A 24 year old male student presented to the Casualty Department with a 2 day history of progressive chest pain radiating from the lower left sternal border to the left axilla.

He was observed to be dyspnaeic and had a slight cough. The student was fully concious but visibly distressed. On examination his pulse rate was 100/min , his breathing was shallow and rapid. He was not cyanosed. Breath sounds were absent on the left and percussion was dull at the left base.

Chest X-Rays were taken one in the P-A view and the other in the lateral view. The chest X-Ray showed a large opacity in the base of the left lung with an upper horizontal fluid-air level. This upper zone was devoid of any lung markings except for a region of collapsed lung medially.

Case Presented by Dr. Martin Schranz
Medical Electives Coordinator for the Medical School of Malta
Inquiries to:The Electives Coordinator, The Malta Medical School, St Luke's Hospital, Guardamangia, Malta
Phone: (00356)331091, Fax: (00356)310966

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