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A nasogastric tube tip is located within the stomach. Heart size is top normal. Mediastinal and hilar contours are unremarkable. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. Pulmonary vasculature is normal. Mild degenerative changes are noted in the thoracic spine. Excreted contrast material from recent ct exam is noted within the collecting systems bilaterally. Multiple dilated loops of small bowel are compatible with known small bowel obstruction.
small bowel obstruction, nasogastric tube placement
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Since the prior radiograph performed several hours earlier, there has been interval development of a diffuse scattered opacities in both lungs. These are much more prominent at the lung bases, particularly the right side. No changes in the position of the support tubes/devices.
<unk>m w hcv/alcohol cirrhosis hcc s/p liver txp s/p multiple ex-laps and graft dysfunction now s/p re-do liver txp s/p takeback for proximal smv-donor pv anatomosis for thrombus // s/p bronch with mucous plugging - assess for interval change
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The lungs are mildly hyperexpanded. The bilateral hila are prominent, likely due to fullness of the vascular structures and mild congestion. There is minimal left basilar atelectasis. No consolidation is identified to suggest pneumonia. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal.
palpitations and atrial fibrillation. evaluate for pneumonia.
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Median sternotomy wires are intact. Heart size is normal. Postoperative cardiomediastinal silhouette and hilar contours are unremarkable. No evidence of pulmonary edema. No dense consolidation to suggest pneumonia. Small left-sided pleural effusion. Lungs appear hyperinflated, unchanged.
dyspnea and dementia. evaluate for pneumonia or pulmonary edema.
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The cardiomediastinal and hilar contours are within normal limits. The lung fields are clear. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable.
<unk>m with chest pain // r/o infiltrate
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As compared to the previous radiograph, no change in appearance of the endotracheal tube and the nasogastric tube is seen. Lateral moderate pleural effusions persist. Normal size of the cardiac silhouette. Mild-to-moderate atelectasis at both lung bases. No overt pulmonary edema. No pneumonia. No pneumothorax.
aspiration pneumonia, intubation. evaluation for interval change.
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The left hemidiaphragm is slightly elevated with blunting of the cp angle. This is slightly more prominent than on the study from three days ago, but there is no definite infiltrate. The lungs are otherwise clear.
fevers.
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Pa and lateral chest radiographs were provided. There is no focal consolidation, pleural effusion or pneumothorax. Right paratracheal opacity is again seen, present since at least <unk>, without definite mass effect on the trachea or enlarged thyroid (correlation was made with ct c-spine from <unk>). This is likely due to prominent and toruous vessels and has been stable. Cardiomediastinal silhouette is unremarkable. Bones are slightly osteopenic and multilevel degenerative changes are noted in the thoracic spine.
<unk>-year-old female with fever, leukocytosis, recent uri. evaluate for pneumonia.
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No focal consolidation, pleural effusion or pneumothorax identified. The size of the cardiac silhouette is at the upper limits of normal.
<unk> year old man having craniotomy tomorrow // pre-op eval surg: <unk> (craniotomy )
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Pa and lateral views of the chest. Sternotomy wires, mediastinal clips are unchanged. Patient is status post partial resection of the left lower lobe with volume loss and mild elevation of the left hemidiaphragm. The right lung is hyperexpanded. There is a blunting of the left costophrenic angle, likely a small pleural effusion. There are increased interstitial markings compared to prior study and fullness of the hila which may indicate mild pulmonary vascular congestion and mild interstitial pulmonary edema. No focal consolidation.
productive cough and fever. evaluate for pneumonia.
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Since the prior exam, small bilateral pleural effusions have increased in size. There is mild associated dependent atelectasis. There is no pulmonary edema, focal consolidation, or pneumothorax. The cardiomediastinal silhouette is normal in size. Calcifications are noted along the aortic arch. There is a moderate-to-severe scoliosis with an associated asymmetry of the rib cage. Increased density at the right apex is likely due to a summation of overlapping shadows related to the patient's scoliosis and rotation.
volume overload and acute kidney injury after pvi. evaluate for congestive heart failure.
