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MIMIC-CXR-JPG/2.0.0/files/p10420269/s58196663/96cdf93a-05c9fe68-d47c6f37-db3d5736-cf5046a7.jpg
cardiomediastinal silhouette is within normal limits. lungs are symmetrically expanded. linear opacities at the left apex at the right base were present previously likely represent scarring. no focal consolidation or pleural effusion. no pneumothorax.
<unk> year old woman with abdominal bloating hyperactive bowel sounds, not passing gas but passing stool // eval for signs of ? partial obstruction
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portable semi-erect chest film <unk> <time> is submitted.
<unk> year old man with respiratory failure // eval position of ett, og tube eval position of ett, og tube
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single portable view of the chest. there is increased opacity identified at the right lung base. elsewhere, the lungs are clear. the cardiomediastinal silhouette is within normal limits. no definite acute osseous abnormalities identified.
<unk>-year-old male with shortness of breath and wheezing for one week.
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the large right superior mediastinal mass extending into the right hemithorax is unchanged. tracheostomy tube in situ. right main bronchus stent is unchanged. feeding tube in situ. right-sided pigtail catheter in situ with no visualized right-sided pleural effusion. minor left-sided pleural effusion with adjacent atelectatic changes appear similar compared to previous imaging.
<unk> year old woman with large right lung mass dx on this hospitalization has had worsening resp status // effusions, consolidation?
MIMIC-CXR-JPG/2.0.0/files/p17225329/s58007352/dd3fbfbb-dbf610aa-11e938ba-c29a499c-3d5ca960.jpg
endotracheal tube terminates approximately <num> cm above the carina. enteric tube courses into the lower chest, as the field of view. there are persistent extensive bilateral pulmonary opacities stable to possibly slightly increased as compared to the prior study. the costophrenic angles are not fully included on the image, no large pneumothorax is seen. the cardiac and mediastinal silhouettes are stable.
history: <unk>f with s/p arrest worsening hypoxia // ?acute cardiopulmonary process
MIMIC-CXR-JPG/2.0.0/files/p19637979/s52107872/8b921a9a-a8da18cb-fc7ca22e-e1e36cc3-29650d96.jpg
cardiac and mediastinal contours are normal. lungs are clear. pulmonary vasculature is normal. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
chest pain.
MIMIC-CXR-JPG/2.0.0/files/p12661334/s56974780/2b24d2c5-2d072d1b-0ea268ec-3ce39c47-4deb38a5.jpg
lung volumes are slightly low. this accentuates the size of the cardiac silhouette which is borderline enlarged. the mediastinal and hilar contours are normal. lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. there is no pulmonary vascular congestion. no acute osseous abnormalities are visualized.
tia versus stroke.
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bibasilar opacities are again seen, more consolidative on the right and possibly slightly increased on the left, which could be due to worsening aspiration and/or infection. blunting of the costophrenic angles could relate to atelectasis or small pleural effusions. mild central pulmonary vascular congestion is re- demonstrated. the cardiac and mediastinal silhouettes are stable. no pneumothorax is seen.
history: <unk>m with fever and cough // eval pneumonia
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the lungs are relatively hyperinflated no focal consolidation is seen. there is mild right apical pleural thickening. no pleural effusion or pneumothorax is seen. the cardiac silhouette is top-normal in size. the mediastinal contours are unremarkable. no pulmonary edema is seen. no evidence of free air is seen beneath the diaphragm.
history: <unk>f with epigastric pain // ?pneumonia
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endotracheal tube, orogastric tube, swan-ganz catheter, mediastinal and pleural drains have been removed. the lungs are well inflated. no pneumothorax or focal consolidation is present. minimal bibasilar hazy opacities are new. trace postoperative pneumomediastinum is again present. moderate cardiomegaly is unchanged.
<unk>-year-old woman status post avr with chest tube with line removal.
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a supine portable frontal chest radiograph demonstrates an endotracheal tube with the tip obscured by overlying support lines and tubes, but appears to terminate <num> cm above the carina. the nasogastric tube courses below the diaphragm and off the inferior edge of the image. metallic clips are again seen in the right axilla. lung volumes are low, resulting in increased prominence of the cardiac silhouette and bronchovascular crowding. no definite focal consolidation is seen. there is a small left pleural effusion. no pneumothorax is identified. free air seen under the right hemidiaphragm on the prior radiograph is not well as well appreciated on this exam.
patient with known gastric perforation, now intubated. evaluate tube position.
