Pneumothorax

d Tension pneumothorax e Wrong diagnosis d Tension pneumothorax e Wrong diagnosis

Depressed Left Hemidiaphragm

Fig. 14.4d Vascular markings are lacking in the periphery of the right hemithorax (compare to the left hemithorax). The visceral pleura and with it the collapsed lung are appreciated with ease. The right hemidiaphragm is severely depressed, while the mediastinum is displaced to the contralateral side (note the course of the nasogastric tube within the esophagus). Subcutaneous emphysema is present in the right cervical region. The parietal

Fig. 14.4d Vascular markings are lacking in the periphery of the right hemithorax (compare to the left hemithorax). The visceral pleura and with it the collapsed lung are appreciated with ease. The right hemidiaphragm is severely depressed, while the mediastinum is displaced to the contralateral side (note the course of the nasogastric tube within the esophagus). Subcutaneous emphysema is present in the right cervical region. The parietal pleura was probably injured during a vascular puncture. Immediate intervention is necessary! e In this radiograph a rather dense line is visible that is traversed by the pulmonary vasculature—it thus cannot be a pneumothorax. The line is paralleled by a dense stripe of attenuation a few centimeters wide: you are looking at a skin fold. Remember: These bedside patients are resting on the film cassette and not everyone is as well built as you are.

artery. For certain measurements the catheter is wedged into a more peripheral pulmonary arterial vessel and temporarily a small balloon is inflated at its tip. The balloon should be deflated at all other times.

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