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Traumatic pneumothoraces may be classified as "open" or "closed". In an open pneumothorax, there is a passage from the external environment into the pleural space through the chest wall. When air is drawn into the pleural space through this passageway, it is known as a "sucking chest wound". A closed pneumothorax is when the chest wall remains ...
Chest x-ray is the first test done to confirm an excess of pleural fluid. The lateral upright chest x-ray should be examined when a pleural effusion is suspected. In an upright x-ray, 75 mL of fluid blunts the posterior costophrenic angle. Blunting of the lateral costophrenic angle usually requires about 175 mL but may take as much as 500 mL.
Chest x-ray demonstrating severe atelectasis or collapse of the right lung and mediastinal shift towards the right. Atelectasis is the partial collapse of a lung that is reversible. There are numerous etiologies, including post-operative atelectasis, surfactant deficiency, mucus plugging, and foreign body aspiration.
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AP chest x-rays are harder to read than PA x-rays and are therefore generally reserved for situations where it is difficult for the patient to get an ordinary chest x-ray, such as when the patient is bedridden. In this situation, mobile X-ray equipment is used to obtain a lying down chest x-ray (known as a "supine film").
During inspiration, only subtle pneumothorax is seen in the apical part of the left thoracic cavity. It can practically be diagnosed only by the absence of vascularity in the most apical lung segment. It is seen more clearly posteriorly on lateral X-ray. During expiration, the pneumothorax takes up approximately 50% of the cavity.
The doctor injects a local anesthetic into the area of the chest wall outside where the fluid is. A plastic tube is then inserted into the chest between two ribs. The tube is connected to a box that suctions the fluid out. A chest x-ray is taken to check the tube's position. A chest tube is also used to drain blood and air from the pleural space.
Treatment for this condition is the same as for hemothorax and pneumothorax independently: by tube thoracostomy, the insertion of a chest drain through an incision made between the ribs, into the intercostal space. A chest tube must be inserted to drain blood and air from the pleural space so it can return to a state of negative pressure and ...