A old male patient came to ER with acute breathlessness cough with white sputum fever since last 10 days pt is on regular medication for COPD Pt is progressively loosing weight at present 38 kgs No previous history of koch's not a diabetic or hypertensive OE pulse 66/min BP 100/60 mmhg Afebrile RR 31 RS reduced bilateral airentry CVS PA normal CNS GCS 15/15 ECG NORMAL X RAY ENCLOSED INTERPRET FINDINGS and Management protocol in this patient

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Agree with Dr Gupta Harbilass

Chiladiti syndrome it is there... But I think acute exacerbation of COPD is more harassing at present to this pt

It is chilladiti syndrome. Wt loss is due to progressive copd.But There are blebs/ bullae visible which may rupture to produce pneumothorax. Loss of breath sounds is due to damaged air spaces. Differentials mimicking this presentation of progressive respiratory distress, wt. Loss is progressive airspace disease, pulmonary lymphangiomyomatosis/ lam. But lam is more common in young females. Ct chest can conclude the diagnosis.

Chilaiditi Syndrome in a case of COPD of long duration. COPD , in a patient of long duration and advanced age, may be cause of weight loss. Rx Rule out Kocks & Malignancy Sputum for AFB CBC, Thyroid-Liver- Kidney Profile CT Chest Antibiotics Bronchodilator Nebulisers Oxygen inhalation Good nourishing diet.

Pseudopneumoperitoneum (Chiladiti syndrome).COPD is apredisposing factor in this case.Patient can have pain abdomen, vomiting. But symptoms can vary from patient to patient.Can have weiget loss also.However should be looked for HIV, pul.kochs and thyroid profile also.

Emphysematous lungs. Scoliosis. Bullae tight lower lobe? One below the left hemidiaphragm (post erior part of left lung? )

Interposition of hepatic flexor of colon in between right dome of diaphragm and liver due to laxity of hepato-phrenic ligament. (Chilaiditi syndrome) COPD.

Chilaiditi syndrome in xray apart from cold changes To rule out dev of lung cancer as pt has dramatic weight loss Management based on gold classification abcd, to calculate mmrc, cat scores, pft

Hepatic flexure of colon is coming under rt dome. Chiladiti snlyndrome Ac breathlessness may be ac excerb of copd part There is no oblivious cause of wt loss Look for HIV for at loss There,is no evidence of Koch's Wt loss may be due to agony of copd Or may be due to ac summer season Appetizers may help Do blood counts Sometimes un attended or un recognized. Un noted raised TLC is cause of poor appetite and hence wt loss

Working diagnosis CCF secondary to COPD
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