Left lung collapse

This 6 year old UAE girl presented with history of fall at home on the left side of the trunk. There was restriction of movement of the intercostal muscles due to pain in trunk because of the blunt trauma. Therefore, patient was not able to cough properly and secretions were retained in her chest.  patient received emergency treatment and discharged home

One week later, patient returned back to hospital    

 Chest x-ray:  showed complete collapse of the left lung. Shifting of the mediastinum to the left side ( same side), crowdness of the ribs and narrowing of intercostals spaces with elevation of the left phrenic copula, compensatory emphysema of the right lung
        P-A view

Case was discussed with the parent for the necessity of rigid bronchoscopy, bronchial toilet and lavage. She may need also to be kept intubated for few days.

Management offered:
    1- Repeated bronchial toilet and lavage with sod. bicarbonate and mestebrone
    2- Repeated ambu bagging till full expansion of the left lung was achieved

Family refused and took patient home.

After 6 months patient was brought again to the hospital with the same finding.
They were advised the same procedure but they refused again and took patient home.

End