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The cardiomediastinal and hilar contours are within normal limits. The lungs are clear without focal consolidation, pleural effusion or pneumothorax.
history: <unk>f with chest pain // acute cardiopulmonary process
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Pa and lateral chest radiographs. The patient has had a prior left lower lobectomy with posterior rib resection and volume loss. Again noted are mediastinal surgical clips. There is no focal consolidation, pleural effusion, or pneumothorax. The heart size is normal.
six months of weight loss and reduced p.o. intake.
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The lungs are well expanded and clear. Pleural surfaces are normal without pleural effusion or pneumothorax. The heart is mildly enlarged, however, is unchanged from prior study. Mediastinal and hilar contours are normal. Atherosclerotic calcification of the aortic arch noted. Visualized osseous structures are unremarkable.
fever. assess for pneumonia.
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In comparison with the study of <unk>, there is no change or evidence of acute cardiopulmonary disease. The apical pleural thickening seen previously is not as well identified. No acute pneumonia, vascular congestion, or pleural effusion.
fever and cough.
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The cardiac, mediastinal and hilar contours appear within normal limits. There is no pleural effusion. No pneumothorax is demonstrated. The lungs appear clear.
shortness of breath.
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In comparison with study of <unk>, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Port-a-cath has been inserted on the right and extends to the mid-to-lower portion of the svc.
dyspnea on exertion after chemotherapy.
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The cardiomediastinal silhouette is enlarged and relatively unchanged. There is an intra-aortic balloon pump with the tip terminating in the lower thoracic aorta approximately <num> cm distal from the aortic knob. The swan-<unk> catheter appears to be in good position. Nasogastric tube is also seen and in unchanged position. The mild pulmonary edema appears stable when compared with most recent study with previous right lower lobe opacity and decreased left lower lobe opacity which could represent superimposed pneumonia however the chronicity of changes is abnormal.
<unk> year old woman with pneumonia, cardiogenic shock // interval change
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Tracheostomy tube is again seen. Left-sided subclavian central venous catheter is present, with the tip in the junction of the brachiocephalic veins. The cardiac and mediastinal silhouettes remain unchanged, allowing for the technique. A balloon is seen projecting over the stomach, probably representing a gastrostomy tube. There is increased opacification of the right hemithorax compared to the prior examination, with an appearance suggesting a small- to moderate-sized layering pleural effusion. The left hemithorax remains clear. No evidence of pneumothorax, although it is noted at the left lung apex is excluded from the imaging.
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The heart size is borderline enlarged, slightly increased in size compared to the previous study. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. Lungs are clear. Blunting of the costophrenic angles on the lateral view posteriorly is compatible with trace bilateral pleural effusions. No pneumothorax is a is identified. There are mild degenerative changes in the thoracic spine.
syncope.
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The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. The lungs are hyperexpanded, and extensive fibrotic changes are again seen in the upper lobes, consistent with known history of sarcoidosis. No acute osseous abnormalities are detected.
<unk>m with cough, dyspnea // eval for infiltrate
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Left ventricular assist device, icd with biventricular pacing lead, and right picc are unchanged in position. Persistent cardiomegaly and pulmonary vascular congestion, accompanied by improving interstitial edema. Additionally, there has been improved aeration in the left retrocardiac region, likely due to improving atelectasis and effusion in this region. Small left apical pneumothorax is unchanged.
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Cardiac, mediastinal and hilar contours are normal. Lungs are clear and the pulmonary vasculature is normal. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities.
lightheadedness and shortness of breath.
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When compared to most recent study dated same date <num> hr previously, the right internal jugular central line has been withdrawn, its tip terminating within the distal svc. There is no pneumothorax. A right pectorally placed pacer is noted, lead tips in stable position. Lungs are clear bilaterally. Cardiomediastinal and hilar contours are stable.
<unk> year old man with new onset chf vs sepsis // confirm central line placement
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The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear.
productive cough and dyspnea. history of asthma.
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An accessed right pectoral mediport terminates at the superior cavoatrial junction. There is no pneumothorax. Mild prominence with increased density of the right hilus as compared to <unk> may be due to mild pulmonary artery dilatation or lymphadenopathy. A faint nodular opacity projecting at the superior aspect of the left hilus may be a small nodule. Moderate cardiomegaly despite the projection is unchanged. Background parenchymal changes consistent with emphysema are unchanged.
