Presentation
Chest x-ray post emergency trauma laparotomy.
Patient Data
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Multiple displaced right sided rib fractures. Patchy increased density in the right hemithorax is probably due to pulmonary contusion. Despite presence of a right sided intercostal catheter, there is evidence of a sizable residual right pneumothorax with a deep sulcus sign. Packing is seen in the left and right upper quadrants of the abdomen related to the trauma laparotomy. ETT and NGT in situ.
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Resolution of the deep sulcus on subsequent chest x-ray. Presumably the ICC was adjusted or placed on suction to assist drainage.
Case Discussion
An example of the deep sulcus sign of pneumothorax in a supine patient. This is an important chest x-ray sign, as a large volume of pneumothorax may be present in supine patients without a pleural edge being visible.