Presentation
Fell from standing height.
Patient Data
Age: 75 years
Gender: Male
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Info
The inferior portion of the azygos vein is hypoplastic, with a compensatory increase in size of the hemiazygos vein. A pneumothorax is seen extending under the fissure of an azygos lobe. Air is also seen outlining the azygoesophageal recess.
There is moderate hydropneumothorax with multiple rib fractures and subcutaneous emphysema.
Case Discussion
Despite azygos lobes occurring in up to 1% of people, reports of pneumothorax in patients with such variant anatomy are surprisingly rare 1-3. The pneumothorax here helps appreciate the anatomy of the azygos vein connecting with the superior vena cava, drawing down with it a thick double layer of pleura.
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