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Image challenge
Air in the lung: can you spot them?
  1. Cho-Han Chiang1,
  2. Cho-Hung Chiang2,
  3. Cho-Hsien Chiang3
  1. 1 Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
  2. 2 Department of Medicine, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan
  3. 3 School of Medicine, Chung Shan Medical University, Taichung, Taiwan
  1. Correspondence to Dr. Cho-Han Chiang, Department of Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; b02401124{at}ntu.edu.tw

https://doi.org/10.1136/emermed-2019-208657

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    Clinical Introduction

    A 26-year-old man presented to our emergency department with a dull, pleuritic chest pain after being shot on the chest during a football match. The pain radiated to the back and was exacerbated by coughing. Shortness of breath was noted.

    On examination, the patient was found to have a high-pitched voice and crepitus over the neck and clavicles. Chest expansion was symmetrical and the lung was clear bilaterally. There was no hyper-resonance on percussion. A crunching sound during systole was auscultated over the precordium. The …

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    Footnotes

    • Contributors C-HaC wrote the manuscript. C-HuC and C-HsC prepared the images and edited the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.