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AP semi-upright portable chest radiograph obtained. As seen previously, there is a left IJ central venous catheter with its tip unchanged in the expected location of the superior vena cava. Lung volumes remain low with an elevated right hemidiaphragm again seen. There is improved aeration in the left lower lung with probable residual left basilar atelectasis. No large effusion is seen. Upper lungs are well aerated. Clips in the right upper quadrant noted. Left IJ central venous catheter in unchanged and appropriate position. Improved aeration at the left lung base. Stable elevated right hemidiaphragm.
Portable upright view of the chest demonstrates normal lung volumes. There is no pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unchanged. The descending aorta is mildly tortuous. There is mild-to-moderate cardiomegaly, unchanged. Pacemaker leads project over right atrium and ventricle. There is no pulmonary edema. No evidence of acute cardiopulmonary process. Persistent cardiomegaly.
Supine portable AP view of the chest was provided. There is stable prominence of the mediastinum, which was fully assessed on the prior CTA chest. Lung volumes are low. Right rib cage deformities are chronic. No effusion or pneumothorax is seen. No convincing consolidation, effusion, or pneumothorax is present. There is a rounded calcification overlying the right upper quadrant, stable, likely a large gallstone. Stable mediastinal prominence which has been previously evaluated on CT from . Stable chronic right rib cage deformity.
The right pigtail catheter has been repositioned. Multiple rounded lucencies in the right lung apex may reflect bullae. There is ground-glass opacity in the right lung likely reflecting residual atelectasis and possibly re- expansion pulmonary edema Repositioned right chest tube now with re-expansion of the right lung. Minimal residual pneumothorax. Multiple rounded lucencies in the right lung apex may reflect bullae.
There has been interval placement of a right pigtail catheter. The large right pneumothorax is minimally decreased. The right lung remains largely collapsed. Interval placement of a right pigtail catheter with minimal decrease in large right pneumothorax and persistent collapse of the right lung
Again noted is a right-sided chest tube in largely stable position. There is a persistent right-sided pneumothorax, not significantly changed in size since the most recent examination. Persistent right-sided pneumothorax with a right sided chest tube.
Redemonstrated is a pigtail catheter within the right hemithorax. There is a residual right apical pneumothorax, slightly enlarged since the most recent comparison. Redemonstrated is opacity in the right lung base, which may reflect residual atelectasis. Persistent, small right sided pneumothorax, slightly enlarged since the most recent examination.
A left PICC line terminates in the left brachiocephalic vein. As compared to prior chest CT from , right upper lobe consolidation is improving. There is still a component of pulmonary vascular congestion. The cardiac silhouette remains enlarged. There are no definite pleural effusions. No pneumothorax. Increased density in the left upper quadrant is consistent with an enlarged spleen. Left PICC line terminates in the left brachiocephalic vein. No definite pneumothorax. Improving right upper lobe consolidation with a persistent component of pulmonary vascular congestion. Splenomegaly.
There is now prominence of interstitial markings at the bases consistent with moderate pulmonary edema. More prominent opacity is present at the right base which may be due to infectious process. The heart appears slightly enlarged since the prior radiograph, which may be technical in nature. There is no pleural effusion. The osseous structures are intact. There is mild dextroconcave scoliosis of the spine. Pulmonary vascular congestions with possible more confluent opacity at the right base which may represent infection.
Heart size is mild to moderately enlarged. Mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is detected. There are no acute osseous abnormalities. No acute cardiopulmonary abnormality.
The right lung base consolidation and has minimally decreased in density. There is increase retrocardiac opacification compatible with left lower lobe atelectasis. No large pleural effusion. Cardiomediastinal silhouette is stable. Minimal decrease in density right lung base consolidation, representing pneumonia. New left lower lobe atelectasis.
