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. With crunching sound . Your most probable diagnosis is:
A. Tension pneumothorax
B. Rupture of esophagus and compressing the pericardium
C. Flail chest due to fracture of ribs 5,6,7,8 ribs
D. Normal CXR
It should be simple pneumothorax. Vitals are stable so b,c are obsolete… in flail no such absent breath sound
But flail chest cause pulmonary contusion… will it not cause absent breath sound ? Just thinking
It’s not tension pneumothorax as the vitals are stable.
So C would be most appropriate answer I think.
What will be the sign of traumatic esophageal rupture ?
it’d be vomiting/retching, surgical emphysema, severe retrosternal pain as in rupture esophagus
thank you so much
Pain due to intercostal nerve fibres streching (NOT mentioned)
Crackling sound heard on auscultation due to rubbing up of pleura against fractured ribs
Normal vitals rule out esophageal rupture and tension pneumothorax completely.
Although flail chest will also have deranged vitals but best option. Where was this asked?