28-year-old Man in Surgery — 28yo Man | Trauma Surgery | SMLE Q#6400

SMLE Question #6400

Surgery Trauma Surgery

Objective: OBJ-TR-THORAX-01

Last updated: January 2026
A 28-year-old man is brought to the emergency department after being stabbed in the right side of his chest during an altercation 30 minutes ago. He is anxious and dyspneic. Vital signs: T: 36.8 °C, BP: 90/60 mmHg, HR: 124/min, RR: 30/min, SpO2: 89% on room air. On inspection, there is a 2-cm stab wound over the right anterolateral chest without a sucking sound. There is decreased chest expansion on the right, and trachea is deviated to the left. Percussion of the right hemithorax is stony dull, and breath sounds are markedly decreased over the right lung field. Which of the following is the most likely diagnosis?

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