A 42-Year-Old Man Is Brought to the Emergency Department 35

question 324

Multiple Choice

A 42-year-old man is brought to the emergency department 35 minutes after being struck by a car while crossing the intersection.  The paramedics found him hypotensive and intubated him in the field for respiratory distress.  After resuscitation with 2 liters of normal saline, his blood pressure is 110/80 mm Hg and pulse is 90/min.  There is diffuse bruising across the chest, and the right lower leg is visibly deformed.  CT scan of the head, cervical spine, and abdomen are normal.  CT scan of the chest reveals bilateral, mildly displaced rib fractures with underlying pulmonary contusions and a right-sided pneumothorax.  A chest tube is placed.  The patient undergoes open reduction and internal fixation of right tibial and fibular fractures and is extubated following surgery.  One day later his chest tube is draining turbid, green fluid.  Repeat chest-x ray shows resolution of the pneumothorax but there is a new right-sided pleural effusion.  Which of the following is the most likely diagnosis?

• A)Bronchopleural fistula
• B)Diaphragmatic rupture
• C)Esophageal perforation
• D)Hemothorax
• E)Pulmonary infarction

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Definitions:

Bin Width

The size of intervals in a histogram or frequency distribution, affecting data visualization and analysis.

Lower Bin Limit

The smallest value in a range (bin) for grouping data points in a histogram or frequency distribution chart.

Histogram

A graphical display of data using bars of different heights to represent the frequency of numerical data intervals.

Bin Width

The size of intervals in a histogram or bar chart, determining the range of values each bin or bar represents.