a. A large left pleural effusion
b. A large right pneumothorax
c. Atelectasis of the left lung because of a mucus plug
d. Pneumonia in the left lung
e. Atelectasis of the left lung because the ETT is too low
Correct Answer:
Atelectasis of the left lung because the ETT is too low
Explanation
There is opacification of the left hemithorax. There is a shift of the heart and mediastinal structures (i.e. the trachea) toward the side of opacification. This eliminates pleural effusion, pneumonia and pulmonary edema as possibilities. A tension pneumothorax will displace the heart and mediastinal structures away from the side of the pneumothorax but it will not cause complete opacification of the opposite lung. In addition, there should be no lung markings visible in the hemithorax which contains the pneumothorax. If you look carefully, you will see the markers on an endotracheal tube that extends into the right mainstem bronchus. Thus, only the right lung is being aerated and the left lung has become atelectatic.