Right lung base opacity is persistent. Left Lung base atelectasis is improved. There is no pneumothorax or large pleural effusion. Cardiac silhouette is within normal size. Left lung base atelectasis is improved. Stable right lung base opacity is consistent with pneumonia. Right lung base opacity is stable. Otherwise No notable interval change to explain patient's new oxygen requirement. Right lung base opacity is stable. Otherwise No notable interval change to explain patient's new oxygen requirement
Consolidation containing air bronchograms in the right lower lung with partial obscuration of the right heart border and lateral right hemidiaphragm suggests right middle lobe and right lower lobe pneumonia. Normal heart size. Normal mediastinal contours. Left hilum is normal and the right hilum is obscured by right middle lobe consolidation. Likely right middle lobe and lower lobe pneumonia.
Heart size is at the upper limits of normal, but unchanged. Mild calcification and unfolding of the aorta is present, similar in configuration to the prior study. No CHF, focal infiltrate or effusion is detected. Rounded density measuring approximately . Incidental note is made of mild curvature of the thoracic spine and background degenerative changes. Slight pleural parenchymal scarring at the right lung apex is unchanged. No acute pulmonary process identified. Question artifact versus calcified granuloma at right lung base.
The inspiratory lung volumes are appropriate. A roughly rectangular lung lesion projecting over the third left anterior interspace is longstanding, but a 6mm round opacity over the third left anterior and smaller lesions over the right third anterior rib are new since . The pulmonary vasculature is not engorged. The cardiac silhouette is top normal in size but stable. The mediastinal and hilar contours are within normal limits and unchanged. Partial calcification at the aortic knob is redemonstrated. A healed lower left rib fracture is noted. Dr notified by and email that there may be three new, small lung nodules. No acute cardiopulmonary process.
A portable view of the chest demonstrates resolution of a right apical pneumothorax. The left lung base appears more clear, which could relate to a more upright position. There is otherwise no interval change. Resolution of right apical pneumothorax.
Right subcutaneous emphysema as well as basilar atelectasis is essentially unchanged. The cardiomediastinal contour is stable. Right pigtail is unchanged in position. Otherwise, little interval change.
Compared to the prior radiograph, the lung volumes are unchanged. Bibasilar atelectasis is unchanged, worse on the right. Right pneumothorax is imperceptible. Right pleural catheter stable. Imperceptible right pneumothorax with otherwise no significant change.
There has been interval placement of a pigtail chest tube catheter within the right lateral lower hemithorax. Previously seen right pneumothorax has decreased in size with a small residual right apical pneumothorax noted. There has been re-expansion of the right lung. Subcutaneous emphysema is noted along the right lateral chest wall along the course of the catheter. Lung volumes are low. The heart size is normal with a left ventricular configuration. The aorta is mildly tortuous. Mediastinal and hilar contours are unremarkable. There is no contralateral shift of the mediastinum. Bibasilar opacities likely reflect atelectasis. Small left pleural effusion may be present. Interval placement of right sided pigtail chest tube catheter with interval reduction in size of the right pneumothorax. Small residual right apical pneumothorax noted.
There continues to be a moderate right pneumothorax. The pigtail catheter subcutaneous emphysema are unchanged. Lung volumes are low. With near complete collapse of right lower lobe. Is also volume loss/ infiltrate in the left lower lobe. Compared to the prior study. The lower lobe volume loss is much worse. An early infiltrate in this region can't be excluded. There is a persistent right-sided pneumothorax.
The pigtail catheter has been repositioned. There is decreased size of the right-sided pneumothorax. A large amount of subcutaneous emphysema is noted within the right chest wall. The rounded mass abutting the right upper lobe is again noted. The parenchymal opacity at the right lung base is stable. Calcified pleural plaques are noted on the left as before. Decreased size of right-sided pneumothorax. Stable rounded mass abutting the right upper lobe.
