48M recent T11/12 decompression for spinal stenosis. Post op | Figure 1

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48M recent T11/12 decompression for spinal stenosis. Post op hydropneumothorax. Comes in to practice with progressive acute onset mild SOB for last 3/7, and "left rib pain" which shifted to sternum today. No peripheral oedema, syncope or Infective Sx. Vitals NAD (known HTNsive) yesterday and noted reduced breath sounds and dull percussion at left lower zone. Told to take CXR and return today sSpO2 dropped from 98-94%. RR still within limits PMHx: had Rt sided pneumonia in past. No occupational exposure of note. Patient advised to go to DEM today probably for chest tube insertion.