CXR Case 067

A 54 year old male develops respiratory distress 7 days post sternotomy for CABG. Initial recovery uncomplicated, worsening cough last 2 days.

click images to enlarge


Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

CXR Interpretation:
There is diffuse opacity over the left hemithorax and loss of distinction of the upper margins of the left heart border.
Pleural spaces are clear, right side normal.
Sternotomy wires noted

CT Interpretation:
There is diffuse opacity over the left hemithorax and loss of distinction of the upper margins of the left heart border.
Pleural spaces are clear, right side normal. Sternotomy wires noted


CLINICAL CORRELATION

In this scenario a sputum plug causing sudden lobar collapse is quite possible.

Assuming intubation is not required, then chest physio is the key to success.

Careful but adequate analgesia is required to allow meaningful coughing despite the sternotomy wound.


CLINICAL PEARLS

The radiological appearance of Left upper lobe (LUL) collapse is often referred to as a ‘veil-like‘ opacity.


TOP 150 CXR SERIES



Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar |

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