Since chest radiograph from earlier this morning, there is a new basilar component to the right pneumothorax, with a stable apical component. The right lower lobe is newly collapsed. The pigtail catheter remains within the lateral right lower hemithorax. No other interval change. New basilar component with unchanged apical right pneumothorax. New right lower lobe either segmental or lobar collapse. Findings were discussed with Dr. by Dr. by telephone on :30AM, min after findings remain
. Right pigtail pleural catheter remains in place with persistent loculated right basilar pneumothorax and adjacent rounded contour right hemidiaphragm. Within the left hemi thorax, there is slight worsening of opacity in the periphery of the left retrocardiac region accompanied by increasing small left pleural effusion. Otherwise no relevant change
There is a moderate right pneumothorax that is slightly increased in size compared to the study from the prior day. The right pigtail catheter is again visualized. There is a moderate amount of right subcutaneous emphysema most notably around the tract of the pigtail catheter. There is volume loss. / infiltrate in the left lower lung. Left-sided pleural plaque is again visualized. Increased right pneumothorax
A portable upright radiograph the chest demonstrates clear lungs and normal hilar and cardiomediastinal contours. There is no pneumothorax or pleural effusion. Pulmonary vasculature is normal. There is no pneumoperitoneum. A left chest wall port catheter terminates at the cavoatrial junction. No evidence of pneumoperitoneum.
Single frontal view of the chest was obtained. The heart size, which is mildly enlarged, is slightly increased compared to the prior exam, likely related to inspiratory effort. The heart size and cardiomediastinal contours are normal. The lungs are clear. No focal consolidation, pleural effusion, or pneumothorax. Dilated loop of bowel is again seen in the left upper quadrant. Left-sided central catheter terminates in the lower SVC. No free abdominal air is identified. Mild cardiomegaly. No free abdominal air identified.
There is a small residual right apical pneumothorax. No focal consolidation, pleural effusion or pulmonary edema is seen. The heart is normal size and the previously noted mediastinal shift has resolved. Interval expansion of the right lung following catheter placement with small residual right apical pneumothorax. Previously noted mediastinal shift has resolved.
After placement of a right apical chest tube right pneumothorax has markedly decreased, now is very small. Cardiomediastinal structures are midline Decrease in now small right pneumothorax.
Single portable AP chest radiograph was provided. There is prominence of the pulmonary vasculature and interstitial markings, likely representing mild pulmonary edema. There are bilateral pleural effusions, small on the right and moderate on the left. Right basilar opacities may again be due to pulmonary edema; however, infection is also possible. The heart remains enlarged. There is no pneumothorax. The bones are intact. Pulmonary edema and bilateral pleural effusions, left greater than right. Right basilar opacity which may be also edema; however, infection cannot be excluded.
Even allowing for the projection, there is mild cardiomegaly. There is persistent left lower lobe atelectasis. Increased opacity at the right lung base is more conspicuous than on the prior study. Given the lack of associated volume loss, appearances are suspicious for superimposed infection. There is persistent prominence of the bilateral hila with mild pulmonary vascular congestion. No pneumothorax seen. Background changes of atelectasis and pulmonary vascular congestion. Increased opacity at the right lung base suspicious for superimposed infection.
Prominence of the pulmonary vasculature and increased interstitial markings likely represent mild to moderate pulmonary edema. There are likely small bilateral pleural effusions. Bibasilar opacities likely reflect dependent pulmonary edema. The heart remains enlarged. Stable cardiomegaly accompanied by interstitial edema. More confluent basilar opacities may reflect dependent edema, but aspiration and infectious pneumonia should also be considered in the appropriate clinical setting.
There has been interval improvement in aeration of the right lung base with residual linear atelectasis. Lung volumes are grossly unchanged. There is persistent moderate cardiomegaly. No pleural effusion or consolidation seen. A dense opacity at the right upper lobe is likely a calcified granuloma. Calcifications in the left upper abdomen are consistent with splenic granulomas. Interval improvement of the right lower lobe airspace opacity.
There may be minimal bibasilar atelectasis. Otherwise no focal consolidation, sizeable pleural effusion or pneumothorax. Cardiomediastinal contours are normal. No acute osseous abnormalities identified. No acute cardiopulmonary process.
AP portable upright view of the chest. Lungs are clear and hyperinflated. Patient is slightly rotated to her right which somewhat limits the assessment. No focal consolidation, large effusion or pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures are intact. No free air is seen below the right hemidiaphragm. Hyperinflated lungs without acute superimposed process.
