CXR Case 114

A 19 year old lady P1,G1 presents with increasingly severe left lower quadrant abdominal pain. Pregnancy test is negative

CXR CASE 114 CXR LITFL

Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

The heart is on the right side representing dextrocardia.
Situs inversus is present (gastric bubble also on the right side).
No free air under the diaphragm.
No evidence of any bronchiectasis.


CLINICAL CORRELATION

Assuming the ‘L’ maker was correctly placed, then this is a case of incidentally found dextrocardia and situs inversus.

Kartagener syndrome (primary ciliary dyskinesia) is very unlikely: there is no radiological evidence of bronchiectasis; the patient has previously fallen pregnant (likely functioning cilia in the Fallopian tubes)


CLINICAL PEARLS

The LLQ pain was from appendicitis. With situs inversus, the gut is rotated – with the appendix on the left side.


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 |

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.