CXR Case 008

40 year old male presents to emergency in severe respiratory distress and is intubated on arrival.

CXR CASE 008 LITFL

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

    • 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!

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