<unk> year old woman with metastatic pancreatic cancer to liver, presenting with confusion // r/o infiltrates
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Single ap view of the chest provided. A right port-a-cath terminates in the distal svc. Moderate pulmonary edema is new. The lungs are well-inflated. There is no pleural effusion, or pneumothorax. The hilar and cardiomediastinal contours are normal.
<unk> year old man with panc ca, respiratory distress transferred from osh for concern for duodenal obstruction. requiring bipap <num>%. // eval for pna, pulm edema
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The cardiac silhouette is mildly enlarged, which does not correlate with ct from same date. No definite focal consolidation or large pneumothorax or pleural effusion is identified.
<unk>f with abd pain, recent admission for dvt and left aortic arch clot
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Lung volumes are slightly low. Bibasilar heterogeneous opacities are likely minimal atelectasis. The lungs are otherwise clear. There are no pleural abnormalities. The cardiac and mediastinal contours are normal aside from unchanged mild tortuosity of the descending thoracic aorta. Multilevel degenerative changes of the thoracic spine are again seen. No rib fractures are identified.
status post fall, assess for rib fractures.
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As compared to the previous radiograph, the lung volumes have substantially increased, reflecting improved ventilation. Currently, there is no evidence of parenchymal opacities suggestive of pneumonia. No pulmonary edema. Borderline size of the cardiac silhouette. Moderate tortuosity of the thoracic aorta. Known calcified pleural plaques and unchanged calcified nodules in both upper lobes, left more than right. As indicated in the previous reports, ct would be helpful, given the fact that the nodules were not all present on the previous exam from <unk>.
hypoxia, evaluation of pulmonary edema and pneumonia.
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Pa and lateral views of the chest provided. Left chest wall aicd is noted with catheter extending into the region of the right atrium or right ventricle. Lungs are clear. 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 icd, concern for cauda equina // needs pa and lateral films to evaluate icd placement by neuroradiology attending, please obtain stat
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Frontal chest radiograph demonstrates a normal cardiomediastinal silhouette. Lungs are well aerated. There is no clear consolidation, pleural effusion, or pneumothorax, but there is a very slight increase in radiodensity of the right lower lung just above the diaphragm compared to the left. It would be very useful to obtain conventional radiographs, particularly the lateral view to re-evaluate this area. . The visualized upper abdomen is unremarkable.
shortness of breath. evaluate for pneumothorax or pneumonia.
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There is again seen right upper quadrant surgical clip, presumably due to prior cholecystectomy. There is again seen mild unchanged s-shaped scoliosis of the thoracic spine. There is stable mild degenerative joint disease of the thoracic spine, with mild compression deformity of a single lower thoracic vertebral body, unchanged from prior radiograph in <unk>. The cardiomediastinal silhouettes are unchanged in appearance. There is unchanged tortuosity of the thoracic aorta. The bilateral hila are normal. There is no evidence of pulmonary vascular congestion. There are no focal lung consolidations or lung nodules. There is no pneumothorax or effusion.
<unk> year old woman with asthmatic bronchitis. former smoker // r/o infiltrate or nodule
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The right port-a-cath and right chest tube appear intact and unchanged in position. New small right apical pneumothorax. Interval slight widening and prominence of the right paratracheal convexity. Otherwise, expected post-surgical changes in the right hemithorax. Stable smaller lung volumes. Normal heart size. No focal consolidation to suggest pneumonia. No pleural effusion.
<unk>-year-old man with b cell lymphoma of the mediastinum, status-post right thoractomy and right upper lobectomy with intercostal muscle flap on <unk>; evaluate for interval changes.
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Previously noted left subclavian catheter has been removed. Left axillary arterial line is again noted. Endotracheal tube terminates <num> cm above the carina. Curved tube projecting over the neck may reflect nasogastric tube coiled in the cervical esophagus. Ng tube terminates in the stomach. Bilateral chest tubes are in place. The lungs are better aerated than on the prior study with decreased bibasilar atelectasis. Calcified and elongated thoracic aorta is noted with normal heart size. Mild pulmonary vascular congestion is noted.
status post poly trauma, assess for interval change.
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In comparison with the study of <unk>, there may be slight increase in the amount of left pleural effusion. The rounded opacity in the left mid zone is again seen, consistent to a mass identified on prior pet-ct scan. Remainder of the study is unchanged and essentially within normal limits.
pleural effusion, evaluation.
