CXR Case 144
A 78 year old lady is admitted from gastroenterology clinic with worsening productive cough. What procedures has she had?
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There is an oesophageal stent in situ with an naso-jejunal tube (NJT).
There are surgical clips in the left lower mediastinum indicating a previous lobectomy.
Further surgical clips in the right upper quadrant, presumably from cholecystectomy.
There are patchy, probably inflammatory changes in both lung fields, with some pleural reaction in the right base.
CLINICAL CORRELATION
This lady developed a broncho-oesophageal fistula 55 years after her left lobectomy for bronchiectasis
CLINICAL PEARLS
With decent antibiotics and postural drainage, lobectomy for bronchiectasis is very rarely performed these days.
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