Potentially fatal blunt chest trauma presenting as occult pneumothorax

Occult pneumothorax (OPTX) after blunt chest trauma can rapidly progress to tension pneumothorax and is life-threatening if not properly diagnosed in the emergency department (ED). Therefore, early detection of OPTX in ED is of great concern. Herein, we report a case of OPTX diagnosed by computed tomography (CT). A 45-year old woman suffered severe head injury, craniofacial injury, and OPTX after a motorbike accident. She was successfully treated with the insertion of a chest tube in ED without mortality. ED physicians should suspect OPTX and arrange for chest CT scan in critical trauma cases with high injury severity score (ISS) and chest injury.