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a new endotracheal tube is in satisfactory position, approximately <num> cm from the carina. nasogastric tube courses below the diaphragm with the tip out of the field of view. the lung volumes are low, accentuating the bronchovascular structures. there is no large airspace opacity, pulmonary edema, pleural effusions or pneumothorax. the cardiomediastinal silhouette is normal.
status post intubation. evaluate tube position.
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frontal and lateral views of the chest. linear opacities at the lung bases bilaterally most likely due to atelectasis. there is mild blunting of the posterior costophrenic angles which could be due to trace effusions. the lungs are otherwise clear of focal consolidation. cardiomegaly is unchanged. left chest wall dual-lead pacing device seen with leads in stable position. degenerative changes seen at the shoulders. no acute osseous abnormality is detected.
<unk>-year-old female with chest pain.
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in comparison with prior radiographs on <unk>, there is moderate pulmonary edema with a persistent left mid lung consolidation likely reflecting pneumonia. et tube, left dialysis catheter, right central venous catheter and ng tube are all unchanged in position. cardiomediastinal silhouette is similar to prior. median sternotomy wires are stable in appearance.
<unk> year old man s/p cabg with increased vent support // eval ett placement, edema/consolidation
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the heart size is normal. the mediastinal contours are unchanged with minimal tortuosity of the thoracic aorta. there are mild aortic calcifications. the pulmonary vascularity is not engorged. linear opacities within the left lower lobe are compatible with subsegmental atelectasis. no focal consolidation, pleural effusion or pneumothorax is present. dish is seen within the thoracic spine.
chest pain.
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there is no focal consolidation, pleural effusion or pneumothorax. the tracheostomy tube now appears midline. there are <unk> in the neck. there is bibasilar atelectasis. the previously elevated right hemidiaphragm is now in normal position. the cardiomediastinal silhouette is unremarkable.
<unk>-year-old woman with substernal goiter, thyroidectomy, evaluate for lung expansion, pneumothorax.
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the lungs are hyperinflated, compatible with copd. mild bibasilar atelectasis is present. calcified apical pleural thickening and scattered calcified pulmonary nodules are stable consistent with prior granulomatous infection. there is no pleural effusion, pulmonary edema, or focal airspace consolidation. a left chest wall pulse generator device, with pacemaker leads in the right atrium and right ventricle are unchanged. multiple healed right-sided rib deformities and compression deformities in the thoracic spine are unchanged.
history: <unk>f with fall with unknown circumstances, ?syncope? // r/o fracture, ich, pna
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frontal and lateral chest radiographs demonstrate clear, well-expanded lungs, with note made of eventration of the right hemidiaphragm. there is no pleural effusion or pneumothorax. the pulmonary vasculature is normal. the cardiac silhouette is mildly enlarged, unchanged. the aortic valve annulus and coronary arteries are heavily calcified. the mediastinal contours are normal. there is a small hiatal hernia, newly appreciated.
<unk>-year-old with chest pain, evaluate for pneumonia.
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the lungs are clear. the cardiomediastinal silhouette is within normal limits. no displaced fractures are identified.
<unk>f s/p mechanical fall // r/o rib fx
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the lungs are clear without a consolidation or pulmonary edema. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is normal. there is no free air below the hemidiaphragms. there is a mild dextroscoliosis centered in the mid thoracic spine.
pleuritic right chest pain. evaluate for consolidation.
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no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. the heart size is normal. mediastinal contours are normal. no bony abnormality is detected.
acute pancreatitis, evaluate for acute cardiopulmonary process.
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moderate cardiomegaly appears somewhat smaller than compared to <unk> with mild tortuosity of thoracic aorta. left-sided dual-lead pacer is unchanged in position. there is a central pulmonary vascular engorgement with moderate right greather than left layering bilateral pleural effusions. there is a suggestion of minimal interstitial edema. there is leftward mediastinal shift. there is no pneumothorax.
chest pain and hypoxia.
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the lungs are clear without focal consolidation, effusion, or edema. cardiac silhouette is top-normal. atherosclerotic calcifications are seen at the aortic knob and there is tortuosity of the descending thoracic aorta. no acute osseous abnormalities.
<unk>f with <unk> and <unk> // hydro? pulm edema
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the cardiomediastinal and hilar contours are stable with top-normal heart size. there is no pleural effusion or pneumothorax. the lungs are well expanded without focal consolidation concerning for pneumonia. pulmonary vascularity is within the patient's baseline, with slight cephalization.
<unk>m with hypoglycemia, leukocytosis.
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lung volumes are low. the lungs are clear without focal consolidation. there is no pneumothorax or pleural effusion. the cardiomediastinal hilar contours are within normal limits.
