Clinical history
A 64-year-old man was burried under a pallet laden with heavy bags. Primary survey showed a normal breathing frequency and oxygen saturation, but decreased breathing sounds and tenderness to palpation across the right hemithorax. There were no circulatory or neurological problems. Secondary clinical examination showed evidence for luxation of the right shoulder and fracture of the right femur.
Radiological images
Radiological findings
CT images
CT findings
(1) Coronal reformatted MDCT confirmed the presence of a mediastinal haematoma (asterisk) and multiple displaced rib fractures (black arrows), (2) and also demonstrated rupture of the aortic arch (white arrow)…
(3) Images obtained in lung window setting confirmed pulmonary contusion, subcutaneous emphysema, and also demonstrated bilateral pneumothorax in addition to pre-existent pulmonary bullae (asterisk), (4) haemothorax (asterisk) and fractures of the scapula, sternum and thoracic spinous processes (not shown).
Extra examinations
No EXTRA EXAMINATIONS for this particular case.
Final diagnosis
High-energy crush trauma to the chest with: aortic rupture for which the patient was treated with an endovascular stent procedure bilateral pulmonary contusion, haemothorax, pneumothorax, displaced rib fractures.
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