Radiology assistant chest

A 45 y/o male was admitted to the hospital with a one-day history of abdominal pain and dyspnea. He noted worsening shortness of breath and a productive cough with clear sputum over the course of several days. He also noted a 9 kg weight loss over a 3 month period but denied fever, chills, or night sweats. Physical exam was notable for tachycardia, distant heart sounds, and decreased breath sounds of the lung bases bilaterally. Temp 99.2°F, HR 104, RR 20, BP 182/106 mmHg, and oxygen saturation of 95% of 2 liters via nasal cannula. Radiograph and CT attached. What are your comments?

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Cxray shows cardiomegaly Rt sided moderate pleural effusion. CT thorax showing bil pleural effusion more on Rt side. Pericardial effusion with thin rim of air ? Pneumopericardium in association. septal thickening noted. Adv echo to confirm the findings. Pleural fluid analysis to differentiate between transudate and exudates. Needs gradual reduction in BP using diuretics. Further management accordingly.

SUGGESTIVE OF... ..... BILATERAL. PLEURAL. EFFUSION... AND PERICARDIAL EFFUSION... ADVISABLE.... 1. ASPIRATION. CYTOLOGY 2. USG. ... ... WHOLE. ABDOMEN. .. 3. BLOOD. AND. ASPIRATION......FOR ......... CULTURE. AND. SENSITIVITY

Homogeneous opacity rt lower zone Hydropneumothorax Hyperinflated lung fields Rt hilar infiltrates noted Likely koch's chest Adv tapping for diagnostic and therapeutic treatment

Thanx dr Ashok Leel
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PTB B/L pleural effusion. Cardiomegaly. Rt sided hydropneumathothorax. Needs further investigations and evaluation to conclude diagnosis and line of treatment.

Thanks Dr Shivraj Agarwal
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B/l effusion....and in ct chest ...pericardial thickening with pericardial effusion...tap out the fluid and send samples for ADA , BIO , LDH CYTOLOGY 2D echo is also advisable to rule out Tubercular paricarditis ,as tb is most common cause of pericarditis...

R sided hydropneumothorax,left sided pleural effusion, pericardial effusion.fluid to be tapped and analysed for biochemistry, cytology, Ada,etc

Bilateral Plueural effusion R>L Cardiomegaly Pneumopericardium Fluid tapping for analysis Treat accordingly

Bilateral pl effusion and pericardia effusion. Adv aspiration cytology

Cardiomegaly Rt side hydropneumothorax Lt lung hyper inflated ? P T B

Tnx
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X ray reveals cardiomeagaly rt sided basal haziness .looks like pleural effusion. Usg abdomen will clear it .he must be having cardiac failure as he is a hypertensive too.pl get his cardiac evaluation ecg 2d echo. Pl rule out pulmonary tuberculosis. If it is exudate in pleural fluid analysis .that has to be addressed. It is a combination of cardiac & pulmonary comorbidity issue

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