There appear to be small bilateral pleural effusions. Left base opacity may be due to combination of atelectasis and pleural effusion or could be due to consolidation, which appears increased as compared to the prior study. Left mid lung opacity may be slightly improved although there appears to be increased opacity at the left lung base. No pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Possible small bilateral pleural effusions with overlying atelectasis. Left base opacity appears increased as compared the prior study and could be due to worsening consolidation, atelectasis, or combination of pleural effusion and atelectasis. While left mid lung opacity may be slightly improved compared the prior study, there appears to be increased opacity in the right perihilar/ right mid lung which could be due to worsening infection or vascular congestion. Consider dedicated PA and lateral views for further assessment.
AP portable upright view of the chest. Overlying EKG leads are present. Lungs are hyperinflated. There is no focal consolidation, large effusion or pneumothorax. No signs of congestion or edema. The cardiomediastinal silhouette is unchanged. Bony structures are intact. No free air below the right hemidiaphragm. As above.
The lungs are relatively hyperinflated. Linear left basilar opacity is likely due to atelectasis. There is no consolidation worrisome for pneumonia. There is no large effusion. The cardiomediastinal silhouette is stable. No acute osseous abnormalities. Old left upper lateral rib deformities are likely from prior healed fractures. No focal consolidation worrisome for pneumonia.
Semi-upright portable view of the chest demonstrates tracheostomy tube in unchanged position. Nasoenteric tube is coursing through the esophagus, its tip out of view. Dual chamber dialysis catheter tip projects over right atrium. Large right pleural effusion is not significantly changed since with mild leftward shift of mediastinal structures. Small segment of aerated right lung is seen in the medial right hemithorax. Left lung remains well aerated without pleural effusion or pneumothorax. Cardiomediastinal silhouette is difficult to discern due to adjacent opacities. Multiple surgical clips and project over right upper abdomen. In comparison to exam, there is no significant change in large right pleural effusion with mild leftward displacement of the mediastinal structures.
A right internal jugular central line ends in the upper SVC. A right Swan-Ganz catheter ends in the proximal right pulmonary artery. Since the prior radiograph, lung volumes have improved. A moderate right pleural effusion is stable. There is no new consolidation. There is no edema or pneumothorax. The cardiomediastinal silhouette is normal. A feeding tube is seen in the stomach with the tip out of view. Multiple supportive and monitoring devices in the proper position. Stable right pleural effusion.
A nasoenteric tube has been inserted with the tip projecting over the stomach. A left internal jugular tunneled catheter tip terminates in the right atrium. A right-sided pleural effusion has increased in size since the preceding exam six days ago. Surgical clips in the right upper quadrant are unchanged. A small left effusion may be present. There is no focal consolidation or pneumothorax. Appropriate position of Dobbhoff tube. Increase in size of moderate right pleural effusion.
The cardiomediastinal and hilar contours are normal. Left dialysis catheter tip terminates in the right atrium. There is a large right pleural effusion with layering of fluid. There is no pneumothorax. There is no definite consolidation. Large right pleural effusion, which is likely stable compared to prior, given change in position. Underlying consolidation at the right base is possible, however, cannot be definitively excluded on this radiograph.
There has been an increase in right-sided pleural effusion with associated collapse of right upper and lower lobe. Right middle lobe appears partially inflated. There has been a corresponding mediastinal and cardiac shift to the right. Left lung volume is slightly decreased with worsened left basal atelectasis. Tracheostomy is seen in place with no obvious complication. A right IJ double-lumen catheter is seen terminating within the right atrium. A left IJ catheter is seen terminating within the low SVC. An NG tube is seen entering the stomach, courses through the pylorus and then terminates near the ligament of Treitz. There is extensive small bowel and stomach gas noted. Near-complete right lung collapse with only partial inflation of the middle lobe. There has been interval increase in right pleural effusion. There is no pneumothorax. These findings were reported to Dr. m. by .
Left-sided dialysis line appears to terminate in the right atrium, overall similar in position compared to the prior exam. Moderate left-sided pleural effusion is unchanged. There is slight interval increase in the moderate pulmonary edema. Small right-sided pleural effusion is persistent. Bibasilar atelectasis is unchanged. There is no evidence of pneumothorax. Note is made of a vascular stent below the right clavicle. The left-sided dialysis line appears to terminate in the right atrium. Interval increase in moderate pulmonary edema.