Emphysematous Bulla

A 74 /m who is chronic smoker since 15 yrs(5-10 beedies/ day) come with c/0 breathlessness once 2 days and cough with expropriation since 2 days . HOPI: breathlessness is grade IX ,insidious & slow to progress ,NO ORTHOPNEA & PND. He also c/o Cough with expropriation x 2days. expectorant is mucoid ,thick, greenish in color, no blood tinged or foul smelling . no fever or evening rise of temperature. Past history:h/o breathlessness since 2 yr on and off, no h/o allergy ,no h/ o TB ,asthma,HTN o/e: Gc fair,bp-110/70mmhg ,p-80/min afebrile ,SPo2 is 88% at room air,with o2 mask 96% R/S: *reduced vocal fermitus at lt side *vocal resonant -not resonant on lt side *percussion -dull on lt side *upper and middle area rhonchi + with end expropriatory wheeze *pt is using accessory muscle of respiration #Investigation been attached ,with CXR -PA view #Pls give diagnosis ? and treatment ? #what are the complication ? #Dx of x- ray ??

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you can get it confirmed by usg thorax, and try to tap... if lung doesn't expand then go for ICD
COPD WITH LEFT SIDE EMPHYSEMA BULLA WITH UTI
left lower lobe emphysematous bulla
left sided pneumothorax...
haziness with infiltration in RT lung .Suspected case P Koch's sputum test Mantoux test Heamogram ESR . Dx P Koch's.?
is it really a bulla?? I don't think so, lung marking r clearly visible.its pneumothorax.with emphysematous changes
confirm with ct
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left side pneumothorax. go for ICD
sir esr level ????
Will let you knoe tommorrow sir
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case of COPD
COPD
yes sir copd what chest x Ray shows ??
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