Teaching image withheldThe image will be revealed when it becomes clinically available in the case.
Axial contrast-enhanced CT of the chest obtained after initial resuscitation, showing extensive right-sided subcutaneous emphysema, a right thoracostomy tube, right pneumothorax and hemothorax with adjacent pulmonary contusion or laceration, and bilateral dependent air-space opacities. • TEACHING IMAGE
Crushed Chest After High-Speed MVC: CT-Defined Thoracic Injury
SCENARIO
A restrained adult is brought after a high-speed MVC with a crushed chest. On arrival, there is marked chest-wall crepitus and subcutaneous emphysema, and the patient is intubated in the trauma bay. The patient is tachycardic but initially maintains blood pressure after blood products and controlled ventilation are initiated. After immediate trauma-bay reassessment and pleural decompression as clinically indicated, a right thoracostomy tube is placed. Oxygenation and blood pressure remain temporarily adequate, so the patient undergoes contrast-enhanced CT of the chest as part of the trauma CT evaluation. The uploaded CT image is now available for interpretation.