CXR Case 123
A 71 year old man with known emphysema / COPD presents in type II respiratory failure and is started on NIV.
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
The large bowel is occupying most of the left hemithorax and mediastinum. The lung field on the right is over inflated consistent with COPD.
There are multiple small, calcified micro-nodules in the right upper lobe consistent with old TB.
CLINICAL CORRELATION
This man needs a surgeon, not a respiratory physician.
At operation he had a large left diaphragmatic hernia.
CLINICAL PEARLS
Type II respiratory failure needs a cause, it should not be a diagnosis in isolation
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 | ICIS Course ANZ
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Is there a defect in the right 5 or 6th rib?