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Image of the Month—Quiz Case
Richard J. Hendrickson, MD;
Mary T. Killackey, MD;
Thomas J. Watson, MD;
David W. Johnstone, MD;
Richard H. Feins, MD
From the Division of Cardiothoracic Surgery, Department of Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY.
Arch Surg. 2004;139:1017.
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INTRODUCTION
An 18-year-old man with a history of asthma presented at a rural hospital with shortness of breath and left shoulder pain. A chest radiograph was obtained, which demonstrated a left pneumothorax; it was decompressed by means of a Foley catheter. The patient had had a similar episode with a similar chest radiograph 3 weeks previously. His medical history was significant for asthma, for which he used multiple inhalers. Results of physical examination showed a cachectic man, 1.6 m tall who weighed 42.3 kg. His vital signs were stable, with a blood pressure of 110/80 mm Hg, apulse of 80 beats/min, and a respiratory rate of 20/min. His lungs were clear to auscultation, and the cardiac examination showed a 2/6 systolic ejection murmur. The patient was transferred to our facility for . . . [Full Text of this Article]
What Is the Diagnosis?
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