Hemopneumothorax secondary to rib fractures

Case contributed by Dr Alborz Jahangiri

Presentation

Fall and trauma to the left side of the chest. Pain and shortness of breath since the accident.

Patient Data

Age: 70 years
Gender: Male

There is evidence of displaced left 5th to 10th rib fractures. Flail segments are noted of the 5th - 9th ribs. There is an associated moderate left pleural effusion. There is a small apical pneumothorax identified (measures approximately 5 mm at the apex). Surgical emphysema is noted overlying the fractures.

There is a moderate left pleural effusion; the largest AP dimension is 3 cm. There is left lower lobe atelectasis with air bronchograms present. There is a small left pneumothorax; the largest AP dimension is 11 mm at the base anteriorly. There is atelectasis also noted in the right lower lobe. There are multiple fractures noted on the left, the 5th to the 10th ribs. There are flail segments of the fifth to the ninth ribs with displacement of the 5-7th flail rib segments medially. There is associated surgical subcutaneous emphysema on the left. 

There is also a small diaphragmatic hernia in the left mid diaphragmatic cupula containing intra-abdominal fat.

 

Case Discussion

Traumatic hemopneumothorax secondary to rib fractures. There is no evidence of mediastinal displacement.

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