DIAPHRAGMATIC RUPTURE AN EMERGENCY CASE REPORT

ABSTRACTIntroduction: Diaphragmatic rupture is a major challenge for the radiologist to be confirmed as an emergency diagnosis. The prevalence of the injury is 5% of abdominal blunt force trauma cases. Left-sided injury is more common with left-to-right ratio 3:1. Chest X-Ray is a conventional modality as an early assessment of abdominal trauma and computed tomography is a standard reference to confirm this diagnosis.Case Report: A 70 yo man complained about chest pain after falling from 4 meter-height tree. Chest X-Ray revealed bowel gas appearance in the left thorax cavity with no appearance of left diaphragm. Contrasted abdominal CT showed gaster and intestine in the left thorax cavity. The patient underwent left diaphragm thoracotomy confirming the existence of gaster, ileum, and spleen in the pleural cavity. Those organs were returned to the abdomen and the left diaphragm repaired. Following-up after discharge obtained remarkable outcomes.Discussion: Confirming the diagnosis of diaphragmatic rupture is a challenge for the radiologist because it can be asymptomatic until life-threatening complications manifest such as respiratory disorders and visceral incarceration.Conclusion: With the improvement of imaging technology, the radiologist is able to confirm a diaphragmatic rupture to get a better prognosis. Key words: diaphragmatic rupture; trauma; chest X-ray; computed tomography ABSTRAK Pendahuluan : Konfirmasi diagnosis emergensi ruptur diafragma masih menjadi tantangan bagi spesialis radiologi. Prevalensi ruptur diafragma sebesar 5% dari kasus trauma tumpul abdomen dan perlukaan diafragma pada sisi kiri lebih umum terjadi dibandingkan sisi kanan dengan rasio 3:1. Foto X-Ray dada merupakan modalitas konvensional sebagai penilaian awal trauma abdomen dan computed tomography scanning (CT scan) merupakan standar pemeriksaan untuk mendiagnosis kasus tersebut.Laporan Kasus : Seorang laki-laki berusia 70 tahun mengeluhkan nyeri dada setelah jatuh dari pohon setinggi 4 meter. X-ray dada menunjukkan gambaran gas usus di sebelah kiri rongga thorax dan tidak tampak gambaran diafragma kiri. CT scan abdomen dengan kontras menunjukkan gambaran lambung dan usus di sebelah kiri rongga thorax. Pasien tersebut kemudian ditatalaksana dengan thorakotomi diafragma kiri untuk mengkonfirmasi adanya lambung, ileum dan lien pada rongga pleura. Organ-organ tersebut kemudian dikembalikan ke dalam abdomen dan diafragma kiri direparasi. Kondisi klinis pasien setelah penatalaksanaan tersebut menunjukkan perbaikan.Diskusi : Konfirmasi diagnosis ruptur diafragma merupakan tantangan bagi spesialis radiologi karena kasus tersebut bisa tidak bergejala sampai timbulnya komplikasi yang mengancam jiwa seperti gangguan respirasi dan perlekatan organ visceral.Kesimpulan : Dengan adanya perkembangan teknologi pencitraan, spesialis radiologi dapat mengkonfirmasi ruptur diafragma sehingga memberikan prognosis yang lebih baik. Kata Kunci : ruptur diafragma; trauma; chest X-ray, computed tomography

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(F)utility of computed tomography of the chest in the presence of pleural effusion

Pleura and Peritoneum ◽

10.1515/pp-2017-0019 ◽

2017 ◽

Vol 2 (4) ◽

pp. 181-186 ◽

Cited By ~ 1

Author(s):

Tilak Pathak ◽

Malvinder S. Parmar

Keyword(s):

Computed Tomography ◽

Pleural Effusion ◽

Ct Scan ◽

Clinical Management ◽

Chest Ct ◽

X Ray ◽

Contrast Enhanced ◽

Plain Chest ◽

Chest X Ray ◽

Chest Ct Scan

AbstractBackgroundPleural effusion is common and can cause significant morbidity. The chest X-ray is often the initial radiological test, but additional tests may be required to reduce uncertainty and to provide additional diagnostic information. However, additional exposure and unnecessary costs should be prevented. The objective of the study was to assess the clinical benefit of an additional chest computed tomography (CT) scan over plain chest X-ray alone in the management of patients with pleural effusion.MethodsRetrospective analysis in 94 consecutive patients with pleural effusion who underwent chest X-ray and CT scan over an 18-month period in a single institution. All chest X-ray and CT scan reports were compared and correlated with clinical parameters in order to assess their utility in the clinical management. No blinding was applied.ResultsIn 75 chest CT scan reports (80 %), information provided by the radiologist did not change clinical management when compared to plain chest X-ray alone and did not provide any additional information over chest X-ray. Only 2/49 (4 %) of the native chest CT scan reports provided clinically relevant information as compared to 17/45 (38 %) contrast-enhanced chest CT scan reports (p<0.001).ConclusionsIn this retrospective cohort of patients with pleural effusion, an additional chest CT scan was not useful in the majority of patients. However, if a chest CT scan is required, then a contrast-enhanced study after pleural aspiration should be performed. Further prospective studies are required to confirm these findings.

