Commentary: A conservative management plan from a place where barracuda are rare

The general availability of chest x ray examinations has prompted some clinicians to diminish the importance of physical examination of the chest. Faced with a barracuda wound to the chest in a remote part of the Solomon Islands there is nothing else to fall back on, and percussion, tactile vocal fremitus, and breath sounds resume their true importance. Dr Berger had to advise at the end of a telephone line before managing to reach the patient. It was then that the main dilemma arose: was it to be …