Extensive rib plating for flail segment
MVA. Red blanket. Left chest wall injuries. Post op.
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Comparison is made with radiograph performed earlier the same day. AP erect projection.
The tip of the endotracheal tube projects 4.5 cm above the carina. A nasogastric tube projects over the region of the stomach. The tip of the left-sided intercostal catheter projects medially over the left mid-zone. Interval screw and plate fixation of multiple left-sided rib fractures as well as a left clavicular midshaft fracture. Associated subcutaneous emphysema is noted. Subsegmental atelectasis within the left lower lobe. Fracture again noted within the neck of the left scapula.
CT panscan findings:
- Fractures left 1st-10th ribs with multiple ribs significantly displaced and fractured in two locations, with radiological flail.
- Non displaced fracture left scapula and left clavicle.
- Left sided hemopneumothorax (ICC in situ) and multifocal left lung lacerations with lower lobe/lingula consolidation.
- Status post splenectomy with drain in situ LUQ.
- Fluid/hemoperitoneum LUQ, right abdomen (adjacent to the ascending colon and proximal duodenum) and pelvis.
- Suspected bowel injury at the hepatic flexure with a small hyperdensity in the bowel wall. Post surgical pneumoperitoneum.
- Superficial (AAST grade 1) hepatic segment 2 laceration.