A 12 years old male involved in a bike accident presents to emergency department with cough, dyspnea and chest discomfort. On evaluation, BP was 130/80 mm Hg, Pulse rate 88/min and respiratory rate 22/min. On auscultation, there was decreased air entry on one side with absent breath sounds. Pulse oximetry shows saturation of 98%. Chest X-ray is given below. Most probable diagnosis is:
A. Left sided pneumothorax with lung collapse
B. Rupture of esophagus compressing the pericardium
C. Flail chest due to fracture of ribs 5, 6, 7 & 8
D. Normal chest X-ray
Ans: A. Left sided pneumothorax with lung collapse
- Probable diagnosis is left sided pneumothorax with lung collapse.
- Traumatic pneumothoraxes can result from penetrating & non-penetrating chest trauma.
- Treated with tube thoracostomy unless it’s very small.
- Type of traumatic pneumothorax becoming more common.
- Transthoracic needle aspiration, thoracentesis & insertion of central intravenous catheterse.
- Supplemental oxygen or aspiration.
- Tube thoracostomy.