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Linear opacity at the left lung base is most compatible with atelectasis in the setting of low lung volumes. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>m with cp // cp
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Ap and lateral views of the chest were compared to previous exam from <unk>. The lungs are clear of focal consolidation. Calcified right mid lung granuloma is again noted. Retrocardiac opacity is compatible with a large hiatal hernia. The cardiomediastinal silhouette is stable as are the osseous and soft tissue structures.
<unk>-year-old female with weakness.
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Lungs are clear of consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities
<unk>m with pe on xarelto, discharged wk prior, now w/chest discomfort // eval interval changes, new effusions, infarctions
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Heart size is mildly enlarged. The aorta is tortuous and unfolded. Mediastinal and hilar contours are otherwise unremarkable. The pulmonary vasculature is not engorged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is demonstrated. No acute osseous abnormality is detected.
history: <unk>m with fever
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Lungs are clear aside from a <num>mm well defined opacity projecting over the upper margin of the posterior right <num>th rib. There is no pleural effusion or pneumothorax. The heart is normal in size. Normal cardiomediastinal silhouette.
smoking with decreased breath sounds and mild clubbing of digits, assess for copd.
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The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable.
<unk>m with chest pain
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The lungs and pleural spaces are clear without evidence of pneumothorax or pleural effusions. The heart is stable in size. There is no evidence of pneumoperitoneum and osseous structures are grossly unchanged.
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Calcified bilateral breast implants overlie the bilateral lower chest.there has been significant interval decrease in opacity in the right upper lung with only minimal residual remaining. No new focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable.
history: <unk>f with lung cancer s/p cyberknife, hx of ptx, here w/ inc creatinine. no cough // pna
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Single supine ap portable view of the chest was obtained. There may be minimal pulmonary vascular congestion. Minimal left base linear atelectasis/scarring is seen. No definite discrete focal consolidation. Slight blunting of the costophrenic angles most likely relates to overlying soft tissue. No large pleural effusion is seen. There is no evidence of pneumothorax. There are low lung volumes. The superior mediastinum appears slightly prominent, but with clear margins, most likely related to supine, ap technique and low lung volumes. The cardiac silhouette is top normal. A stent is seen projecting over the right upper quadrant. It appears slightly different in location as compared to the study earlier the same date. However, appears similar in appearance as compared to <unk>.
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As compared to the previous radiograph, no relevant change is seen. <num>-mm calcified granuloma in the left lower lung. No evidence of acute or chronic diffuse lung disease. No acute pneumonia or pulmonary edema. Borderline size of the cardiac silhouette. Moderate tortuosity of the thoracic aorta. No evidence of pleural effusions.
chronic cough, evaluation.
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The cardiac silhouette is mildly enlarged, unchanged since the prior examination. Again noted are mitral annular calcifications. The mediastinal and hilar contours are unchanged. Again noted is cephalization of the pulmonary vascular markings, suggesting stable, mild pulmonary vascular congestion. No focal consolidation or definite pleural effusion or pneumothorax is identified. The bones are diffusely demineralized. Multilevel vertebral body height loss is noted in the midthoracic spine, which are age-indeterminate. There is exaggerated kyphosis of the thoracic spine.
<unk>f with weakness // eval for pna
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Heart size is mildly enlarged, slightly enlarged compared to the previous radiograph. The mediastinal contour is unchanged. Enlargement of the hila bilaterally is compatible with underlying pulmonary arterial hypertension. There is no pulmonary edema. Lungs are hyperinflated with marked emphysematous changes again noted. Increased interstitial markings are noted along the periphery and lung bases suggestive of a mild chronic interstitial abnormality. Patchy opacities the lung bases may reflect areas of atelectasis, though infection is not excluded in the correct clinical setting. No large pleural effusion or pneumothorax is seen.
history: <unk>m with pulmonary hypertension with worsening hypoxia, concern for worsening pulmonary hypertension, chf exacerbation, cor pulmonale
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The patient is status post recent coronary artery bypass surgery and cardiac valvular surgery. Allowing for rightward patient rotation, cardiomediastinal contours are stable in appearance. Indwelling support and monitoring devices are unchanged in position, including a left internal jugular vascular catheter with tip directed towards the lateral wall of the superior vena cava. Cardiomegaly is accompanied by pulmonary vascular congestion and persistent diffuse pulmonary edema, affecting the right lung to a greater degree than the left. Coexisting pneumonia is also possible in the appropriate clinical setting. Small left and moderate right pleural effusions are also noted.
