Left lung atelectasis caused by right main bronchus intubation

Case contributed by Dr Balint Botz

Presentation

In ICU after an MVA sustained a few days earlier. Reduced oxygenation.

Patient Data

Age: 40
Gender: Female
X-ray

Supine AP CXR (mobile unit)

  • The ETT tip arches into the right main bronchus. As a consequence the transparency of the left hemithorax is markedly reduced, due to resultant atelectasis. For a supine CXR like this pleural effusion is an important differential diagnosis. The marked shift of the mediastinum to the left confirms that air space collapse is the main contributor to the reduced transparency. 

Other findings:

  • Diffuse bilateral air space opacities represent prior lung contusion
  • Multiple rib fractures (right), bilateral clavicle and right scapular fracture.
  • Right subclavian CVC in a normal position.
Annotated image

Rewindowed, magnified key image

The image highlights the position of the ETT tip in relation to the carina (arrow).

Case Discussion

Typical presentation of endobronchial intubation and its sequelae. 

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Case information

rID: 63575
Published: 9th Oct 2018
Last edited: 9th Oct 2018
System: Chest
Inclusion in quiz mode: Included
Institution: University of Pécs

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