A young male met with a road traffic accident and came to the emergency department, he was evaluated found to have BP-130/80 mm HG, pulse rate - 88/min, RR -22/min. On auscultation there was decreased air entry on one side with absent breath sounds. X-ray chest is given below. Your most probable diagnosis is
Ans. (b) Rupture of esophagus and compressing the pericardium* This image shows Pneumo mediastinum which is a feature of Esophageal rupture.* Decreased air entry implies collection of esophageal contents and pleural effusion on that side.* Naclerio's V sign- Presence of V shaped Gas shadow near Cardiophrenic angle on left side in Boerhaave syndrome Esophagus rupture.* Mackler's triad- Vomiting, Chest pain and Subcutaneous emphysema in Barotrauma Esophagus.
Tension pneumothorax
Rupture of esophagus and compressing the pericardium
Flail chest due to fracture of ribs 5,6,7,8 ribs
Normal CXR
Trauma