Alruways Abdullah, Alharbi Nader, Alharbi Turki, Alotaibi Faisal, Aloraini Ahmed, Alharbi Nawaf
Department of Emergency Medicine, College of Medicine, Shaqra University, King Abdulaziz Road, Aldawadmi 17464, Saudi Arabia.
Department of Otorhinolaryngology, Buraidah Central Hospital, Altaalim Road, Buraidah, Qassim 52361, Saudi Arabia.
J Surg Case Rep. 2025 May 30;2025(5):rjaf350. doi: 10.1093/jscr/rjaf350. eCollection 2025 May.
We present a 20-year-old male involved in a high-energy vehicle accident with back pain, chest pain, and a scalp abrasion. A supine chest radiograph revealed a linear lucency in the right apical lobe, raising concern for pneumothorax or a retained foreign body. A contrast-enhanced chest computed tomography (CT) identified an azygos lobe with its characteristic fissure and preserved pulmonary markings, with no evidence of pneumothorax or foreign objects. The patient remained stable and was discharged without intervention. This case highlights the diagnostic challenges of recognizing congenital anomalies like the azygos lobe, present in 0.4%-1.2% of the population, which can mimic critical conditions such as pneumothorax or foreign bodies, particularly in trauma settings. Identifying key imaging features, including the azygos fissure's alignment and normal lung markings, is essential to avoiding misdiagnosis. CT is the gold standard for resolving uncertainty, ensuring accurate diagnosis, and preventing unnecessary interventions in trauma cases.
我们报告一名20岁男性，因高能车辆事故导致背痛、胸痛和头皮擦伤。仰卧位胸部X线片显示右肺尖叶有一线状透亮区，引发了气胸或异物残留的担忧。胸部增强计算机断层扫描（CT）显示为奇叶，有其特征性的裂沟且肺纹理正常，未发现气胸或异物迹象。患者病情稳定，未经干预即出院。该病例凸显了识别奇叶等先天性异常的诊断挑战，奇叶在人群中的发生率为0.4%-1.2%，在创伤情况下可能会被误诊为气胸或异物等危急情况。识别关键的影像学特征，包括奇叶裂沟的走向和正常肺纹理，对于避免误诊至关重要。CT是解决诊断不确定性、确保准确诊断以及防止创伤病例中不必要干预的金标准。
