Presentation
Toppled to the right side. She subsequently experienced thoracic tenderness and mild shortness of breath.
Patient Data
Fractures of the right ribs 3-8 with obvious displacement of the 5th and 6th ribs. The thin pleural line and the lack of the pulmonary vessels in the right apex are clearly visible reflecting a pneumothorax. Subcutaneous emphysema of the thoracic wall.
The zoomed view clearly demonstrates the thin pleural line and the lack of the pulmonary vessels in the right apex.
After insertion of a thoracic drain, there is partial resolution of the pneumothorax. Additionally, there is a small pleural effusion and progressive subcutaneous emphysema of the thoracic wall.
Case Discussion
The first x-rays taken in the ED reveal multiple, partially displaced rib fractures and a pneumothorax on the right side.
After insertion of a thoracic drain, felt necessary due to the multiple fractures, progressive shortness of breath and the presence of pleural space air, the pneumothorax has partially resolved.
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