Presentation
With-held
Patient Data
Mobile AP chest radiograph.
Hazy / veiling opacity obscuring the left cardiomediastinal contour, in keeping with left upper lobe collapse.
Apparent elevation of left hemidiaphragm.
Chest radiograph from 4 hours previous demonstrates patient intubation, normally aerated left upper lobe, partial collapse of the left lower lobe, CVC, nasogastric tube.
Subsequent (supine) radiograph of same day demonstrate interval progressive collapse of left upper and lower lobes with leftward medistinal shift.
Follow-up (erect) radiograph same day post bronchoscopy (removal of mucous plug) demonstrates re-expansion of left upper and lower lobes.
Case Discussion
Acute left upper lobe collapse due to mucous plugging (post extubation).
In the viva, as in everyday practice, reviewing prior imaging is vital.
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