Radiography and Computed Tomography of the Chest

A portable chest radiograph frequently complements the clinical evaluation of a patient in the intensive care unit (ICU). Standard posteroanterior (PA) chest radiographs are obtained from a distance of 72 inches with the patient erect and facing the detector. The x-ray tube is behind the patient, and the beam passes from posterior to anterior. In the ICU, the PA radiograph is replaced by the portable anteroposterior radiograph, which is obtained from a 40-inch distance with the tube in front of the patient and the patient supine or semierect.

Pneumomediastinum after Rigid Bronchoscopy

The accumulation of extrapulmonary air is a well-known complication of airway endoscopic procedures. However, pulmonic disease alone can predispose toward pneumomediastinum and pneumothorax, without iatrogenic manipulation. In this case, a portable chest radiograph diagnosed the cause of the sudden accumulation of extrapulmonary air after rigid bronchoscopy as alveolar rupture, rather than iatrogenic airway perforation. The pathophysiology of pneumothorax and pneumomediastinum and the interpretation of chest radiographs in these situations is reviewed.