<unk>f with left chest pain, myalgias. evaluate for acute abnormality.
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medial right lower lobe consolidation is worrisome for pneumonia. the left lung is clear. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>m with cough // evaluate for pneumonia
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there is a subtle, left lower lobe airspace opacity concerning for infection. no pleural effusion, pneumothorax, or overt pulmonary edema is seen. the heart size is top normal. mediastinal contours are normal.
fever.
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the cardiomediastinal silhouette and pulmonary vasculature are unremarkable. the lungs are grossly clear. there is no pleural effusion or pneumothorax.
history: <unk>m with tachycardia, wbc // eval for pna
MIMIC-CXR-JPG/2.0.0/files/p11512369/s55063138/c85b92cc-b02d2e34-451303f5-9eae3b26-f0be004a.jpg
an endotracheal tube terminates <num> cm above the carina. an enteric tube passes below the diaphragm, outside the field of view. there is retrocardiac linear atelectasis at the left lung base. lung volumes are low with associated crowding of the bronchovascular structures. no pleural effusion or pneumothorax. heart size is normal. cardiomediastinal and hilar silhouettes are normal. surgical clips projecting over the with right upper quadrant are presumably related to cholecystectomy. a radiopaque pin projecting over the left lung apex is likely external to the patient.
<unk>f with endotracheal tube placement
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right internal jugular venous catheter terminates in mid svc. two transesophageal tubes terminate in the stomach. prosthetic aortic and mitral valves are noted. et tube terminates <num> mm above the carina. there is increased alveolar consolidation with air bronchogram involving entire right lung. multiple foci of opacity in the left lung is similar as before. bilateral pleural effusion appear stable. right pleural pigtail catheter is in unchanged position. cardiac silhouette is within normal size.
<unk> year old man with ivdu, hcv, recent <unk> endocarditis, complex pleural effusions now intubated with hypoxic respiratory failure // assess for interval change
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heart size is mildly enlarged. the mediastinal and hilar contours are unremarkable. pulmonary vasculature is not engorged. patchy opacities in the lung bases may reflect atelectasis, but infection is not excluded in the correct clinical setting. no pleural effusion or pneumothorax is detected. mild degenerative changes are noted in the thoracic spine.
<unk> year old man with sudden onset dysarthria // eval for consolidation
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portable semi-erect chest radiograph <unk> <time> is submitted.
<unk> year old woman with new left sided chest tube // r/o ptx r/o ptx
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lower lung volumes seen on the current exam with streaky left basilar opacity which is compatible with atelectasis. superiorly, the lungs are clear without focal consolidation. there is no effusion or pneumothorax. degree of cardiomegaly is unchanged. tortuosity of the descending thoracic aorta is again noted as well as median sternotomy wires which are intact. compression deformity in the upper lumbar spine is unchanged. no acute osseous abnormalities.
<unk>m with cp // acute process
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a right internal jugular approach central venous dialysis catheter is present with tip terminating in the low svc. bilateral pleural effusions are present, small to moderate on the right and small on the left, with moderate pulmonary edema. opacification of the right lung base may be accounted for by the pleural effusion with associated atelectasis, but an underlying consolidation is not excluded; the right hemidiaphram also appears elevated. there is no pneumothorax. there is moderate cardiomegaly, and the mediastinal contours are unremarkable.
<unk>-year-old male, preoperative assessment.
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frontal and lateral views of the chest. the lungs are clear without focal consolidation, effusion or pulmonary vascular congestion. the cardiomediastinal silhouette is normal. no acute osseous abnormality is identified.
<unk>-year-old male with productive cough and low-grade fevers.
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portable semi-erect chest radiograph <unk> <time> is submitted.
<unk> year old woman s/p cabg // eval for effusion eval for effusion
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pa and lateral views of the chest provided. hyperinflation with upper lobe lucency and splaying of bronchovasculature is concerning for underlying emphysema. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>m with cough x<num> weeks // eval for infiltrate
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cardiomediastinal and hilar contours are within normal limits. there is increased opacity in the right mid to lower lung, best appreciated on the frontal view concerning for pneumonia. no pleural effusion or pneumothorax.
<unk>f with cough and fevers // pna
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ap portable upright view of the chest. left chest wall pacer device is seen with pacer leads extending into the region of the right atrium and right ventricle. lung volumes are low. the heart is mildly enlarged. there is hilar congestion and mild interstitial edema. no large effusion is seen though the right cp angle is excluded. no pneumothorax. no convincing evidence for pneumonia though the left base is suboptimally assessed. no bony abnormalities. no free air below the right hemidiaphragm.
