Pleuritic Right-sided Chest Pain in Surgery — 50yo Man | Trauma Surgery | SMLE Q#11388

SMLE Question #11388

Surgery Trauma Surgery

Objective: OBJ-TRM-AIRWAY-01

Last updated: February 2026
A 50-year-old man presents after a high-speed motor vehicle collision with pleuritic right-sided chest pain and dyspnea. Examination shows decreased breath sounds and hyperresonance over the right hemithorax. A right tube thoracostomy releases a rush of air, but there is a large continuous air leak and the lung does not re-expand. A second right chest tube is placed with persistent large air leak, and repeat chest radiograph shows a large right pneumothorax. What is the most appropriate next step in management?

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