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
Tension pneumothorax
Rupture of esophagus and compressing the pericardium
Flail chest due to fracture of ribs 5,6,7,8 ribs
Normal CXR
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.
Trauma