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Tension pneumothorax and the “forbidden CXR”
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  1. R McRoberts1,
  2. M McKechnie1,
  3. S Leigh-Smith2
  1. 1Emergency Department, The Royal Infirmary, Edinburgh, UK
  2. 2Defence Medical Services, Gosport, UK
  1. Correspondence to:
 Mr S Leigh-Smith
 c/o, Institute of Naval Medicine, Monckton House, Alverstoke, Gosport PO12 2DL, UK; simonlsukaol.com

Abstract

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.

  • CT, computed tomography
  • CXR, chest x ray
  • pneumothorax
  • tension
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Footnotes

  • Funding: none.

  • Competing interests: none declared

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