Another complication of facial trauma

aka Trauma Tribulation 002

A 27 year old male with head and extensive facial trauma is admitted to the intensive care unit after a neurosurgical intervention for an acute subdural haemorrhage. There has been difficulty with oxygenation in the operating theatre.

Trauma Tribulation 002 Arrival
CXR 1: performed at the time of admission to ICU
Trauma Tribulation 002 post procedure
CXR 2: performed after a therapeutic intervention.


Q1. Describe chest X-ray 1.

Answer and interpretation

There is an ETT in appropriate position and an orogastric tube in an appropriate position.

There is right upper lobe collapse.

The left lung is significantly hyperinflated due to the provision of a large amount of PEEP.

Q2. What is the diagnosis?

Answer and interpretation

There is right upper lobe collapse which in the context of the history provided is likely to be due to a blood clot in the right upper lobe bronchus.

Q3. What therapeutic intervention was performed?

Answer and interpretation

A bronchoscopy was performed to suck the clot out of the right main bronchus leading to subsequent reinflation of the right upper lobe.


Trauma Tribulation

Intensivist in Wellington, New Zealand. Started out in ED, but now feels physically ill whenever he steps foot on the front line. Clinical researcher, kite-surfer  | @DogICUma |

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