X-ray Conference
OK, I'm stumped.
Anyone can tell me what's wrong with this X-ray?
posted by angry doc at
9:07 pm
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This blog is not a substitute for medical advice. If in doubt consult your physician.
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- Name: angry doc
- Location: Singapore
Works like no one's paying him, blogs like no one's reading, and hurts like he'll never be loved.
Recent Comments
2 Comments:
A very curious CXR. Given the history supplied, of sudden onset chest pain, effusion and then pneumothorax, followed by tension pneumothorax, I'm thinking:
- sudden onset suggests acute event such as rupture of a viscus or tube
- effusion + pneumothorax --> rapid onset suggests it is not reactive in nature but direct transit of contents. this narrows it down to either a communication with [a] a viscus containing fluid and air, or [b] two visci, each containing fluid or air.
- tension pneumothorax --> one-way valve effect?
my initial thought were oesophageal transection, but this would not produce this much fluid [?]. but i haven't seen a oesophageal transection before, so maybe this is just b.s.
hazarding a guess, maybe a strangulated or infected hiatus hernia that subsequently eroded/ruptured into the pleural cavity? thus stomach contents would be present, as well as air. I am harder pressed to explain the tension pneumothorax though, since the stomach only has a fixed volume.
okay, will give up now. :)
By
Anonymous, At
September 20, 2005 5:48 pm
What wouldn't go with the oespphagus is that you'd expect a pneumomediastinum and not a tension.
Stomach bubble isn't there...
I'm waiting for the answer myself.
By
angry doc, At
September 20, 2005 5:56 pm
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