TY - JOUR T1 - Interesting case of traumatic paediatric chest pain: don’t forget the vessels JF - Archives of Disease in Childhood JO - Arch Dis Child DO - 10.1136/archdischild-2021-321621 SP - archdischild-2021-321621 AU - Matthew G W Macartney AU - Nick Clarke AU - Julie-Ann Collins AU - Stephen Mullen Y1 - 2021/04/30 UR - http://adc.bmj.com/content/early/2021/04/29/archdischild-2021-321621.abstract N2 - A male adolescent was a restrained passenger in a high-speed road traffic collision. At the scene he was noted to be hypotensive and received one unit of blood. In the emergency department, he presented with mild chest pain. He had a normal chest examination. A 20 mm Hg blood pressure difference was found between his right and left arms. His CT chest is displayed in figure 1.Figure 1 CT chest with contrast, axial 3 mm slice taken just below the level of the subclavian artery origin.What is the most likely cause of the CT appearance identified by arrow ‘C’?PneumothoraxHaemothoraxEmpyemaPulmonary contusionWhat does the arrow ‘B’ show?Aortic dissectionAortic transectionNormal anatomyCardiac tamponadeHow would you manage this patient acutely?When would you decide to organise a CT chest … ER -