European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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We encountered a case whereby an 18-year-old boy presented to the Emergency Department with a stab wound to the left posterior chest. Chest X-ray (CXR) showed what appeared to be a pneumothorax and chest drain insertion was considered. It was confirmed subsequently that this apparent pneumothorax was due to a linear artefactual projection from the edge of the oxygen mask reservoir bag. We set out to investigate whether our colleagues would have misdiagnosed this artefact and what their initial treatment plan would have been. ⋯ Our results show that almost half of our colleagues would have carried out tube thoracostomy when no pneumothorax was actually present. In a situation where a pneumothorax is a clinical possibility we would recommend either temporarily removing the oxygen mask if clinically stable, or fixing the reservoir bag outwith the field of the CXR by means of adhesive tape to avoid any misinterpretation of this 'mask sign'.
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High velocity impact by handlebar is a rare cause of abdominal wall hernia following blunt trauma. We report a case of bicycle handlebar induced traumatic hernia with jejunal perforation. This case demonstrates that presentation of a traumatic hernia can be delayed and that computed tomographic scanning is useful in confirming the diagnosis. Surgical exploration with primary repair of the defect is the definitive treatment in cases of traumatic hernia.