Presentation
Presented after being kicked by a horse.
Patient Data
Three orthogonal projections of the thorax are available for review. The lung lobes are mildly retracted from the thoracic wall and the heart is elevated from the sternum. Pleural fissure lines are also noted. Focal alveolar patterns are noted in the right caudal lung lobe. There is a diffuse mild interstitial pattern throughout the lungs. A rounded bulla is present in the right caudodorsal lung lobe. There is complete fracture of the ribs from the 7th to the 11th on the left side and a free fragment is visible associated with the 9th rib on the left side. The cardiovascular structures are within normal limits. Severe soft tissue emphysema is visible in the thoracic wall and axillary region on the left side.
Case Discussion
Bilateral pneumothorax associated with multiple rib fractures and segmental rib fracture of the left 9th rib. The focal alveolar pattern in the right caudal lung lobe is suggestive of severe contusion. Moderate subcutaneous emphysema in the left thoracic wall and axillary region. Pulmonary bulla in the right caudodorsal lung lobe.
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