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BMJ Case Reports 2012; doi:10.1136/bcr-2012-006358
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Development of a tension pneumothorax despite intercostal drain insertion

  1. Pantelis Vassiliu3
  1. 1Imperial College School of Medicine, Imperial College London, London, UK
  2. 2Department of Faculty of Medicine Nursing and Health Sciences, Monash University, Victoria, Australia
  3. 3Department of Fourth Surgical Clinic, Attikon University Hospital, Athens, Greece
  1. Correspondence to Dr Alasdair James Scott, as703{at}ic.ac.uk

Description

A 21-year-old man presented to a trauma department in Johannesburg with two sucking stab wounds on each side of his posterior thorax. The patient was in respiratory distress with oxygen saturation of 91% on 15 L O2. Blood pressure was 105/72 mm Hg, pulse 112/min and blood gas analysis demonstrated a mixed metabolic and respiratory acidosis.

A left haemopneumothorax was detected clinically although there was no evidence of tensioning. The stab wounds were covered with damp, three-sided dressings and an intercostal drain (ICD) …

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