Pneumothorax and bullae
Publication Date: 2016-12-21
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Findings
There is a severe bilateral pneumothorax, worse on the right side with elevation of the heart from the sternum on both lateral views. The lung lobes are retracted from the thoracic wall. There is a mild diffuse unstructured interstitial pattern in the remaining lung lobes. The skeletal structures and visible abdominal organs are normal.
There is a round gas filled and thin walled structure within the right cranial lung lobe. There are focal regions of alveolar lung pattern affecting the right and left cranial lung lobes. There is a mild diffuse unstructured interstitial pattern in the remaining lung lobes.
The skeletal structures and visible abdominal organs are normal.
Diagnosis
Severe bilateral pneumothorax, worse on the right side. The etiology of the pneumothorax is likely secondary to a ruptured bulla given the presence of an intact large bulla in the right cranial lung lobe.
Focal alveolar pattern in the right and left cranial lung lobes most likely represents atelectasis secondary to pneumothorax. The possibility that these represent areas of aspiration pneumonia cannot be ruled out. The diffuse unstructured interstitial pattern is likely due to decreased lung volume.
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