CXR Case 090

You are asked to review an CXR while on call. Note: This is the same patient from CXR case 089.

CXR CASE 090 CXR LITFL

Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

There is a large bore chest drain on the right with surgical emphysema and a hydropneumothorax.

The chest drain tip is situated towards the apex (or cupola) of the hemithorax.


CLINICAL CORRELATION

This lady has trapped lung – the pleural fluid has been removed, but the visceral pleura is thickened with a malignant rind which encases it, prevents full expansion of the lung.


CLINICAL PEARLS

Sometimes suction and time can allow the lung to expand.

If there are complex loculations, VATS can be useful, rarely.

More recently indwelling pleural catheters (IPCs) have transformed the management of trapped lung – allowing patients to get home with periodic drainage in the community.


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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