Article Text

Download PDFPDF
CASE REPORT
Traumatic haemopneumothorax and ‘whole-body’ subcutaneous emphysema: successful use of a small-bore chest drain
  1. Benjamin Hardy,
  2. Nicholas Sunderland,
  3. Mevan Perera,
  4. Kathryn Channing
  1. Croydon University Hospital, Croydon, UK
  1. Correspondence to Dr Nicholas Sunderland, nicholas.sunderland{at}nhs.net

Summary

A 56-year-old man presented having had two falls at home. He had a background of multiple sclerosis. After his second fall, during which he had fallen onto the toilet injuring his right chest, he was brought into the emergency department reporting pleuritic chest discomfort. Immediately evident was extensive swelling from his forehead to his thighs, which on palpation was found to be subcutaneous emphysema. A chest X-ray showed a large right-sided pneumothorax for which a chest drain was inserted. A CT revealed extensive surgical emphysema, pneumomediastinum, pneumoperitoneum and gas within the spinal canal. It also showed right-sided rib fractures and associated haemothorax. He was managed conservatively with a 12-French (F), small-bore, chest drain and made a complete recovery without complication. This case challenges the widely held, but poorly evidenced, opinion that traumatic haemopneumothorax needs to be managed with a large-bore surgical chest drain.

View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors BH and NS wrote and prepared the article. KC and MP edited and supervised the project.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.