Thoracic abnormal air collections in patients in the intensive care unit: radiograph findings correlated with CT

AbstractAn abnormal collection of air in the thorax is one of the most common life-threatening events that occurs in the intensive care unit. Patient management differs depending on the location of the air collection; therefore, detecting abnormal air collection and identifying its exact location on supine chest radiographs is essential for early treatment and positive patient outcomes. Thoracic abnormal air collects in multiple thoracic spaces, including the pleural cavity, chest wall, mediastinum, pericardium, and lung. Pneumothorax in the supine position shows different radiographic findings depending on the location. Many conditions, such as skin folds, interlobar fissure, bullae in the apices, and air collection in the intrathoracic extrapleural space, mimic pneumothorax on radiographs. Additionally, pneumopericardium may resemble pneumomediastinum and needs to be differentiated. Further, some conditions such as inferior pulmonary ligament air collection versus a pneumatocele or pneumothorax in the posteromedial space require a differential diagnosis based on radiographs. Computed tomography (CT) is required to localize the air and delineate potential etiologies when a diagnosis by radiography is difficult. The purposes of this article are to review the anatomy of the potential spaces in the chest where abnormal air can collect, explain characteristic radiographic findings of the abnormal air collection in supine patients with illustrations and correlated CT images, and ...
Source: Insights into Imaging - Category: Radiology Source Type: research

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Authors: Langner S, Kolditz M, Kleymann J, Tausche K, Almeida AB, Schweigert M, Koschel D Abstract CPAP is the most common treatment for obstructive sleep apnea.Serious complications from this treatment are very rare. Pneumothorax following lung barotrauma under CPAP therapy has been described in case reports only in patients with pre-existing lung and thoracic diseases.A 68-year-old sleep apnea patient without pre-existing lung or thoracic diseases and with established CPAP therapy since many years was admitted to the hospital after a severe thoracic pain event with persistent shortness of breath. Chest radiograph...
Source: Pneumologie - Category: Respiratory Medicine Tags: Pneumologie Source Type: research
Discussion The embryonic mesoderm forms the skeletal system. The mesoderm is further divided into the dorsal, sclerotome and ventral dermatome. The sclerotome forms the ribs which are under the influence of various genes and growth factors. Congenital rib abnormalities occur in number ( the normal 12 ribs) or in formation/structural. Malformations can include hypoplastic, bridging, forked, fused and hypoplastic ribs. Even ribs with holes occur because of the segmentation issues. Illustrated examples can be found here. The rib’s cartilage, bone or both can be affected. Location along the rib is also variable. Abnormal...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
We report a case where serial follow-up chest computed tomography revealed progression of pulmonary lesions into confluent bilateral consolidation with lower lung predominance, thereby confirming COVID-19 pneumonia. Furthermore, complications such as mediastinal emphysema, giant bulla, and pneumothorax were also observed during the course of the disease. PMID: 32207255 [PubMed - as supplied by publisher]
Source: Korean Journal of Radiology - Category: Radiology Tags: Korean J Radiol Source Type: research
Conclusions: SPM should be considered in the differential diagnosis of acute chest pain in adolescents. Asthma patients may necessitate prolonged hospital stay and require careful surveillance, eliminating complications that may influence outcome.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric respiratory epidemiology Source Type: research
ConclusionOur results demonstrate that bedside thoracic US is characterized by a very good accuracy in the diagnostic work-up of major trauma patients, even in difficult conditions, allowing rapid diagnosis of PNX.Advances in knowledgeThe novelty of this research lies in the possibility of diagnosing potential life-threatening conditions in a very short time by means of US, thus proposing a revision of the Advanced Trauma Life Support (ATLS) guidelines in order to incorporate it in the work-up of high-energy injured patients.
Source: Journal of Ultrasound - Category: Radiology Source Type: research
ConclusionsSimilar to tension pneumothorax, thoracic stomach syndrome requires immediate drainage of air from the thoracic cavity. However, unlike tension pneumothorax, this condition requires nasogastric tube insertion, which is the only way to safely remove the accumulated air and avoid possible complications that could occur due to percutaneous drainage. For patient safety, it might be clinically important to place nasogastric tubes after esophagectomy with whole-stomach reconstruction, even if radiographic guidance is required. In addition, clinicians should consider thoracic stomach syndrome as one of the differential...
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
CONCLUSIONWe report a case of laparoscopic hepatectomy for liver metastasis of lung LCNEC. It is suggested that surgical resection for solitary distant metastasis of LCNEC may improve prognosis.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
CONCLUSIONS: PJP on CT differs substantially between RTRs and HIV-positive patients. Physicians should be aware of such differences in order not to delay treatment, particularly in renal transplant recipients. PMID: 31580472 [PubMed - in process]
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research
This study evaluated whether or not patterns of emphysema and their qualitative and quantitative severity can predict the risk of complications with post-computed tomography (CT)-guided transthoracic lung biopsy (TTLB).Materials and methodsThree hundred and ninety-seven patients who underwent CT-guided TTLB in 2010 –2018 were retrospectively reviewed. The severity of emphysema and presence of perilesional emphysema were assessed visually using the Fleischner Society classification. Ninety seven of the 397 patients underwent quantitative analysis of emphysema. Complications, including pneumothorax, chest tube insertio...
Source: Japanese Journal of Radiology - Category: Radiology Source Type: research
ConclusionPneumothorax is less common in the pediatric than the adult trauma population, and when encountered in children pneumothorax is often occult and might be associated with lung contusions. Existing evidence supports the usefulness of chest US in detecting pneumothorax in adults and suggests that it can be translated to injured children. However, our findings suggest that the sensitivity of lung US as a single-point anterior exam extension of the FAST exam might not be as reliable in the pediatric trauma population as in adults. Other methodologies using lung US might improve sensitivity.
Source: Pediatric Radiology - Category: Radiology Source Type: research
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