Imaging Case of the Week 179

The following chest x-ray is from a 40 year old with right sided chest pain and dyspnoea. This x-ray has been taken the day after patient has had a chest drain insertion. What can be seen?

 

PA chest x-ray

Answer will be posted on 18/11/2015.

 

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One thought on “Imaging Case of the Week 179

  1. R hydropneumothorax. chest drain in an unusual position, does not appear to have been inserted laterally. curled back on itself at the end but not in a way that suggests it is a pigtail catheter. no definite kinking identified.

    ddx: blocked ICC (eg inspissated secretions or ICC too narrow if exudate or blood is being drained)
    kinked ICC (internally or externally)
    underwater seal drain not attached properly
    ICC in s/c tissue not pleural space – (r/v films from time of insertion & technique of insertion).

    If ICC cannot easily be unkinked or unblocked, needs new ICC left midaxillary line 5th intercostal space confirming finger through to pleura.

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