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Hepatisation of the lung

Case contributed by Dr Ian Bickle

Presentation

Cough and fever.

Patient Data

Age: 4 years
Gender: Female
X-ray

Extensive opacification of the right mid and lower zones clearly demarcated by the horizontal fissure.

Heart size normal.   Left lung clear.

Ultrasound

Clinicians concerned if a there is a pleural empyema.

Dense consolidation of the right lower lobe as evidenced by hepatisation of the right lung.

The diaphragm separates the right lobe of the liver from the right lower lobe.

No pleural collection.

Annotated image

The liver and lung are labeled with the arrow defining the diaphragm.

The only real difference in appearance between the normal liver and consolidation lung is the anechoic dots/lines indicating the hepatic veins.   The bronchioles in the consolidated lung appear identical to the biliary radicles.

X-ray

6 week follow up

Heart size normal.

The right sided consolidation has resolved.  Both lungs are now clear.

Case Discussion

Ultrasound is a quick, cheap, radiation free and effective tool for assessing for a pleural collection in all ages. 

It can distinguish pleural collection from consolidated lung as in this case.

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Case information

rID: 76173
Published: 27th Apr 2020
Last edited: 21st May 2020
System: Chest
Inclusion in quiz mode: Included

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