CXR Case 008
40 year old male presents to emergency in severe respiratory distress and is intubated on arrival.
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There is complete white out of the left lung caused by pneumonia (air bronchograms mid zone).
* There is partial volume loss with collapse because the right heart border and trachea have shifted to the left. *
There is a large bore chest drain in situ on the left.
*ETT (probably a bit too proximal) and NG tube also present*
CLINICAL CORRELATION
Severe pneumonia can rarely cause secondary pneumothorax.
CLINICAL PEARLS
Most pneumothoraces do not require a large bore drain, 12-14F may well be adequate.
TOP 150 CXR SERIES
Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar | ICIS Course ANZ
2 Comments
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I think the tracheal shift described here belongs to case 007
Thanks Stefan – I take your point although in this case the whole mediastinum is shifted to the left – not too pronounced for the trachea, but it isn’t normal!