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Un neumotórax engañoso
A Deceptive Pneumothorax
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B)<span class="elsevierStyleHsp" style=""></span>Neumotórax extenso.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Un varón de 45<span class="elsevierStyleHsp" style=""></span>años, exfumador, fue ingresado tras sufrir heridas de bala en la cabeza y el abdomen. Al ingreso, la puntuación en la escala de Glasgow era de 3. El paciente necesitó una intubación inmediata en el servicio de urgencias, y tras una laparotomía urgente fue trasladado a la unidad de cuidados intensivos (UCI) para recibir apoyo respiratorio. La tomografía computarizada (TC) de tórax no mostró signos de lesión torácica, pero sí evidenció alteraciones enfisematosas extensas con formación de bullas.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Tras 2 semanas de ventilación mecánica en la UCI, una radiografía de tórax ordinaria mostró un aumento de la hiperclaridad (signo del surco profundo) en la base del pulmón izquierdo, con un colapso asociado. Había también una depresión del hemidiafragma izquierdo. Se identificó una línea pleural visible en la región apical del pulmón izquierdo (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>A). En ese momento el paciente estaba asintomático y hemodinámicamente estable. Recibía ventilación mecánica con control de volumen, con una presión teleespiratoria positiva (PEEP) de 10<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O. Se realizó una TC de tórax (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>B) para completar la evaluación, y se observó que se había producido un gran neumotórax izquierdo, que se trató con éxito mediante la introducción de un drenaje torácico intercostal.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 556 "Ancho" => 1300 "Tamanyo" => 82075 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A)<span class="elsevierStyleHsp" style=""></span>Aumento de hiperclaridad pulmonar inferior izquierda. B)<span class="elsevierStyleHsp" style=""></span>Neumotórax extenso.</p>" ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "titulo" => "Agradecimientos" "texto" => "<p id="par0015" class="elsevierStylePara elsevierViewall">A la Dr. Orla Buckley, Radiologist Consultant in Adelaide and Meath Hospital, Tallaght, Dublín.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005000000011/v1_201410280129/S0300289613003505/v1_201410280129/es/main.assets" "Apartado" => array:4 [ "identificador" => "21422" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Clinical Images / Imágenes clínicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005000000011/v1_201410280129/S0300289613003505/v1_201410280129/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289613003505?idApp=UINPBA00003Z" ]
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