What A Heavy Box.

A 48 years old man was brought to the emergency room complaining of difficulty of
breathing. The shortness of breath started two hours ago, just after he lifted a
heavy box. He also complained pain in the left chest, and the pain got worse when
he was breathing. The man has a long history of cough and had underwent a 6
months of treatment.
In the ER, the patients blood pressure was 100/60 mmHg, his pulse was 120 times
per minute, and his respiratory rate was 34 times per minute. On inspection, the
examiner found an asymmetrical chest wall movement. On palpation the absence of
the tactile fremitus on the left side was found, along with hiperresonant on the left
chest percussion and diminished breath sound on the left chest auscultation.
Reference
Karnadiharja W, Djojosugito MA, Lukitto P, Rahmad KB, Manuaba TW. Dinding toraks
dan pleura: trauma. Dalam : Sjamsuhidayat R, de Jong W, editor. Buku Ajar
Ilmu Bedah. Edisi kedua. Jakarta : Penerbit buku kedokteran EGC; 2005. p406
Maddaus MA, Luketich JD. Chest wall, lung, mediastinum and pleura. Schwartzs
Principles of Surgery. Eighth edition, Mc Graw Hill, London, 2005
Sjamsuhidayat R, Ahmadsyah I, Busroh IDI, Rahmad KB. Trakea, mediastinum dan
paru, trauma. Dalam : Sjamsuhidayat R, de Jong W, editor. Buku Ajar Ilmu
Bedah. Edisi kedua. Jakarta : Penerbit buku kedokteran EGC; 2005. p429-30