Test Yourself

Case 1 - small

HISTORY

Blunt thoracic and abdominal trauma.

EFAST performed immediately.

ULTRASOUND FINDINGS

The right upper quadrant view is free of intraabdominal blood, but a small rim of fluid is evident in the most dependent portion of the intrathoracic space, filling the posterior costophrenic angle.

The first view is taken intercostally, with the probe in a longitudinal orientation in the anterior axillary line.

The second view demonstrates the small haemothorax again. On this occasion the probe is placed more posteriorly and so the effusion is interrogated much more closely.

DISCUSSION

The EFAST examination routinely explores for pneumothorax and haemothorax.

In the usual RUQ view pleural fluid is seen as a triangle of black filling the costophrenic angle. Normally this area is not directly visible with ultrasound because the lung filling the angle causes a mirror image type artefact.

SUBMITTED BY:

James Rippey


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Haemothorax

RUQ view including costophrenic angle
Haemothorax Hemothorax