There is volume loss in the left lung as indicated by an elevation of the left hemi-diaphragm and shift of mediastinum to the left. The left hemithorax is also smaller than the right. In addition, the left hemidiaphragm is obscured indicating a left lower lobe collapse. At bronchoscopy, she was found to have a benign stricture of the left lower lobe orifice (Fig. 69.2) from previous tuberculosis.
Case 70. This 35-year-old female had a long history of chronic productive cough. Her CXR is shown (Fig. 70.1).
CASE 70 DEXTROCARDIA DUE TO KARTAGENER'S SYNDROME
This patient has obvious dextrocardia (the heart is on the right side) and situs inversus (the stomach bubble is also on the right side instead of the left). There is also right lower lobe bronchiectasis (Fig. 70.2) as evidenced by bronchial wall thickening, bronchial opacification (bronchocele), and loss of volume. Dextrocardia and situs inversus may be associated with ciliary dysfunction causing sinusitis and bronchiectasis. This is called Kartagener's Syndrome.
Case 71. This elderly male alcoholic had a binge and subsequently presented with alcoholic intoxication and vomiting. His CXR is shown (Fig. 71.1). What is the main abnormality?
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