A 40-year-old male presented with several days history of increasing dyspnoea. On examination the left side of the chest was hyper-resonant with no breath sounds. A pneumothorax was suspected and chest X-ray was performed. As insertion of an intercostal chest drain was being arranged by, the duty surgeon reviewed the chest X-ray and requested a MDCT of the chest and abdomen (Image 1, chest X-ray; Image 2, scanogram of CT; Image 3, coronal CT of chest (lung windows); Image 4, axial CT of upper abdomen and Image 5, coronal CT of upper abdomen).
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