Herein, we present the case of a 45-year-old female suffering from a motor vehicle accident who developed Grade IV liver laceration complicated with intra-abdominal hemorrhage and right-sided fractures from the fourth to the ninth rib, which required preventive CTI for potential hemopneumothorax
. In the emergency department, misplacement of the chest tube during the first insertion attempt, which was observed by computed tomography (CT), led simultaneously to diaphragmatic penetration.
A follow-up chest and abdomen CT showed resolution of the right hemopneumothorax
, a healing liver injury, and right diaphragmatic eventration, with no radiological evidence of a hernia.
While some of the patients also had additional system injuries, also multiple chest injuries (flail chest, hemopneumothorax
, lung contusion, etc.) were found in a single patient.
Clinical signs Findings n % Pneumothorax 58 65 Hemopneumothorax
22 25 Hemothorax 9 10 Total 89 100 Table 4.
In our reported case, the addition of chest CT in order to confirm the presence of hemopneumothorax
allowed inferring the oblique route of the stab wound through the findings of subcutaneous hematoma on the entry site and emphysema over the contralateral chest muscle tissue.
He was diagnosed with a depressed skull fracture, acute epidural hematoma, left hemopneumothorax
that required placement of a thoracostomy tube, massive subcutaneous emphysema, left coracoid process fracture, left scapula body fracture, and type III superior dislocation of the left ACJ.
The following injuries were diagnosed in the primary survey: fractures of the sixth through eighth and eleventh thoracic vertebrae, complete paraplegia below T7, a fracture of the first lumbar vertebra, serial rib fractures, a lung contusion, a right-sided hemopneumothorax
, and pancreatic injury.
For example, hemopneumothorax
, which does not initially occur after a rib fracture but is due to fracture fragments of the rib puncturing the lung and pulmonary vessels, is a derived injury.
Frisch thought the post about giving someone a hemopneumothorax
Symptoms of cardiac perforation vary, including extracardiac muscle stimulation, chest pain, shortness of breath due to pneumothorax, and hemothorax, hemopneumothorax
, pneumomediastinum, and/or pericardial tamponade .
Because of hemopneumothorax
, multiple rib fractures, and pulmonary contusions, severe acute respiratory distress syndrome developed, and the patient was treated with venovenous extracorporeal membrane oxygenation for 3 days.
Post-procedure chest x-ray revealed no hemopneumothorax