ONLY 100 WORDS
SCENARIO
A 22-year-old man who was a known heroin abuser was admitted to an emergency department comatose, with shallow respirations. Routine laboratory studies and chest x-ray studies were done after the patient was aroused. He was then transferred to the ICU. He complained of left-sided chest pain. Examination of the chest film showed three fractured ribs on the right and a large right pleural effusion. Further questioning of a friend revealed that he had fallen and struck the corner of a table after injecting heroin.
The diagnosis was traumatic hemothorax secondary to rib fractures and a chest tube was inserted into the right pleural space. No blood could be obtained despite maneuvering of the tube. Another chest x-ray showed that the tube was correctly placed in the right pleural space, but the fractured ribs and the pleural effusion were on the left. The radiologist then realized that he had reversed the first film. A second tube was inserted into the left pleural space, and 1500 ml. [6 to 7 cups] of blood was evacuated.
Note: The image above is an example and is not the x-ray of this scenario.
1. Using the scenario above, answer the following questions:
A. What did the initial chest x-ray show? Explain the medical terms used.
B. What term indicated that the condition was caused by fractured ribs?
C. What procedure was used to relieve the condition?
D. What is the lesson from this case report?
Follow these guidelines when answering the questions:
- Use a maximum of 100 words.
- Be clear, concise and well organized using as many pertinent medical terms as possible.
- Be free of grammatical, mechanical, and format errors.
- Be in your own words (do not copy text directly from a website, text, or other reference materials) and contain citations from all sources used.
Expert Solution Preview
A. The initial chest x-ray showed a large right pleural effusion and three fractured ribs on the right. Pleural effusion is the build-up of fluid in the pleural space, which can compress the lung and cause difficulty breathing. Fractured ribs can cause pain and difficulty breathing as well.
B. The term indicating that the condition was caused by fractured ribs is traumatic hemothorax. Hemothorax refers to the accumulation of blood in the pleural cavity, while traumatic hemothorax specifically refers to this condition caused by injury or trauma to the chest, such as fractured ribs.
C. A chest tube was inserted into the right pleural space to relieve the condition, but no blood could be obtained. Another chest tube was then inserted into the left pleural space, and 1500 ml of blood was evacuated.
D. The lesson from this case report is the importance of proper diagnosis and communication between healthcare professionals. The incorrect interpretation of the first chest x-ray led to the insertion of a chest tube in the wrong pleural space and delayed treatment, causing further complications. It emphasizes the need for thorough review and double-checking of diagnostic images and for clear communication among healthcare providers.