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Sclerosing haemangioma of the lung: A case report

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v1i1.7254 ◽

2012 ◽

Vol 1 (1) ◽

pp. 33-36

Author(s):

R Thapa ◽

M Lakhey ◽

U Shrestha

Keyword(s):

Case Report ◽

Chest Pain ◽

Ct Scan ◽

Left Lung ◽

Lower Lobe ◽

X Ray ◽

Medical College ◽

Bronchoscopic Biopsy ◽

Chest X Ray ◽

Sclerosing Haemangioma

Sclerosing haemangioma is a rare neoplasm of the lung which behaves in a clinically benign fashion. Herein, a case of sclerosing haemangioma of the lung in a 52 years old woman is reported. She presented with symptoms of cough and chest pain. Chest X-ray and CT scan showed a well-defined lesion in lower lobe of left lung. Bronchoscopic biopsy findings were suggestive of a carcinoid tumor. Later the tumor was removed by lobectomy. The distinctive constellation of histologic findings revealed it to be a sclerosing haemangioma. DOI: http://dx.doi.org/10.3126/jkmc.v1i1.7254 Journal of Kathmandu Medical College, Vol. 1, No. 1, Issue 1, Jul.-Sep., 2012 pp.33-36

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Seorang Wanita Mengalami Aspirasi Barium Dengan Komplikasi Pneumonia

Jurnal Respirasi ◽

10.20473/jr.v5-i.1.2019.5-9 ◽

2019 ◽

Vol 5 (1) ◽

pp. 5

Author(s):

Isnin Anang Marhana ◽

Adhari Ajipurnomo

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Clinical Symptom ◽

Atomic Number ◽

Aspiration Pneumonia ◽

Major Complication ◽

X Ray ◽

High Atomic Number ◽

Chest X Ray

Background. Barium aspiration is one of rare major complication of esophagography. Aspiration pneumonia occurs about 40% without clinical symptom and can cause 30% of dead. Case. A female 62 years old choked a mount of barium when swallowing barium liquid in esophagography procedure. There was ronkhi on lower left haemithorax and granuler pattern on left paracardial impressed the rest of barium in chest x-ray photo. Patient suffered symptom of infection in eight days evaluation with infiltrate and rest of barium from chest x-ray photo. Microbiology examination of bronchus lavage founded pathogen microbe Burcholderia Gladioli and Pseudomonas and containing 1,22 mg/L of barium. Discussion. Barium aspiration can occur in esophagography procedure in extreme age. Chest x-ray and Computed Tomography can be used as primer tool to diagnose and evaluate barium aspiration which imaging hiperdens pattern due to barium with high atomic number (56). Prognosis of aspiration barium can be affected by the quantity and density of barium liquid which is choked and comorbid factor in patient. Barium aspiration mixed with secrete of oropharing which containing colony of pathogen can cause penumonia as disease complication. There is still no guideline for barium aspiration management, but bronchoscopy is recommended by many clinician. Conclusion. Pneumonia occur when aspiration barium mixed with secrete oropharing which containing colony of pathogen. Chest x-ray and CT scan can be used as tool to diagnose barium aspiration. Bronchoscopy is recommended to diagnose and to manage barium aspiration. When pneumonia is suspicious, antibiotic with anaerob activity is recommended given.

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Computed Tomography-Guided Percutaneous Drainage of Pneumomediastinum in a Newborn: A Case Report

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666210907165737 ◽

2021 ◽

Vol 17 ◽

Author(s):

Turkay Rzayev ◽

Efe Soydemir ◽

Safak Gucyetmez ◽

Gursu Kiyan ◽

Hulya Ozdemir ◽

...