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The et is unchanged in standard position, ending at <num> cm from carina bifurcation. The ng tube ends below the diaphragm, probably in the distal gastric cavity, but the tip cannot be visualized. The side-hole of the ng tiube is in mid-gastric cavity. Lung is well inflated without consolidation. There is no vascular congestion. There is no pleural effusion or pneumothorax. Heart size and <unk> vessels are normal.
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Dual lumen right-sided subclavian central venous catheter tip terminates in the proximal right atrium. Mild to moderate cardiomegaly is re- demonstrated. Atherosclerotic calcifications are noted at the aortic knob. Mediastinal and hilar contours are unchanged. Mild pulmonary vascular congestion is present. There is a small left pleural effusion, as seen previously, with focal opacity in the left lung base potentially reflective of compressive atelectasis though infection is not excluded. No pneumothorax is detected. There are no acute osseous abnormalities.
history: <unk>f with fall on hemodialysis
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Cardiac silhouette size remains mildly enlarged. The mediastinal contour is unchanged with unfolding of the thoracic aorta again noted. Pulmonary vasculature is not engorged. Hilar contours are normal. Subsegmental atelectasis is demonstrated in the lung bases. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities.
history: <unk>m with sepsis status post whipple in <unk> complicated by sepsis, mi, pulmonary embolism
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Frontal and lateral radiographs of the chest demonstrate a moderate-sized right apical and basilar pneumothorax without evidence shift of the cardimediastinum. There is a small right-sided pleural effusion. The left lung is clear.
<unk>-year-old man with recurrent right pleural effusion status post thoracentesis. evaluate for pneumothorax.
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Tip of intra-aortic balloon pump terminates <num> cm below the superior aspect of the aortic knob. Other indwelling devices are in standard and unchanged position, except for removal of midline drains. Bilateral chest tubes remain in place, with no visible pneumothorax. Cardiomediastinal contours are slightly decreased in width compared to the prior study, likely due to improving volume status of the patient. There remains pulmonary vascular congestion and mild interstitial edema, however. Bibasilar retrocardiac atelectasis is again demonstrated, slightly improved on the left.
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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. A <num> cm nodular opacity overlying the inferior endplate of the mid thoracic vertebral body is likely an osteophyte.
<unk> year old man with cough and fever // ? infiltrate
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Heart size is normal. Mediastinal silhouette is unremarkable. Hilar contours are unchanged since <unk>. Areas of right greater than left biapical linear probable scarring are unchanged since prior examination. There are slight increased opacities in the right medial lung base. There is mild bibasilar atelectasis. Lungs are otherwise clear. Pleural surfaces are clear without effusion or pneumothorax.
sarcoidosis and cough.
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Large right pleural effusion has worsened. Right basilar consolidation, similar. Shallow inspiration accentuates heart size, pulmonary vascularity. More prominent retrocardiac atelectasis.
<unk> year old man with etoh cirrhosis w/ massive ascites, r hydrothorax s/p lvp // eval for interval change in effusion
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No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. No displaced fracture is seen. There is no overt pulmonary edema.
chest pain
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Single frontal view of the chest demonstrates similar extent of subcutaneous emphysema in the right chest wall. There has been interval removal of one of the two indwelling right chest tubes. A left-sided chest tube remains similar in location. The heart is enlarged, but unchanged. Perihilar vascular congestion and pulmonary edema appears similar as compared to prior exam. There is no discernable pneumothorax. There is persistent lucency projecting over medial left hilus, which upon correlation with prior ct dated <unk> likely represents posterior medial pleural air collection. The lung bases demonstrate ill-defined opacities which could represent residual post-traumatic contusions. There are bilateral pleural effusions with compressive atelectasis. There is also marked distention of the azygos contour, in keeping with increased volume status. The et tube is stable and in appropriate position. An enteric tube traverses inferiorly out of view. A right central venous catheter is unchanged in location. Multiple bilateral rib fractures, better discerned on prior ct.
<unk>-year-old male with polytrauma, here for assessment of interval change.
