Tension pneumothorax and the "forbidden CXR".
A case is presented of unilateral tension pneumothorax associated with flail chest and pulmonary contusions in a spontaneously ventilating patient after a fall. The tension element was not suspected until chest x ray was available, nor was immediate needle thoracocentesis performed. No morbidity resulted as a consequence. This case highlights the difficulty in deciding whether or not tension pneumothorax is the predominant cause of respiratory distress in a patient with multiple chest injuries. It provides further evidence challenging some of the doctrine on how to treat suspected tension pneumothorax.
McRoberts
R
R
Emergency Department, The Royal Infirmary, Edinburgh, UK.
McKechnie
M
M
Leigh-Smith
S
S
D000058:Accidental Falls; D005409:Flail Chest / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D011030:Pneumothorax / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D011859:Radiography; D012131:Respiratory Insufficiency / Q000209:etiology; D013907:Thoracostomy