<unk>m with concern for perforation
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the et tube is approximately <num> cm from the carina. the enteric tube traverses below the diaphragm with the tip out of view of the film. the right-sided ij ends in the superior svc. there has been an interval increase in pulmonary vascular congestion and bilateral pulmonary edema. there has also been an increase in mild bibasilar atelectasis. the heart remains moderately enlarged, stable compared to studies back to <unk>. the mediastinal contours remain widened compared to the study from yesterday, likely secondary to vascular engorgement. no new focal consolidations are seen. there is no pneumothorax. there is no significant pleural effusion.
<unk>-year-old man with an increased need for peep, history of pulmonary edema.
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the cardiac, mediastinal and hilar contours are normal. the pulmonary vascularity is normal. the lungs are clear. no pleural effusion or pneumothorax is identified. no acute osseous abnormality seen.
fall with left tibial fracture. preop evaluation.
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right internal jugular central venous catheter tip is in unchanged position. left picc tip terminates in the upper svc. lung volumes are lower than on the prior study. heart size is top-normal. mediastinal and hilar contours are unchanged. there is mild pulmonary vascular congestion without overt pulmonary edema. patchy ill-defined opacities are noted in the lung bases concerning for infection. no pleural effusion or pneumothorax is present. there are no acute osseous abnormalities.
history: <unk>m with hypoxia
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frontal and lateral views of the chest. region of consolidation identified in the retrocardiac region which silhouettes the descending thoracic aorta. blunting of posterior costophrenic angle suggests small effusions. elsewhere, the lungs are clear. cardiac silhouette is the mildly enlarged. no acute osseous abnormalities detected.
<unk>-year-old male with weakness. prior left lower lobe pneumonia.
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the cardiac, mediastinal and hilar contours appear unchanged. the heart is mild to moderately enlarged but unchanged. fissures are minimally thickened. there is no pleural effusion or pneumothorax. a diffuse moderate interstitial abnormality appears very similar to the prior studies. no superimposed acute focal abnormality is identified. there has been no definite change.
shortness of breath.
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pa and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. an old ununited left mid shaft clavicle fracture is seen. chronic right rib cage deformities are also seen. no free air below the right hemidiaphragm is seen.
<unk> year old woman with <num> pack-year smoking hx and cough
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ap portable semi upright view of the chest. an endotracheal tube is seen positioned approximately <num> cm above the carina. advancement by at least <num> cm would result in more optimal positioning. an endogastric tube is also seen extending into the left upper abdomen with its tip excluded from view. extensive bilateral patchy airspace consolidation is noted involving the bilateral mid and lower lungs with relative sparing of the apices. findings may reflect severe pneumonia versus extensive aspiration. cardiomediastinal silhouette is normal. bony structures are intact. no free air below the right hemidiaphragm.
<unk>m with pneumonia s/p intubation // eval ett s/p transfer
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no focal consolidation is identified. there is moderate pulmonary vascular congestion and interstitial edema. the cardiac silhouette is normal. there is no pleural effusion or pneumothorax. included upper abdomen is unremarkable. calcifications of the aortic arch are noted.
stroke, evaluate for acute process.
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frontal and lateral chest radiographdemonstrates hypoinflated lungs with crowding of vasculature. no pleural effusion or pneumothorax. cardiomediastinal silhouette is newly enlarged, likely accentuated due to low lung volumes. mediastinal contour, and hila are unremarkable. limited assessment of the upper abdomen is within normal limits.
fever. assess for infectious process.
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pa and lateral chest radiographs are obtained with the patient in the upright position. the heart is normal in size and cardiomediastinal contours are unremarkable. lungs are clear. no focal consolidation, pleural effusions, or pneumothorax.
<unk>-year-old woman with severe persistent asthma.
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there are bilateral pleural effusions, right greater than left. there is no focal consolidation or pulmonary edema. old posterior right rib fractures, right proximal humeral and distal right clavicle fractures are noted. hypertrophic changes are noted in the spine. tips identified in the upper abdomen.
<unk>m with cirrhosis, doe // eval for acute process, attn to effusion
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the lungs are well expanded and clear. mediastinal contours, hila, and cardiac silhouette are normal. the aorta is calcified and tortuous. no pneumothorax or pleural effusion. no osseous abnormality identified within the limits of plain radiography.