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The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. Surgical clips are seen in the upper right hemithorax. There is evidence of prior right thoracotomy. There is no focal consolidation. No pleural effusion or pneumothorax is present. No definite acute rib fracture is identified.
history: <unk>f with chest wall pain // evaluate for injury, acute process
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There has been interval placement of an ng tube with tip terminating in the stomach. Otherwise there is been no significant interval change since the prior study with multiple dilated loops of bowel seen in the upper abdomen.
history: <unk>m with sbo, hx of crohn's. had ngt placed // please evaluate for ng tube placement
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Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. There is mild cardiomegaly, which is unchanged. Again seen is a chronic left-sided pleural effusion versus pleural thickening with some adjacent atelectasis, overall not significantly changed from the prior study. A left-sided peripheral line ends in the axilla. The patient is status post cabg with median sternotomy wires in place.
<unk>-year-old man with end-stage renal disease on peritoneal dialysis. evaluate for interval change.
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The heart size is large but stable. The mediastinal and hilar contours are unremarkable. The lungs are clear. There is no pleural effusion or pneumothorax.
<unk>-year-old male with chills and right lower lung rales.
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Large left mid-to-lower lung/perihilar opacity is worrisome for pneumonia. This appears even more prominent as compared to the prior study earlier the same date. An underlying component of aspiration or hemorrhage is not excluded. Slight reticulation at the right lung base could be due to chronic changes. No pneumothorax. The cardiac silhouette is enlarged. The mediastinum is unremarkable. Patient is status post median sternotomy and cabg.
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Frontal and lateral views of the chest were obtained. Relative linear opacity at the left lung base may relate to atelectasis, although underlying consolidation due to infection or aspiration cannot be excluded in the appropriate clinical setting. There are low lung volumes and there is mild elevation of the right hemidiaphragm. Perihilar peribronchial thickening is again seen. No pleural effusion or pneumothorax seen. Cardiac and mediastinal silhouettes are stable.
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The lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. The hilar and pleural surfaces are normal.
history: <unk>f with shortness of breath // ?pneumonia
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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 tachycardia, chest pain // eval for structural process
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Pa and lateral views of the chest demonstrate small bilateral pleural effusions, stable since the most recent prior exam with bibasilar atelectasis. No focal consolidation concerning for pneumonia is identified. There is no pulmonary edema or pneumothorax. The bony structures appear intact.
<unk>-year-old female with unwitnessed fall, and dementia with change in mental status.
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In comparison with the study of <unk>, the monitoring and support devices remain in place. The cardiac silhouette remains enlarged and there is again evidence of elevated pulmonary venous pressure. The hazy opacification at the right base has decreased. It is unclear whether this represents improvement in pleural effusion or merely a manifestation of a more erect posture of the patient. There are streaks of atelectasis at the right base. On the left, there is some residual opacification at the base, consistent with a small effusion and volume loss in the left lower lobe.
sma embolectomy, to assess for pneumonia.
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The previous opacity in the right lower lobe has mostly resolved, with minimal residual opacity remaining. Otherwise, the lungs are clear. Cardiac silhouette, hilar contours, and pleural surfaces are unremarkable. No pleural effusion or pneumothorax. No free air.
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A portable frontal chest radiograph demonstrates a severely widened mediastinum, correlating to the ascending and descending aortic aneurysm and type b dissection. The aortic knob is not well visualized, and there is rightward deviation of the trachea. There is moderate to severe cardiomegaly. A left perihilar opacity corresponds to the mass seen on recent ct. A left pleural cap and left base opacity represent pleural effusion. There is no pneumothorax.
preop evaluation for an ascending aorta replacement, now with hypoxia.
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Small right pleural effusion is re- demonstrated. Basilar atelectasis is seen. No new focal consolidation is seen. There is no pneumothorax. Mild to moderate enlargement of the cardiac silhouette is re- demonstrated. Cardiac and mediastinal contours are stable. No overt pulmonary edema is seen.
history: <unk>m with fever, neutropenia // cxr: eval for pneumonia
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The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear.
chest pain.
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Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
history: <unk>m with headache, fever
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The endotracheal tube projects <num> cm above the carina. The right port is projecting over the lower svc. Left subclavian venous line in the upper svc. Nasogastric tube is in the stomach but the tip is not visualized on the image. Mild increase in severity of the bibasilar areas of atelectasis. No larger pleural effusions. No pulmonary edema.
respiratory distress, new intubation.
