The Chest X-Ray Database
The Chest X-Ray Database
This previously healthy young patient presented to the emergency department after a motor vehicle collision. There is marked widening of the vascular pedicle and loss of the normal contour of the aortic arch. This finding is consistent with acute traumatic aortic injury. The lungs are clear and there are no radiographically evident fractures.
This case demonstrates both a right pneumothorax and pneumopericardium. In this case, the cause was iatrogenic during a bronchoscopy. A right chest tube is in place, though a small apical pneumothorax is still visible.
Clamshell sternotomy closure hardware is also seen, indicating that this is a lung transplant patient.
This radiograph shows severely dilated pulmonary arteries. The differential for this finding includes pulmonary hypertension, flow abnormalities from shunting or valvular disease, and connective tissue diseases, among others. This a young patient with Eisenmenger Syndrome, a condition resulting from a longstanding uncorrected left-to-right shunt. The shunt causes pulmonary hypertension, which eventually becomes so severe that the direction of flow through the shunt reverses resulting in significant hypoxemia.
The exam is otherwise normal.
This radiograph demonstrates a large hiatal hernia projecting over the mediastinum. In this case there is air within the gastric lumen which greatly aids in identification. In situations where air is not present within the herniated stomach, it can have the appearance of an abnormal cardiomediastinal silhouette. Review of prior images may assist with identification of a hernia, if available.
The exam is otherwise unremarkable.