CXR Case 124
An 84 year old lady is referred in by her GP with cough low grade fever.
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There is a large hiatus hernia and air fluid level within the stomach.
There is consolidation in the right base.
Otherwise lung parenchyma and pleura are normal.
CLINICAL CORRELATION
Aspiration pneumonia
It is highly likely that this lady has aspirated her stomach contents into her right lung.
After recovery, if fit for surgery then a repair of this hiatus hernia should be considered, particularly if this is a recurrent problem.
CLINICAL PEARLS
Aspiration may be the cause of recurrent chest infection – you don’t have to have a hiatus hernia – any swallowing dysfunction may be enough.
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