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Lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.
<unk>f with hyperglycemia and fatigue // eval for pna
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Re-identified is a tunneled left ij dialysis catheter with distal tip projecting over the high right atrium. A right axillary region vascular graft is new since prior. The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion.
<unk>f with esrd on hd who missed <unk> hd, evaluate for pneumonia, fluid overload.
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Ap and lateral views of the chest. Relatively low lung volumes are noted. The lungs are clear. Cardiomediastinal silhouette is within normal limits. Hypertrophic changes are noted in the spine. Mild height loss in the upper lumbar spine vertebral bodies better seen on lumbar spine films. No displaced rib fractures identified.
<unk>-year-old female with mechanical fall from standing with back pain.
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There is mild pulmonary edema. More confluent opacity at the right lung base may relate to vascular congestion although infectious process or aspiration is not excluded in the appropriate clinical setting. Mid lung atelectasis/ scarring is best seen on the lateral view. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal to mildly enlarged. Mediastinal contours are unremarkable.
history: <unk>m with hypotension and hypoxia // pulmonary edema
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A right mediport terminates in the distal superior vena cava. Elevation of left hemidiaphragm is unchanged. There is no pleural effusion, pneumothorax or focal airspace consolidation. The cardiac mediastinal contour is are durable. Hilar structures are unremarkable.
fever and cough. evaluate for an acute cardiopulmonary process.
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Pa and lateral views of the chest are compared to previous two-view chest x-ray from <unk>. Exam is slightly limited secondary to patient body habitus. There is hazy increased opacity at the left lung base which is likely due to overlying soft tissues and prominent pericardial fat pad. There is no evidence of consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Left shoulder arthroplasty is again seen in addition to hypertrophic changes in the spine.
<unk>-year-old female with shortness of breath.
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As compared to the previous radiograph, the left chest tube has been removed. There is currently no evidence of left pneumothorax. A previously placed mediastinal drain has also been removed. The right central introduction sheath persists. Moderate cardiomegaly without pulmonary edema. Hiatal hernia.
status post chest tube removal, evaluation for pneumothorax.
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Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. There is no pleural effusion or pneumothorax. Paradoxical lordosis in the lower thoracic spine is responsible for increasing density in the lower lung fields on the lateral view and this should not be confused with infected consolidation.
cough and high grade fever.
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Compared with most recent prior radiograph there has been no significant change. The lungs remain hyperinflated with lucency at the lung bases consistent with emphysematous changes and bulla seen on prior ct. No pleural effusion or pneumothorax is seen. Heart size, mediastinal contours and hilar contours are stable.
myeloma, productive cough, question infection.
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Lung volumes are low and the lungs are clear. Mediastinal contour, hila, and cardiac silhouette are stable from <unk>. There is no pneumothorax or pleural effusion.
<unk>m with acute confusion s/p <num> cvas (<unk> and <unk>) with acute confusion // pna? acute process?
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Frontal and lateral chest radiograph demonstrates hypoinflated lungs with crowding of vasculature and left lower lobe atelectasis. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Left chest pacer defibrillator device leads are intact and in appropriate position within the right atrium and right ventricle. Limited assessment of the abdomen demonstrates <num> biliary stents. No free intraperitoneal air.
fever status post biliary stent placement. assess for pneumonia.
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Lung volumes are unchanged compared to the prior study with persistent moderate bibasal pleural effusions and associated atelectasis. There are coarse interstitial markings bilaterally which may reflect interstitial pulmonary edema in this setting. The patient's known pulmonary nodules are difficult to visualize on today's study. The visualized bony structures the spine are densely sclerotic consistent with metastatic disease. Oral contrast material is noted in the colon.
<unk> year old man with metastatic prostate cancer with dyspnea on exertion and pleural effusions // evaluate pleural effusions
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Endotracheal tube terminates approximately <num> cm above the carina. A nasogastric tube terminates in the stomach with side port beyond expected location of the gastroesophageal junction. Lung volumes are low with bibasilar atelectasis, slightly improved. Mediastinal contours and cardiac silhouette are unchanged. No pleural effusion or pneumothorax.
