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Chest Trauma, Iatrogenic Trauma including drainage tubes and some Post-surgical Conditions and Complications of Radiotherapy.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Mediastinal shift depends on expansion of the residual lung. It rotates following a right pneumonectomy and tends to shift following a left pneumonectomy, nearly always with an anterior lung herniation; some also with a posterior herniation (see also lung herniation ps. 2.39 - 40). Reversal of the shift, with a more central mediastinum and a convex fluid interface, may suggest increased fluid in a pneumonectomy space, usually due to recurrence of tumour or infection.
Thorax
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
In tension pneumothorax, air enters into the pleural cavity with inspiration but cannot leave due to a flap of tissue acting as a one-way valve. The developed pressure collapses the affected lung and if high enough can cause a mediastinal shift.
Multiple choice questions (MCQs)
Published in Tristan Barrett, Nadeem Shaida, Ashley Shaw, Adrian K. Dixon, Radiology for Undergraduate Finals and Foundation Years, 2018
Tristan Barrett, Nadeem Shaida, Ashley Shaw, Adrian K. Dixon
With regards to a CXR performed post pneumonectomy, which of the following statements are correct? Progressive increase in the size of the air bubble is normal.Two thirds of the hemithorax fills with fluid in 4–7 days.Mediastinal shift occurs towards the operated side.Elevation of the hemidiaphragm is seen on the affected side.Successive radiographs demonstrate filling in of the hemithorax.
Primary Pleuropulmonary Synovial Sarcoma: Report of Two Cases and a Comprehensive Review of the Literature
Published in Cancer Investigation, 2022
Neda Khalili, Elham Askari, Nastaran Khalili, Aboulghasem Daneshvar-Kakhki, Makan Sadr, Sara Haseli, Mihan Pourabdollah Toutkaboni
Since primary pleuropulmonary SSs are typically large tumors, mediastinal shift may occur. According to reports from previous studies, mediastinal shift was detected in 7% of patients (Table 4). Overall, ipsilateral pleural effusion is a frequent observation and might be attributed to acute or recurrent hemothorax (15,16,57). The results of our literature review also showed that pleural effusion was existent in 21% and 32% of cases on CXR and CT, respectively. On the other hand, the presence of pneumothorax was a rare finding that was observed in the chest CT of only 2% of cases. Calcification and mediastinal lymphadenopathy were also infrequent CT features of primary PPSS and were reported in less than 10% and 11% of cases, respectively (Table 4). Hilar or mediastinal lymphadenopathy shifts the diagnosis toward other malignancies of the lung, such as bronchogenic carcinoma (15,16). Also, the presence of multiple foci of calcification can complicate the diagnosis of SS and raise the suspicion for other tumors such as carcinoid tumor and metastatic SS (31). In such instances, PET/CT imaging might be able to narrow the diagnosis (16). Table 4 shows in detail the frequency of reported imaging features of primary pleuropulmonary SS on CXR and CT.
Abstracts book
Published in Acta Clinica Belgica, 2020
A 30-year-old male was brought into the emergency department with dyspnoea and right-sided thoracic pain since 3 days. The patient was hemodynamically stable and had a saturation of 94% at room air. Chest auscultation revealed absent air entry on the right side. A chest X-ray showed a large right sided pneumothorax with complete lung collapse and mediastinal shift (Figure 1), for which an intercostal drain was inserted. Soon after this procedure, saturation and blood pressure dropped. The patient was given fluids and high flow oxygen. An additional chest x-ray was taken which showed correct drain positioning and diffuse densifications over the right lung compatible with lung edema (Figure 2). The patient was admitted to intensive care where he received non-invasive continuous positive airway pressure (CPAP) therapy and a minimal dose of norepinephrine. An adjacent CT-thorax confirmed findings for REPE (Figure 3). The patient stabilized and was transferred to the ward after 3 days, and 6 days post admission he was discharged home in good condition.
Congenital Pulmonary Airway Malformation – 19-Year Experience from a Tertiary Care Center in India
Published in Fetal and Pediatric Pathology, 2019
Hema Kini, Saraswathy Sreeram, Saumya Shukla, Sadashiva Rao, Kausalya Sahu, Deepa Adiga, Pooja Suresh
Type 2 cysts also communicated with the bronchial tree. The cysts linings were smooth to wrinkled (Figure 1c). Our series had a case of type 2 CPAM with extralobar pulmonary sequestration (ELS) in a 30-week-old fetus with hydrops fetalis (Table 2, case 2). Another case of type 2 CPAM had an associated trachea-esophageal fistula (TEF) (Table 1, case 7). Other than TEF, associated non-pulmonary lesions were not seen. Type 3 lesions presented with a mediastinal shift in all cases. Loose mesenchymal layer composed of fibroblasts and smooth muscle cells surrounded the lesion. They resembled early canalicular stage of the lung development (16–20 weeks gestational age). The single case of type 4 CPAM was in a 4-month old boy with unilateral disease showing three cysts, largest measuring 5 cm (Table 1, case 10). The boy presented with sudden respiratory distress. The cysts were thin-walled, peripherally located, and lined by alveolar and bronchial epithelial cells surrounded by loose mesenchyme. The stroma was focally hypercellular. Arteries and arterioles were prominent in the loose mesenchyme surrounding the cysts. Surgical margins were uninvolved. The patient was symptom free for 5 years, after which he was lost to follow-up.