After having a fight, a young man presented to the trauma center with a lacerated wound in the right chest. Patient was in severe respiratory distress. Examination showed there was tachycardia and tachypnea. Moreover, breath sounds were absent in right chest. Chest x-ray showed mediastinal shift to left. What is the most likely diagnosis?
  1. Tension pneumothorax
  2. Spontaneous pneumothorax
  3. Pneumonia
  4. Emphysema
Explanation
Answer- A - The most likely diagnosis in this case, where patient has long history of fighting, during which he got lacerations that could have ruptured the pleura and led to pneumothorax is tension pneumothorax. Tension pneumothorax is evident from patient's dyspnea and mediastinal shift in CXR (PA).
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