<unk>f with s/p fall, on ground x <num> days, complains of left sided rib pain. // fracture
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frontal and lateral chest radiographdemonstrates hypoinflated lungs with crowding of vasculature and heterogeneous right lower lobe opacity. no pleural effusion, pneumomediastinum, or pneumothorax. heart size, mediastinal contour, and hila are unremarkable. limited assessment of the upper abdomen is within normal limits.
new <num> /<unk> chest pain after nausea vomiting in blood pressure in the <num>s. heart rate in the <num>s. assess for pneumomediastinum or esophageal rupture.
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this film is centered in the thoracoabdominal region to assess the placement of the ng tube, and evaluation of the thorax is limited. there is a new ng tube with tip terminating in the ge junction.
<unk>-year-old with new ng placement.
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a monitoring device overlaps the left lower chest on the pa view. no consolidation is otherwise seen. there is no evidence for pulmonary edema or pleural effusion. the previously noted nodule in the left lower lung field is not well seen. heart size is near the upper limit of normal, unchanged. mediastinal and hilar contours are stable and unremarkable. mild degenerative changes are noted in the thoracic spine.
history: <unk>f with chest pain just prior to arrival with associated dizziness and left sided arm pain. evaluate for cardiomegaly.
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left-sided port-a-cath tip terminates in the svc. right-sided dual-lumen pacemaker device is again noted with leads terminating in the regions of the right atrium and right ventricle. moderate cardiomegaly has decreased in size compared to the prior study. similarly, widening of the mediastinal contour has also improved, with continued but improved mild to moderate pulmonary edema. moderate, multiloculated left pleural effusion has slightly decreased in size with unchanged trace right pleural effusion. thickened irregular pleural thickening is also noted bilaterally, as seen previously. patchy left basilar opacity likely reflects compressive atelectasis, however infection cannot be completely excluded. no pneumothorax is present. compression deformities within the lower thoracic spine with associated kyphosis are unchanged.
<unk> year old man with productive cough and shortness of breath
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there is a faint tubular density approximately <num> cm in length, projecting over the expected course of the right mainstem bronchus. this would be compatible with a right mainstem bronchus stent, best correlated with details of the procedure. again seen is patchy opacity of both lung bases, slightly increased at the base of the right cardiophrenic region. no pneumothorax is detected. the cardiomediastinal silhouette is unchanged allowing for technical differences. again seen is linear density projecting over the right heart silhouette, of uncertain etiology or significance --? vascular calcification, surgical material, or residual oral contrast, for example, in the neo esophagus. no new focal infiltrate is identified. minimal blunting of the right costophrenic angle is unchanged. oral contrast again noted in the bowel.
<unk> year old man with te fistula now s/p airway stenting // stent placement (r mainstem bronchus), ptx
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the cardiomediastinal and hilar contours are normal. there is no pleural effusion or pneumothorax. previously seen mild interstitial abnormality has largely resolved with only very mild septal thickening seen on the lateral view, consistent with near complete resolution of mild pulmonary edema. there is no focal consolidation concerning for pneumonia.
cough, relative leukocytosis.
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lungs are hyperinflated. biapical scarring is unchanged. no new focal opacity. multiple embolization coils project over the right upper lung, right lower lung, and left lower lung, and are unchanged in position. heart size is normal. cardiomediastinal hilar silhouettes are unremarkable.
<unk> year old woman with lung avm, ?stroke // lung avm and coils?
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pa and lateral views of the chest provided. left chest wall aicd again noted with single lead extending into the region of the right ventricle. a prosthetic cardiac valve and midline sternotomy wires are noted. the heart is enlarged in the interval. the aorta appears unfolded. there are small bilateral pleural effusions. hilar engorgement is noted with mild interstitial pulmonary edema. no focal consolidation to suggest pneumonia. no pneumothorax.
<unk>m with sob
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single frontal view of the chest demonstrates multiple ekg leads projecting over the thorax limiting underlying assessment. the lung volumes are low accentuating a prominent cardiac silhouette which is likely accentuated by ap technique. there are left greater than right bilateral pleural effusions. retrocardiac opacity likely represents consolidation admixed with compressive atelectasis upon correlation with prior ct. scattered perihilar right greater than left opacities on correlation with preceding ct represent multifocal consolidation and cavitary sequela of septic emboli. there is no pneumothorax. median sternotomy wires are in place.
<unk>-year-old female with heart block, mvr and tvr. question pneumothorax.
