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Surgery
A teenage boy falls from his bicycle and is run over by a truck. On arrival in the emergency room, he is awake and ale and appears frightened but in no distress. The chest radiograph suggests an airfluid level in the left lower lung field and the nasogastric tube seems to coil upward into the left chest. The next best step in management is
Placement of a left chest tube
Immediate thoracotomy
Immediate celiotomy
Esophagogastroscopy
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