After blunt trauma to the chest, a man suffers several left-sided rib fractures. He has pain when he tries to inhale or exhale. On assessment he is exquisitely sensitive to percussion of the left side of the chest, where a dull sound is heard. A chest x-ray shows fluid in the pleural space, but no collapse of the lung, no displacement of the trachea, and no elevation of the diaphragm. This patient has suffered which of the following injuries?

Question

Quizplus · Accepted Answer

The liver is on the right side of the abdomen. It is unlikely to be injured during left-sided chest trauma. There is no collapse of the lung or displacement of the trachea on the chest x-ray described in this question: these findings rule out pneumothorax or tension pneumothorax. The fluid in the patient's pleural space is likely hemorrhagic: a hemothorax.

After Blunt Trauma to the Chest, a Man Suffers Several