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right subclavian central venous catheter, swan-ganz catheter, endotracheal tube, nasogastric tube and left chest tube are unchanged in position. there is persistent retrocardiac and left basilar opacification with deep sulcus sign on the left suggesting a combination of atelectasis and pneumothorax, although superimposed infection is not excluded. a small left apical pneumothorax is also present. multiple rib fractures are re-demonstrated. the cardiomediastinal and hilar contours are within normal limits.
pre-operative evaluation of the chest prior to organ donation.
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portable semi-erect chest film <unk> at <time>
<unk> year old man with acute hypoxia after cabg // reason for hypoxia reason for hypoxia
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patient is status post median sternotomy with unchanged fractures of the <num> superior most wires. heart size is normal. mediastinal and hilar contours are unchanged. mild probe vascular congestion is present. patchy opacities are seen within the right mid lung field as well as within both lung bases, not substantially changed in the interval, and may be reflective of chronic or recurrent aspiration. no pleural effusion or pneumothorax is present. calcifications in the right upper quadrant of the abdomen likely reflect cholelithiasis.
history: <unk>m with shortness of breath and fever
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frontal and lateral chest radiographs demonstrate moderate cardiomegaly and hyperinflated lungs without focal consolidation. emphysematous changes are seen bilaterally. there is no pleural effusion or pneumothorax. the visualized upper abdomen is unremarkable.
fever.
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portable ap chest radiograph. lung volumes are very low with worsening perihilar and interstitial opacities consistent with pulmonary edema. there is also probably a mild pleural effusion on the left. the heart size is mildly enlarged. there is no pneumothorax.
brachial thrombectomy performed. patient has had a prior cabg and now is in chf with an ejection fraction of <num>%. evaluation for pulmonary edema.
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the right picc line terminates in lower svc. the enteric tube terminates in the stomach. bilateral patchy opacification is unchanged. bilateral lower lobe atelectasis is persistent. left pleural effusion has increased. no pneumothorax. mediastinal silhouette is normal and unchanged.
<unk> year old woman with <unk>'s and schizoaffective now req o<num> // interval worsening
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there has been interval placement of a left subclavian picc with the tip projecting over the cavoatrial junction. heart size, cardiomediastinal silhouette and hilar contours are normal. the left cardiophrenic angle is excluded however the lungs are otherwise clear. there is no pleural effusion or pneumothorax.
left picc placement.
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increase in the size of the bilateral pleural effusions, now small to moderate in extent. there are overlying opacities which likely reflect atelectasis and/or consolidation. no pneumothorax identified. the size the cardiac silhouette is enlarged but unchanged. there is calcification of the mitral annulus. a right internal jugular central venous catheter is present, the tip projecting over the superior cavoatrial junction. marked degenerative changes of the right shoulder.
<unk>f s/p recent r colectomy for obstructing colon cancer <unk> s/p recent fall from standing s/p l hip orif <unk>, now w abscess cavity near r colectomy anastomosis s/p ir drain now w/ new oxygen requirement // ?pna ?aspiration
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pa and lateral views of the chest. the lungs are clear. there is no consolidation, effusion or pneumothorax. note is made of an azygos fissure. cardiomediastinal silhouette is normal. osseous and soft tissue structures demonstrate no acute abnormality.
<unk>-year-old male with chest pain radiating to left arm.
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endotracheal tube terminates <num> cm above the carina. left internal jugular catheter is unchanged in position, and terminates in the low svc. right lower lobe pneumonia continues to improve. there is streaky atelectasis at the left lung base. no other consolidation. right pleural effusion is small, if any. no pneumothorax. there is no pulmonary edema. cardiomediastinal contours are normal.
<unk> year old woman with hypoxemic respiratory failure // eval for pneumonia, pulm edema
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after placement of a right apical chest tube right pneumothorax has markedly decreased, now is very small. cardiomediastinal structures are midline
<unk> year old man with ptx, s/p ct placement // eval for ptx
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pa and lateral views of the chest. there is a new large right pleural effusion with adjacent atelectasis. there is also new moderate left pleural effusion. there is increased opacity throughout both lungs, most consistent with pulmonary edema. the heart is not well evaluated due to the adjacent effusions. there are aortic knob calcifications. no pneumothorax.
shortness of breath and weight gain for the past two weeks.
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moderate cardiomegaly, possibly slightly increased from <unk>. no rib fracture seen on limited assessment. no chf, focal infiltrate or effusion detected. mild upper zone redistribution again noted. the azygos vein measures <num> mm.
history: <unk>f with chest pain after fall // ?pneumonia
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single portable chest radiograph obscured by trauma board demonstrates low lung volumes. cardiac silhouette appears enlarged though this may reflect expiratory phase scanning. diffuse bilateral lung opacifications likely reflect technique and low lung volumes. no definite pleural effusion or pneumothorax is evident on this limited study.
