CASE REPORT
Tension pneumothorax and the "forbidden CXR"
1 Emergency Department, The Royal Infirmary, Edinburgh, UK
2 Defence Medical Services, Gosport, UK
Correspondence to:
Correspondence to:
Mr S Leigh-Smith
c/o, Institute of Naval Medicine, Monckton House, Alverstoke, Gosport PO12 2DL, UK; simonlsuk{at}aol.com
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.
Abbreviations: CT, computed tomography; CXR, chest x ray
Keywords: pneumothorax; tension
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