A 59-year-old man with a cardiac history was seen after a collapse e.c.i. This patient was found in the bathroom by his partner and was unable to tell what had happened. At physical examination, oxygen saturation was 97% without any other (respiratory, circulatory, and neurological) abnormalities.

Participation

Evidence of a previous median sternotomy. At initial interpretation: no (other) abnormalities.

Requirements

MDCT performed after 2 hours to exclude pulmonary embolism demonstrated a large pneumothorax and three rib fractures (not shown). In retrospect, separation of the left visceral pleura from the chest wall could already be identified on chest X-ray.

Extraexaminations

No EXTRA EXAMINATIONS for this particular case.

Requirements

Patient who had a high-energy collision resulting in: rib fractures and a secondary pneumothorax that was treated with a chest drain.

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