<unk>-year-old female found down.
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lung volumes are low. no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. heart size is exaggerated by low lung volumes and therefore difficult to evaluate. no rib fracture is detected on these views.
<unk>-year-old male status post assault with left chest pain.
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a do lead pacemaker is unchanged in position compared to the prior study. the heart size appears enlarged even allowing for the projection. lung volumes are within normal limits. there is diffuse prominence of the bronchovascular markings with apparent diffuse reticular opacities. the findings are more consistent with interstitial lung disease than acute infection although this could have a similar appearance. there are small bilateral pleural effusions.
history: <unk>f with ? lll pna from osh, ? worsening infection in r foot // ? pna? signs of osteo in foot
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pa and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>f with cp // evidence of effusion, pneumonia
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an endotracheal tube is in place with the tip <num> cm from the carina. an enteric tube courses below the diaphragm with the tip in the left upper quadrant. the lung volumes remain low. parenchymal opacities bilaterally are significantly increased in the left lung from the most recent prior study performed <num> hours earlier. small pleural effusions are likely present. no pneumothorax is seen although there is an air-fluid level in the left lung base. the pulmonary vasculature is engorged. the cardiomediastinal contours are within normal limits. the left hilus is obscured by diffuse parenchymal opacities.
recent intubation, here to evaluate et tube placement.
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frontal and lateral views of the chest demonstrate low lung volumes. there is no focal consolidation, pleural effusion or pneumothorax. lungs are essentially clear. the hilar and mediastinal silhouettes are unchanged. the descending aorta appears tortuous. there is moderate cardiomegaly. the patient is status post medial sternotomy. no pneumothorax.
right pleuritic chest pain.
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mild enlargement of the cardiac silhouette with enlargement of the bilateral hila and widening of the upper mediastinum likely related to lymphadenopathy some of which appears calcified. thickening of the pleural space on the right could represent a partially loculated effusion and/or pleural thickening. there is some degree of volume loss in the right lung. an interstitial process in the right lower lobe could reflect asymmetric edema with pulmonary vascular congestion noted elsewhere. there is a small left pleural effusion. no pneumothorax. calcification is noted along the pericardium consistent with history of constrictive pericarditis.
<unk> year old man with constrictive pericarditis, hx tb. am sputum with small amount blood // evaluate for abnormalities
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a portable upright ap chest radiograph shows a large right pleural effusion obscuring the right lung base with what appears to be loculation medially. this, as well as hazy opacity in the left mid lung are not significantly different compared to yesterday's study, but appear increased compared to <unk>. the side hole of the patient's nasogastric tube is just above the level of the gastroesophageal junction and should be advanced. some radiodense contrast persists in the colon, probably from abdominal ct scan.
cough after surgery, question pneumonia.
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ap and lateral views of the chest. the lungs are clear of consolidation or effusion. cardiac silhouette is enlarged but unchanged. osseous and soft tissue structures are unremarkable.
<unk>-year-old male with failure to thrive.
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cardiomediastinal contours are normal. the lungs are clear. there is no pneumothorax or right pleural effusion. there is trace small left pleural effusion. the osseous structures are unremarkable
<unk> year old man with decompensated cirrhosis // evidence of infection
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ap upright and lateral chest radiographs demonstrate interval placement of a left chest wall pacer device with leads projecting over the right atrium and ventricle. sternal wires and a valve prosthesis are also new compared to <unk>. cardiomediastinal silhouette appears grossly normal. a small to moderate left pleural effusion is noted with associated lower lobe atelectasis, difficult to exclude pneumonia. there is no pneumothorax. no free air below the right hemidiaphragm. clips project over the right upper chest.
<unk>m with lle absent pulses, infection of great toe, also crackles on lung exam
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two views were obtained of the chest. right basilar pleural pigtail catheter has been removed. a meniscus/air fluid level at the right lower lung identifies an air-fluid collection in the medial right pleural space which is likely smaller than on the previous examination given improved visualization of the right heart border, though this may also be due to air within the collection. right lung parenchymal opacities are similarly slightly improved. trace pleural effusion is present on the left. the heart and mediastinal contours are left picc an esophageal stent are unchanged.
esophageal perforation right pleural effusion. assess for interval change.
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interval nasogastric tube removal. the lungs are clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. the cardiomediastinal silhouette is within normal limits.
