ONLY 100 WORDS
A 22-year-old man who was a known heroin abuser was admitted to an emergency department comatose, with shallow respirations. Routine laboratory studies and chest x-ray studies were done after the patient was aroused. He was then transferred to the ICU. He complained of left-sided chest pain. Examination of the chest film showed three fractured ribs on the right and a large right pleural effusion. Further questioning of a friend revealed that he had fallen and struck the corner of a table after injecting heroin.
The diagnosis was traumatic hemothorax secondary to rib fractures and a chest tube was inserted into the right pleural space. No blood could be obtained despite maneuvering of the tube. Another chest x-ray showed that the tube was correctly placed in the right pleural space, but the fractured ribs and the pleural effusion were on the left. The radiologist then realized that he had reversed the first film. A second tube was inserted into the left pleural space, and 1500 ml. [6 to 7 cups] of blood was evacuated.
Note: The image above is an example and is not the x-ray of this scenario.
1. Using the scenario above, answer the following questions:
A. What did the initial chest x-ray show? Explain the medical terms used.
B. What term indicated that the condition was caused by fractured ribs?
C. What procedure was used to relieve the condition?
D. What is the lesson from this case report?
Follow these guidelines when answering the questions:
A 22-year-old heroin abuser presented to the emergency department comatose with shallow respirations. The initial chest x-ray showed three fractured ribs on the right and a large right pleural effusion. The term indicating that the condition was caused by fractured ribs is traumatic hemothorax. The procedure used to relieve the condition was the insertion of chest tube. In this case, a chest tube was inserted into the right pleural space, but the fractured ribs and the pleural effusion were on the left, which led to the reversal of first film. A lesson from this case report is to ensure accuracy in medical imaging interpretation to avoid diagnostic and treatment errors.
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