(BMJ) - A 49-yo woman fell 4 days ago, striking her back on concrete. The next day, swelling began in her ankles and spread through her body. In the ED, L breath sounds were reduced; L posterior thorax was tender. RA O2 sat: 96%. What caused her swelling?
Aspirin-induced anaphylaxis
Anasarca from traumatic renal failure
NSAID-induced sodium retention
Subcutaneous emphysema
Edema from Takotsubo (stress) cardiomyopathy
You are correct. The CT shows a L posterior rib fracture, L hemopneumothorax, and extensive gas throughout subcutaneous tissues. After chest tube drainage, symptoms resolved in 48 hours, and she left against medical advice. By 6 months, she had made a full recovery.