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Management of Pneumothorax
Dr Swapnil Pawar
Written by – Dr Andrew Lam
FAST scan
| View | Cavity Assessed | Findings |
| Subxiphoid | Pericardial | Assessing for anechoic (dark) fluid between the visceral and parietal pericardium suggestive of pericardial effusion. |
| Anterior Pleural | Pleural | Assessing for pleural effusion/haemothorax. Absence of lung sliding on respiration is also suggestive of pneumothorax. |
| Right Upper Quadrant | Peritoneal | Assesses Morrison’s Pouch (Hepatorenal Recess) for dependent anechoic fluid suggestive of intra-abdominal bleeding |
| Left Upper Quadrant | Peritoneal | Assesses Splenorenal Recess for dependent anechoic fluid suggestive of intra-abdominal bleeding |
| Pelvic | Pelvic | Assesses Pouch of Douglas (Rectouterine Pouch) or rectovesical pouch for anechoic fluid suggestive of pelvic bleeding |
Radiological Signs of Pneumothorax
- Visible visceral pleural edge with the absence of lung markings peripheral to this line
- Peripheral space is lucent compared to the rest of the hemithorax
- In cases of tension pneumothorax, you may see a mediastinal shift and tracheal deviation away from the lesion
- Subcutaneous emphysema may be present
- It May be associated with atelectasis
Triangle of Safety
Demarcates the anatomical region of the axilla which demarcates a guide for safe insertion of an intercostal catheter.
Borders:
- Anteriorally: Lateral border of Pec Major
- Posteriorally: Lateral border of Latissimus Dorsi
- Inferiorally: 5th Intercostal Space
References:
Bickle, I., Gorrochategui, M. (2021). Pneumothorax. Radiopaedia. Retrieved February 23, 2021 from https://radiopaedia.org/articles/pneumothorax
Botz, B., Bickle, I. (2021). Focused Assessment with Sonography for Trauma (FAST) Scan. Radiopaedia. Retrieved February 23, 2021 from https://radiopaedia.org/articles/focussed-assessment-with-sonography-for-trauma-fast-scan
Hacking, C. (2021). Triangle of Safety. Radiopaedia. Retrieved February 23, 2021 from https://radiopaedia.org/articles/triangle-of-safety
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