<unk>f with cirrhosis, fatigue // rule-out pneumonia
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the lungs are clear. the cardiomediastinal silhouette, pleura, and hila are normal. there is no pneumothorax, focal consolidation, pleural effusion, or pulmonary edema. there is slight elevation of the diaphragm consistent with known intra-abdominal process.
<unk>-year-old woman with a <num> week history of epigastric pain, acute onset luq pain, osh ct with ruptured splenic cyst, pending splenectomy; cardiopulmonary surveillance surg: <unk> (splenectomy).
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a single upright frontal chest radiograph was obtained. a left-sided chest tube has been removed. there is a miniscule residual left apical pneumothorax. retrocardiac opacity is compatible with residual atelectasis. the positions of an endotracheal tube, enteric catheter, and swan-ganz catheter are unchanged. there is no pulmonary consolidation, effusion, or pneumothorax. central pulmonary vascular congestion is mild.
left chest tube removal.
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elevated right hemidiaphragm is unchanged back to <unk>. the lungs are clear of consolidation or effusion. the cardiomediastinal silhouette is within normal limits. right humeral head orthopedic hardware is noted.
<unk>m with ams // ?pna
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clear lungs bilaterally without pleural effusion or pneumothorax. heart size, mediastinal contours and hila are normal. mild degenerative change of the thoracic spine without additional bony abnormality.
male with recent cough, productive of phlegm. assess for pneumonia.
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compared with earlier the same day, i doubt significant interval change. the cardiomediastinal silhouette is unchanged. slight displacement of the cardiac silhouette by large right base bulla is again noted. again seen are lobulated, partially calcified masses in both lung apices suggesting prior granulomatous disease and/or silicosis/ pneumoconiosis. there is minimal atelectasis at the left lung base, without significant change. no focal infiltrate or effusion is otherwise identified on this ap view. old healed right-sided rib fractures again noted. a small nodular opacity in the right mid zone laterally overlying the right seventh rib posteriorly measures approximately <num> mm in corresponds to a noncalcified nodular density on the <unk> ct scan (<num>b:<num>). thin caliber appearance of the trachea within the chest raises question of saber sheath trachea/tracheomalacia.
<unk> year old man with desat // ? aspiration
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ap and lateral views of the chest. again seen are bilateral nodular opacities in the lungs compatible with patient's known metastatic disease. new from prior chest x-ray but seen on interval ct scan is a left-sided pleural effusion with associated atelectasis. increased pleural based opacity on the left laterally adjacent to the lung base is likely progression of metastatic disease as well. trace right effusion is also seen. there is no definite superimposed acute consolidation although one would be difficult to exclude and definite acute osseous abnormality detected.
<unk>-year-old male with renal cancer presents with right leg swelling.
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>f with chest pain // eval for acute process
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<num> views were obtained of the chest. the lungs are low in volume but clear. there is no pleural effusion or pneumothorax. the heart is mildly enlarged and the aorta is mildly tortuous, with otherwise normal mediastinal and hilar contours. surgical clips are seen in the epigastrium with incompletely assessed cervical hardware.
fever and upper abdominal pain with vomiting. assess for pneumonia.
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pa and lateral views of the chest provided. mild bibasilar atelectasis noted. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>f with sickle cell, worsening dyspnea on exertion // r/o pna, acute chest
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pa and lateral chest radiograph is limited secondary to underpenetration/large body habitus. allowing for this, heart is moderately enlarged though similar in appearance to prior examination dated <unk>. hilar and mediastinal contours are within normal limits. no focal consolidation convincing for pneumonia is identified. no definite large pleural effusion or pneumothorax. visualized osseous structures demonstrates no acute abnormality.
<unk>-year-old female with asthma exacerbation and cough.
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the lungs are clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>f with cp // r/o acute process
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there is left apical pleural thickening and scarring with associated volume loss and superior retraction of the left hilum. calcified left hilar nodes are again noted. new perihilar opacities are noted on the right greater than left as well as blunting of the right lateral costophrenic angle suggesting underlying effusion. cardiomediastinal silhouette is grossly unchanged given differences in positioning and technique. severe degenerative changes noted at the shoulders bilaterally. median sternotomy wires are intact.
<unk>f with dyspnea and lethargy // r/o acute process
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pa and lateral views of the chest. there is no focal consolidation, pleural effusion, or pneumothorax. there is mild cardiomegaly, otherwise the cardiomediastinal and hilar contours are normal.
afib, copd, cough, smoking history, evaluate for lung lesion or chf.
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pa and lateral chest radiographs demonstrate clear lungs. the heart size is normal. the cardiac, hilar, and mediastinal contours are normal.
chest pain.