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Demographics:
62 years old, Male
Indication:
Trauma
Findings
- Veil-like increased opacification of the left hemithorax
- Patchy right perihilar opacities
- No pneumothorax
- Slight rightward mediastinal shift
- Normal size of the cardiopericardial silhouette
Diagnosis
Layering pleural effusion
Sample Report
Veil-like increased opacification of the left hemithorax likely represents a large layering pleural effusion versus hemothorax.
Slight rightward mediastinal shift. Recommend correlation with clinical signs of tension physiology.
No pneumothorax.
Patchy right perihilar airspace opacities likely relate to contusion or aspiration in the setting of trauma.
Discussion
- When a patient is positioned supine, fluid will layer along the posterior chest wall, and if there is enough fluid it will appear as if one hemithorax is shaded in more than the other
- Remember that if fluid accumulates quickly enough, it can lead to tension physiology just like air