Deep sulcus sign of supine pneumothorax

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Motor vehicle collision. Intubated.

Patient Data

Age: 45 years
Gender: Male

Deep sulcus sign on the left in keeping with a large left pneumothorax.

Right apical pleural capping and widening of the superior mediastinum.

ETT and bilateral pneumocatheters.

Malpositioned nasogastric tube located in the mid esophagus.

Bilateral pneumothoraces moderate to large on the left and small on the right. Bilateral pneumocaths, within the pneumothorax on the left, and within the right upper lobe on the right. Bilateral rib fractures. 

Superior mediastinal hematoma extending as bilateral extrapleural hematomas at the apices related to thoracic spine fractures. No evidence of a traumatic aortic injury within the limitations of a non- gated scan.

Case Discussion

Typical appearances of a large pneumothorax on a supine chest radiograph. 

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