During eFAST in a patient with blunt chest trauma, the anterior chest wall at the mid-clavicular line shows absence of lung sliding and a barcode pattern on M-mode. What is the most likely diagnosis?
- A Haemothorax
- B Pneumothorax ✓
- C Pulmonary contusion
- D Diaphragmatic rupture
Correct answer: B. Pneumothorax
Explanation
Loss of lung sliding with the barcode (stratosphere) sign on M-mode indicates air between the pleural layers, which is pneumothorax. Haemothorax would show an anechoic or echogenic dependent collection above the diaphragm but sliding is usually preserved because the visceral pleura still apposes parietal pleura. Barcode sign kills the haemothorax distractor.
Reference: ATLS Student Course Manual, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.