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Case 8: Acute shortness of breath

This 24 year old man presented with sudden onset pleuritic right scapular region pain and shortness of breath. A chest xray was obtained and prompted the emergency department to perform a procedure.

Pneumothorax with pigtail drain

1. What does the xray show?

2. How would you manage the problem in the emergency department?

3. He returns 6 months later with the same problem. How would your management differ now?