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Case 3 - Pneumothorax with Tension

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0:01

And this is another companion case.

0:02

And so, again, when we look at the lung fields,

0:05

we see a paucity of lung markings here in the left lung with a totally

0:09

collapsed left lung here along the mediastinum. We do see lung markings along the right.

0:16

But different from the other cases that we've discussed,

0:18

when we look the midline structure,

0:20

so the airway, and line it up along the spine, it's off center.

0:24

So here, we also see that the distance

0:27

between the ribs is actually a little asymmetric.

0:30

So this is a case where we do have a very large pneumothorax with tension, pushing

0:35

structures, midline structures to the right.

0:38

So again, in terms of the work that we normally do,

0:40

we will measure our apical air gap and we're getting about twelve to 13cm.

0:47

We can also get the lateral aspect which measures another 4.5cm.

0:53

So we have large tension pneumothorax pushing things to the right.

0:57

We also want to make sure that we remember to look at our other structures.

1:01

So we've talked about the airway. Looking at the heart,

1:04

it's not enlarged, but it is obscured and a little bit hard to find,

1:08

in terms of the silhouettes and the shadows, given everything that's going on.

1:11

We'll take a look at the osseous structures, so we want to make sure

1:15

that we're looking at the ribs, that they are intact.

1:18

Take a look at the clavicles,

1:20

the shoulders, the scapula, the visualized portions of the humerus,

1:26

and make sure we're looking at the soft tissues

1:28

and below the diaphragm. Everything else looks fine.

1:32

Large left tension pneumothorax, this is an example.

Report

Faculty

Jamlik-Omari Johnson, MD, FASER

Chair, Department of Radiology

University of Southern California

Tags

X-Ray (Plain Films)

Trauma

Syndromes

Pleural

Mediastinum

Lungs

Infectious

Idiopathic

Iatrogenic

Emergency

Chest

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