Pneumothorax

The Image

Clinical presentation:

Sudden onset of pleuritic pain and breathlessness in a young adult male. Clinical examination reveals reduced breath sounds, but no dullness to percussion.

Features in Image

There is increased density around the hila with a peripheral well-defined margin. The pulmonary vessels are not seen beyond this margin. The right sided density has a cleft which corresponds to the position of the horizontal fissure. On the left side there is a density marking the site of the lingula.

General features in Pneumothorax

No vessel markings beyond extent of collapse. A white line indicates the lung edge. In tension pneumothorax, there may be marked mediastinal shift. This is a surgical emergency.

Diagnosis

Spontaneous Bilateral Pneumothorax.

It sucks to be tall and skinny. Literally.

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