Right upper lobe pneumonia and iatrogenic subdiaphragmatic free gas
Fever, tachypnoea and tachycardia.
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Airspace consolidation with air bronchograms obscuring the right superior mediastinal contour, in keeping with right upper lobe pneumonia. Sliver of free gas under the right hemidiaphragm. High-flow oxygen mask present.
This case has two main findings:
- obvious right upper lobe pneumonia
- less obvious free gas under the right hemidiaphragm
How are the two findings related? The patient was 24 hours post-operative for appendicectomy, and had developed respiratory symptoms, most likely an aspiration pneumonia given the history and that the right upper lobe is affected.
This case demonstrates a potential satisfaction of search error, where the on spotting the right upper lobe pneumonia further abnormalities are not sought.