<unk> year old woman with seizures <unk> etoh w/d? intubated and <unk> to tongue lac // pleural effusions, consolidation
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Lung volumes remain low. There is minimal streaky density consistent with subsegmental atelectasis as before. In addition, there is increased density in the right lung base that is more confluent. The heart and mediastinal structures are unchanged. The patient has been extubated. A left subclavian catheter remains in place.
interval change
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No focal consolidation is seen. There is no pleural effusion or pneumothorax. Gaseous distension of bowel is re- demonstrated under the diaphragms. Cardiac and mediastinal silhouettes are stable. Again seen posterior right-sided rib fracture is chronic of the right seventh rib.
history: <unk>m with ams // pna? sdh?
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Right-sided port-a-cath is again seen, terminating in the mid to distal svc. The patient is status post median sternotomy. Right apical pleural thickening is again seen. Pleural thickening on the right lateral chest and right base/costophrenic angle again seen which may be due to a small pleural effusion. There has been interval development of patchy opacity at the lateral left lung base raising concern for developing pneumonia. There may be mild pulmonary vascular congestion. No pneumothorax is seen. The cardiac silhouette remains enlarged.
worsening dyspnea, fever.
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Pa and lateral views of the chest. There is no evidence of radiopaque foreign body. There is no focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal contours are normal. No evidence of pneumomediastinum is seen.
aspiration of a small piece of glass. assess for foreign body.
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Ap single view of the chest has been obtained with patient in semi-upright position. Comparison is made to the next preceding similar portable chest examination of <unk>. The patient is now extubated. The previously existing swan-ganz catheter has been removed, but the right internal jugular approach sheath remains in place terminating in the mid portion of the svc. Bilateral chest tubes have been withdrawn. Lungs remain well expanded and no evidence of pneumothorax is present. Mild blunting of the lateral pleural sinuses persist, but no new evidence of pulmonary congestion or infiltrates is seen. Within the heart shadow, there is evidence of a mitral valve prosthesis and an open circular wire indicating a tricuspid valve annuloplasty.
<unk>-year-old female patient status post mitral valve and tricuspid valve repair, evaluate for pneumothorax status post chest tube removal.
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Lung volumes are low. The cardiac silhouette is unchanged. The aorta is tortuous. Minimal basilar opacity may represent atelectasis. There is no pleural effusion or pneumothorax.
history: <unk>m with fall, dizziness // trauma? infn?
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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>m with left sided chest pain, sob.
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Adjusting for changes in position, the cardiomediastinal silhouette is unchanged. Right chest tube is seen with associated small right apical pneumothorax. Smaller lung volumes, the upper lungs are clear. Cardiomediastinal silhouette appears unchanged. . Severe generalized intestinal distention persists.
<unk> year old man with fall, broken ribs, pneumothorax, s/p ct placement // would like to have an expiratory pa film to assess for any signs of pneumothorax? would like to have an expiratory pa film to assess for any s
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Lung volumes have slightly improved since the prior exam. Mild increased opacity in the right infrahilar region as compared to the prior exam may reflect early bronchopneumonia in the appropriate clinical setting. The left lung is clear. No effusion or pneumothorax. The heart is normal in size. The mediastinum is not widened. No acute osseous abnormality. There is nonspecific gaseous distension of loops of small bowel and a fluid-filled stomach in the left upper quadrant, incompletely assessed on this exam.
<unk>-year-old man presenting with fever. evaluate for pneumonia.
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A picc line terminates in the superior vena cava. The patient is status post fusion of the lumbar spine and sternotomy. The base of the chest is not completely included, but cardiac, mediastinal and hilar contours appear unchanged. Hazy opacification projecting over the lower lungs suggests persistent pleural effusions. Otherwise, the lungs appear clear, however. There is no pneumothorax.
altered mental status; question pneumonia.
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In comparison with the study of <unk>, the tip of the endotracheal tube remains above the clavicular level, approximately <num> cm above the carina. Dobbhoff tube is essentially unchanged. There are better lung volumes with some residual atelectatic change at the left base.
encephalopathy and intubation.
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Again noted is a port-a-cath in the chest wall of the upper right hemithorax with the tip of the catheter ending in expected position at the cavoatrial junction. The lungs are well expanded and clear, with the exception of a small discoid atelectasis noted in the left lung base. Cardiomediastinal and hilar contours are unremarkable. There is no evidence of pleural effusion or pneumothorax.
<unk>-year-old female with a fever. evaluate for acute cardiopulmonary process.