Endotracheal tube in bronchus intermedius
Car accident. Reduced GCS. Intubated.
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No abnormality is seen on the initial chest x-ray prior to intubation.
On the first post ETT x-ray the tube tip is within the right bronchus intermedius and there is evolving collapse of the right upper lobe and entire left lung as evidenced by volume loss and increased density compared to the right lower and middle lobes.
On the second post ETT x-ray the tube tip has been retracted less than 2 cm and is now within the right main bronchus. There is some re-expansion of the right upper lobe seen.
Finally by the fourth post ETT x-ray the tube has been retracted to the point where it is appropriately positioned within the trachea and there is re-expansion of the left lung.
An example of collapse of the right upper lobe and left lung in evolution due to inadvertent right bronchus intermedius intubation.