IMAGE OF THE
BY PROF.P.VIJAYARAGHAVAN’S UNIT
50 yr male old came with c/o
Hemoptysis three episodes over 1 day
◦ Around 100-150 ml per episode
Blood stained sputum since morning
No h/o breathlessness.
Past h/o : not a known DM/HT/BA/PT
Personal h/o: known smoker 15 yrs
Contact h/o : no contact with TB
O/E conscious ,afebrile
VITALS - stable
RS: Tracheal shift to left
apical impulse at 5 ICS lat to mid
VF,VR diminished Lt side lung fields
Dullness in same side on percussion
Lt side BS absent
Rt side NVBS heard.
Chest x ray PA view
In full inspiration
Soft tissue shadow normal
Trachea shifted to left
Homogenous opacity seen in lt upper/ mid/lower
Lt diaphragm silhouetted
Lt heart border couldn’t be made out.
Lt side crowding of ribs+
Rt side hyperinflation+
RADIOLAGICAL SIGNS: DIRECT
displacement of inter lobar fissures
crowding of vessels& bronchi
crowded air bronchograms.
Approximation of ribs
overinflation of remainder lung
displacement of hila
absence of visibility of inter lobar A.