An unexpected finding on a trauma chest x-ray

Author: Michael John Stewart / Editor: Michael John Stewart / Reviewer: John Wilson / Codes: RP4, SLO1, SLO4, SLO6, TP3 / Published: 24/02/2021

A 43-year-old cyclist arrives after being struck by a car. He arrives collared and blocked on a scoop stretcher with evidence of bruising to the right chest, abdomen, and pelvis.

He has a GCS of 6 (E2V2M4) and saturations of 86% on high-flow oxygen. His heart rate is 110 with a BP of 100/40.

He is intubated with rapid sequence induction, vascular access is obtained, and a pelvic binder applied. There is a delay in transfer to CT, so a plain chest x-ray is taken.