Case 29
This radiograph demonstrates a left subpulmonic pneumothorax in the upright position. Typically pleural air would be expected to collect apically (anti-dependently) in this position. However, this patient has a history of wedge resection evident by the staple line seen in the apical left upper lobe. This was complicated by recurrent pneumothorax for which the patient underwent pleurodesis. The resultant pleural scarring is preventing the pleural air from rising, giving this appearance.
Other than the presence of EKG leads, the remainder of the exam is unremarkable.