Hydropneumothorax

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Penetrating trauma to the left hemithorax. Short of breath.

Patient Data

Age: 17 years
Gender: Male

Erect CXR

x-ray

Hydropneumothorax on the left. The gas-fluid level extends across the entire left thoracic cavity. Superior to this, the hemithorax is relatively hypertransradiant and the pleural margin is seen as a thin line roughly parallel to the chest wall.

Case Discussion

Erect positioning is optimal for diagnosis of hydropneumothorax as the gas-fluid level is tangential to the horizontal x-ray beam. The gas-fluid level extends across the thoracic cavity from wall to wall.

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