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Tension pneumothorax

Case contributed by Dr Derek Smith ◉

Diagnosis certain

Diagnosis certain

Presentation

Sudden onset pleuritic chest pain, with progressive dyspnoea leading to presentation at hospital. Reduced air entry on right side, with hyper-resonance on examination. Reduced saturations on room air. Ex-smoker. No significant respiratory history.

Patient Data

Age: 45

Gender: Female

From the case: Tension pneumothorax

X-ray

Frontal

There is a large right sided pneumothorax.

The trachea is central, however there is early mediastinal shift with rib splaying on the right.

No displaced rib fractures.

2 case question available

From the case: Tension pneumothorax

X-ray

Frontal

Right sided intercostal drain in situ.

Re-expansion of the lung with normal lung volume.

1 case question available

Case Discussion

Spontaneous pneumothorax with early signs of tensioning.

This was quickly recognized by the clinical team who treated this with insertion of an intercostal chest drain. This is appropriately oriented to the apex of the lung.

4 public playlist includes this case

Case information

rID: 40127

Published: 10th Oct 2015

Last edited: 14th Aug 2019

System: Chest

Tag: tension pneumothorax, cxr, emergency medicine, chest drain

Case of the day: 10 Dec 2015

Inclusion in quiz mode: Included

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