aka Trauma Tribulation 002
A 27 year old male with head and extensive facial trauma is admitted to the intensive care unit after a neurosurgical intervention for an acute subdural haemorrhage. There has been difficulty with oxygenation in the operating theatre.
CXR 1 was performed at the time of admission to ICU
CXR 2 was performed after a therapeutic intervention.
There is an ETT in appropriate position and an orogastric tube in an appropriate position.
There is right upper lobe collapse.
The left lung is significantly hyperinflated due to the provision of a large amount of PEEP.
There is right upper lobe collapse which in the context of the history provided is likely to be due to a blood clot in the right upper lobe bronchus.
A bronchoscopy was performed to suck the clot out of the right main bronchus leading to subsequent reinflation of the right upper lobe.