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Continuous diaphragm sign

Case contributed by Yusra Sheikh
Diagnosis certain

Presentation

Background of Apert syndrome, tracheostomy in place, admitted with severe pneumonia. A follow up chest radiograph was requested as the patient deteriorated.

Patient Data

Age: 2 years
Gender: Male
x-ray

There is a linear lucency at the base of the heart, giving an impression of a continuous diaphragm, representing the continuous diaphragm sign and lucency along the right superior mediastinum consistent with pneumomediastinum. All this is on a background of extensive bilateral confluent opacification.

Right sided ventriculoperitoneal shunt traverses the chest. Tracheostomy in place.

Case Discussion

Our patient stayed in ICU for several months, later improved and was discharged home.

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