Bat's wings of pulmonary edema

Case contributed by Ian Bickle
Diagnosis almost certain


Elderly female attends hospital acutely short of breath.

Patient Data

Age: 75 years
Gender: Female

Bilateral perihilar consolidation in a 'bat's wing' configuration.

Supine projection does not allow comment on heart size.

No pleural effusions.

Case Discussion

Heart failure on the chest x-ray has several well-described appearances.

a. Cardiomegaly

b. Pleural effusions

c. Upper lobe venous distension

d. Interlobular septal (Kerley B) lines

e. Perihilar consolidation

In only a small portion of usually the most severe cases of pulmonary edema are the bat's wings appearance observed.

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