On examination of a critically ill patient who was in respiratory distress, the following signs were noted:
a) What is the likely lung pathology?
b) List 3 causes of this pathology in critically ill patients.
a) What is the likely lung pathology?
Left lung collapse
b) List 3 causes of this pathology in critically ill patients.
Right bronchial intubation
Mucus plugging – left main bronchus
Obstructive lesions left main bronchus.
a) What is the likely lung pathology?
There can really be only one sort of pathology which causes a retraction of the mediastinum towards the silent lung. Atelectasis of the whole lung has somehow occurred.
b) List 3 causes of this pathology in critically ill patients.
The Required Reading chapter on the care for the post-pneumonectomy patient includes a brief section with this list of differentials. It was not the most appropriate place to put this list, but there was nowhere else to put it.
In brief, these are the causes of a silent hemithorax with mediastinal shift towards the quiet side, in a patient who is in respiratory distress:
Clinical Examination of the Critically Ill Patient, 3rd edition by L.I.G. Worthley - which can be ordered from The Book Depository
Clinical Examination: whatever edition, by Talley and O'Connor.
Iyer, Anand, and Sumit Yadav. "Postoperative Care and Complications After Thoracic Surgery." (2013).