08-03-2009, 06:52 PM
24. A 15-year-old boy is brought to the emergency department 30 minutes after being involved in a motor vehicle collision. He was the unrestrained passenger. On arrival, he is disoriented. His blood pressure is 80/40 mm Hg, pulse is 112/min, and respirations are 24/min. There is no jugular venous distention. Examination of the chest shows dullness to percussion and decreased breath sounds over the right hemithorax. Which of the following is the most likely diagnosis?
A
) Diaphragmatic rupture
B
) Flail chest
C
) Hemothorax
D
) Massive aspiration
E
) Pneumothorax