X- ray quiz: A 27-year-old male with sudden dyspnoea

A 27-year-old male presented to our emergency department due to sudden onset of dyspnoea. On clinical examination, his vital signs were normal except for the dyspnoea (27 breaths/min). Physical examination revealed decreased breath sound and tympanic percussion note over the right hemithorax. The blood test showed no specific findings. Chest radiography revealed right-sided pneumothorax with a severely collapsed lung. Emergency chest tube insertion was done, but there was poor expansion of the lung, and low pressure suction was applied after admission. Suddenly, a large amount of fresh blood was drained.