A 60 year old lady with COPD and bronchiectasis presents with severe abdominal pain and breathlessness.
RR 22, BP 102/62, P 110, SpO2 96% on air.
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Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There is air under both hemidiaphragms suggesting a perforated viscus.
Bilateral patchy shadowing and atelectasis in both lung bases.
Chronic bronchiectatic changes right base.
This lady had a perforated large bowel from severe constipation.
She had a Hartmann procedure and survived.
Despite normoxia, her respiratory rate was raised when she presented due to severe metabolic acidaemia
This case emphasizes the importance of having an erect CXR in the context of severe abdominal pain – compare with Case 137