extensive bilateral pulmonary opacity, predominantly centered in the right middle and bilateral lower lobes consistent with pulmonary contusions.
A traumatic haemopneumatocoele is identified within the posterior basal segment of the left lower lobe.
There is a small amount of gas tracking within the posterior mediastinum. Small right hemothorax.
Minimally displaced fracture through the spine of the left scapula. Left second rib fracture.
Case Discussion
Deep sulcus sign is one of pneumothorax on supine radiographs as air collects in the most antedependent (i.e. antero-inferior) aspect of the pleural cavity. In this case, the sign is still present despite decompression with an ICC.
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