Left lung lower lobe collapse in trauma patient
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This 55 year old male was involved in a motor vehicle accident. An X-ray was performed on day 2 of admission.
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This X-ray shows an obvious left lung collapse. Notice the patchy opacity adjacent to the left heart border, inferior to the pulmonary hilar vessels. This opacity represents collapsed lung parenchyma hyperdense relative to the surrounding inflated parenchyma. Also, note the loss of the left heart border. This is a classic sign of left lower lobe collapse 2.
Notice the widened mediastinum which is a non-specific sign of aortic injury. Posterior-anterior (PA) chest radiographs are more sensitive than anterior-posterior (AP) chest radiographs, in respect to detection of aortic dissection 1. In this case, the chest radiograph was an AP projection, and the mediastinal widening was insignificant.
Case contributed by A/Prof. Pramit Phal.
- 1. Lai V, Tsang WK, Chan WC et-al. Diagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection. Emerg Radiol. 2012;19 (4): 309-15. doi:10.1007/s10140-012-1034-3 - Free text at pubmed - Pubmed citation
- 2. Khan AN, Al-Jahdali H, Al-Ghanem S et-al. Reading chest radiographs in the critically ill (Part II): Radiography of lung pathologies common in the ICU patient. Ann Thorac Med. 2009;4 (3): 149-57. doi:10.4103/1817-1737.53349 - Free text at pubmed - Pubmed citation