By Oli Flower
These are images from real ICU patients. The stories and details are changed to preserve confidentiality.
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70 year old man 2 days after cardiothoracic surgery
His chest drains were removed earlier in the day
An AP semi erect chest X-ray is taken
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The blue arrows show a band of linear atlectasis that at first glance gives the appearance of air under the diaphragm
This was not the case as became evident in subsequent films
This distracts from a more important diagnosis: a pneumothorax (red arrows)
There was no respiratory compromise and the pneumothorax was managed conservatively
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British Thoracic Society Guidelines on Management of Pneumothorax
Lots of great pneumothorax images
A video showing one approach to inserting a formal chest drain for a pneumothorax
A video showing a Seldinger technique for insertion of a chest drain
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