Keyword(s):

Computed Tomography ◽

Case Report ◽

Respiratory Distress ◽

Percutaneous Drainage ◽

Ct Guided ◽

X Ray ◽

Live Births ◽

Surfactant Treatment ◽

Newborn Girl ◽

Chest X Ray

Background: Neonatal pneumomediastinum is seen in 2.5 per 1000 live births and mostly managed conservatively. An intervention is essential in cases with tension pneumomediastinum. Ultrasonography-guided (USG-guided) relief of pneumomediastinum has been reported in newborns. There are no reported cases of computed tomography-guided (CT-guided) drainage of pneumomediastinum in neonates. Case report: A newborn girl born at 34 week of gestation was intubated due to respiratory distress and received intratracheal surfactant treatment. Pneumomediastinum was detected at the chest X-ray on the 6th postnatal hour. On the second postnatal day, the patient's oxygen needs increased, tachypnea and subcostal retractions recurred, so it was decided to intervene. USG-guided drainage of the pneumomediastinum was attempted twice but was unsuccessful. Percutaneous drainage with CT guidance was performed successfully. Conclusion: This report aims to emphasize that CT-guided intervention of pneumomediastinum can be an effective alternative in a newborn if USG-guided intervention fails.

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Symptomatic Bochdalek Hernia in Adult: a Case Report

International Archives of Medicine ◽

10.3823/2550 ◽

2018 ◽

Vol 11 ◽

Author(s):

Luis Eduardo Almeida de Souza ◽

Karlla Lorena Dos Santos Anjos ◽

Danielle Oliveira Sousa ◽

Gabriel De Jesus da Fonseca Loureiro ◽

Deborah Marques Centeno ◽

...

Keyword(s):

Case Report ◽

Ct Scan ◽

Congenital Malformation ◽

Pharmacological Treatment ◽

Chest Ct ◽

Differential Diagnoses ◽

Bochdalek Hernia ◽

X Ray ◽

Chest X Ray ◽

Chest Ct Scan

Background: The congenital malformation of the posterolateral portion of the diaphragm is called the Bochdalek hernia, and was first described in 1948 by anatomy professor Bochdalek. The diagnosis in adults is extremely rare, being in the majority, an occasional finding in a chest x-ray. Case: The authors report a Bochdalek Hernia case in an adult pacient, with complaints of dyspnea and epigastralgia refractory to pharmacological treatment. The diagnosis was confirmed after a chest CT scan. Conclusion: Bochdalek hernias are extremely rare in adults, commonly diagnosed in childhood. The importance of recognition of its diagnosis is crucial, so it should be always among differential diagnoses in radiology, due to the range of complications that may affect the patients.

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Radiological profile of patients undergoing Chest X-ray and computed tomography scans during COVID-19 outbreak

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.5.4290 ◽

2021 ◽

Vol 37 (5) ◽

Author(s):

Sohail Ahmed Khan ◽

Murli Manohar ◽

Maria Khan ◽

Samita Asad ◽

Syed Omair Adil

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

P Value ◽

X Rays ◽

Lung Involvement ◽

Rt Pcr ◽

X Ray ◽

Computed Tomography Scans ◽

Chest X Ray ◽

Bilateral Lung

Background & Objective: Radiology has played a significant role in the diagnosis and quantifying the severity of COVID 19 pulmonary disease. This study was conducted to assess patterns and severity of COVID-19 pulmonary disease based on radiological imaging. Methods: A prospective observational study was conducted in a large tertiary care public sector teaching hospital of Karachi, Pakistan from June 2020 till August 2020. All confirmed and suspected COVID-19 patients referred for chest X-rays and computed tomography (CT) scans were evaluated along with RT-PCR results. Suspected patients were followed for RT-PCR. Radiological features and severity of imaging studies were determined. Results: Of 533 patients in whom X-rays were performed, majority had severe/critical findings, i.e., 304 (57.03%). Of 97 patients in whom CT scan was performed, mild/moderate findings were observed in 63 (64.94%) patients. Of 472 patients with abnormal X-rays, majority presented with alveolar pattern 459 (97.2%), bilateral lung involvement 453 (89.6%), and consolidation 356 (75.4%). Moreover, lobar predominance showed lower zone preponderance in 446 (94.5%) patients. Of 88 patients with abnormal CT findings, ground-glass opacity (GGO) 87 (98.9%) and crazy paving 69 (78.4%) were the most common findings. An insignificantly higher association of PCR positive cases was observed with severe/critical X-rays (p-value 0.076) and CT scan findings (p-value 0.431). Conclusion: Most common patterns on CT scans were GGO and crazy paving. While on chest radiographs, bilateral lung involvement with alveolar pattern and consolidation were most common findings. On X-rays, majority had severe/critical whereas CT scan had mild/moderate findings. doi: https://doi.org/10.12669/pjms.37.5.4290 How to cite this:Khan SA, Manohar M, Khan M, Asad S, Adil SO. Radiological profile of patients undergoing Chest X-ray and computed tomography scans during COVID-19 outbreak. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4290 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Tension Bullae With Peripheral Pneumothorax

