Presentation
Man versus propeller
Patient Data
There is extensive subcutaneous emphysema on the right aspect of the chest, alongside an obvious soft tissue defect. Pneumomediastinum extending into the neck with a paratracheal stripe.
Ribs 4-8 of the right side are fractures, with 5-8 are comminuted with anterior displacement; some of these bone fragments are resting on the adjacent lung.
Subcutaneous emphysema is seen in the neck, hemithorax of the right side and the lateral portion of the lateral wall of the abdomen.
The pneumomediastinum seen in the CXR is mostly superior.
Right sided pneumothorax and tiny hemothorax.
Small contusions of the right lower and upper lobe.
Case Discussion
Subcutaneous emphysema will be absorbed over time by the body, it is the associated injuries that have cause the subcutaneous emphysema that can be problematic. In this particular case, it was via a boat propeller injury to the right thorax.
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