Tuesday, November 3, 2009

Out of the Frying Pan

The is the second part of a three part CXR case. Please see the previous case for the first radiograph. You initiate treatment for the patient and get a follow-up X-ray. Here's what you see.

Challenge: Explain.

Image shown under fair use.

2 comments:

Suheil said...

is it a haemothorax compressing the left lung, which occurred as a result of the chest tube insertion?

Craig Chen said...

ooh good answer! not what i was thinking of but certainly a possibility. there might be a hint of a costophrenic angle suggesting that it's not a pleural process, but it's on the differential.
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Out of the Frying Pan

Reexpansion pulmonary edema occurs unilaterally after rapid expansion of a collapsed lung or rarely, from evacuation of pleural fluid >1L or removal of an obstructing tumor. Mortality rate is up to 20% and treatment is supportive. The pathophysiology is unknown.

Sources: UpToDate; ispub.com The Internet Journal of Anesthesiology.