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709620963646 ◽

2020 ◽

Vol 8 ◽

pp. 232470962096364

Author(s):

Tushar Bajaj ◽

Bushra Malik ◽

Sudhagar Thangarasu

Keyword(s):

Computed Tomography ◽

Case Report ◽

Rare Case ◽

Tension Pneumothorax ◽

Accurate Assessment ◽

X Ray ◽

Standard Management ◽

Size Number ◽

Rare Case Report ◽

Chest X Ray

The differentiation between tension bullae, chronic tension pneumothorax, and atypical pneumothorax is difficult just from history and physical examination alone. A chest X-ray may help determine the underlying etiology; however, further imaging with computed tomography in stable patients may be necessary for accurate assessment of size, number, and location before considering any interventions. In this article, we present a rare case report of tension bullae with peripheral pneumothorax and recommend against needle thoracostomy in stable patients with tension bullae in order to obtain further imaging that may result in a change in the standard management.

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Requesting physicians’ knowledge of X-radiation exposure from computed tomography scan examinations: A case study of two Nigerian tertiary hospitals

Calabar Journal of Health Sciences ◽

10.25259/cjhs_9_2019 ◽

2020 ◽

Vol 3 ◽

pp. 36-39

Author(s):

Samson O. Paulinus ◽

Benjamin E. Udoh ◽

Bassey E. Archibong ◽

Akpama E. Egong ◽

Akwa E. Erim ◽

...

Keyword(s):

Computed Tomography ◽

Ionizing Radiation ◽

Ct Scan ◽

Radiation Exposure ◽

Work Experience ◽

Radiation Risk ◽

Radiological Protection ◽

X Ray ◽

Tertiary Hospitals ◽

Medical Exposure

Objective: Physicians who often request for computed tomography (CT) scan examinations are expected to have sound knowledge of radiation exposure (risks) to patients in line with the basic radiation protection principles according to the International Commission on Radiological Protection (ICRP), the Protection of Persons Undergoing Medical Exposure or Treatment (POPUMET), and the Ionizing Radiation (Medical Exposure) Regulations (IR(ME)R). The aim is to assess the level of requesting physicians’ knowledge of ionizing radiation from CT scan examinations in two Nigerian tertiary hospitals. Materials and Methods: An 18-item-based questionnaire was distributed to 141 practicing medical doctors, excluding radiologists with work experience from 0 to >16 years in two major teaching hospitals in Nigeria with a return rate of 69%, using a voluntary sampling technique. Results: The results showed that 25% of the respondents identified CT thorax, abdomen, and pelvis examination as having the highest radiation risk, while 22% said that it was a conventional chest X-ray. Furthermore, 14% concluded that CT head had the highest risk while 9% gave their answer to be conventional abdominal X-ray. In addition, 17% inferred that magnetic resonance imaging had the highest radiation risk while 11% had no idea. Furthermore, 25.5% of the respondents have had training on ionizing radiation from CT scan examinations while 74.5% had no training. Majority (90%) of the respondents were not aware of the ICRP guidelines for requesting investigations with very little (<3%) or no knowledge (0%) on the POPUMET and the IR(ME)R respectively. Conclusion: There is low level of knowledge of ionizing radiation from CT scan examinations among requesting physicians in the study locations.

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A Survey on Deep Convolutional Generative Adversarial Neural Network (DCGAN) for Detection of Covid-19 using Chest X-ray/CT-Scan

2020 3rd International Conference on Intelligent Sustainable Systems (ICISS) ◽

10.1109/iciss49785.2020.9316125 ◽

2020 ◽

Author(s):

S. Nikkath Bushra ◽

G. Shobana

Keyword(s):

Neural Network ◽

Ct Scan ◽

X Ray ◽

Chest X Ray

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Efficacy of chest X-ray in the diagnosis of COVID-19 pneumonia: comparison with computed tomography through a simplified scoring system designed for triage

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00541-x ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Akın Çinkooğlu ◽

Selen Bayraktaroğlu ◽

Naim Ceylan ◽

Recep Savaş

Keyword(s):

Computed Tomography ◽

Intensive Care ◽

Intensive Care Units ◽

Scoring System ◽

Imaging Modality ◽

Ground Glass Opacity ◽

Initial Presentation ◽

X Ray ◽

Chest X Ray

Abstract Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.

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