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Ginkgo leaf sign

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Admitted following thoracic trauma 2 days prior. Expanding thorax and crepitus.

Patient Data

Age: 46
Gender: Male
x-ray

Extensive bilateral surgical emphyesema throughout the visualized soft tissues of the chest and neck.

It is more pronounced on the left with the air tracking between the fibers of the pectoralis major muscle, giving the appearance of a Gingko leaf.

Case Discussion

The ginkgo leaf sign (of subcutaneous emphysema) is a radiographic appearance identified with severe subcutaneous emphysema of the chest wall. Air outlines the fibers of the pectoralis major muscle and forms a streaky pattern that is like the branching pattern in the veins of a ginkgo leaf.

Ginkgo biloba (aka the maidenhair tree) is a tree native to China and is used in traditional medicines.

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