A: Computed tomography examination (lung window setting) after intubation and during resuscitation. A: Computed tomography examination (lung window setting)

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A: Computed tomography examination (lung window setting) after intubation and during resuscitation. A: Computed tomography examination (lung window setting) after intubation and during resuscitation. A coronal image at the level of the heart shows marked thickening of the subcutaneous fat with a massive amount of subcutaneous emphysema. There is downward displacement of the right diaphragm (white arrow) with a large secondary pneumothorax. The normal density of the venous (and partially arterial) system is extensively replaced by air. The right side of the heart (asterisk) is distended and completely filled with air. Also note air in the hepatic veins and portal system (red arrows). B: A coronal view more anterior than in A demonstrates air in the pulmonary arteries (single asterisk), the inferior vena cava (double asterisk), and small mesenteric vessels (red arrows). Wim Verelst et al. Respir Care 2015;60:e6-e10 (c) 2012 by Daedalus Enterprises, Inc.