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This image is centered over the epigastrium, excluding the apices from view. The newly placed dobbhoff tube courses through the stomach and out of view, with tip projecting over the lower abdomen, likely within the antrum. Two surgical drains and surgical <unk> are seen over the abdomen. The lungs, though incompletely assessed, display right greater than left pleural effusions and dense retrocardiac atelectasis, likely unchanged with interval removal of swan catheter and likely et tube.
<unk>-year-old man status post orthotopic liver transplant with new dobbhoff. please assess dobbhoff position.
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Swan-ganz catheter has been repositioned, now coiling within the right atrium before terminating in the region of the right ventricular apex. Intra-aortic balloon pump has been advanced to the superior aspect of the aortic knob in close proximity to the origin of the left subclavian artery. Nasogastric tube terminates below the diaphragm. Other support and monitoring devices are unchanged in position, and previously described mild fluid overload has improved. Bibasilar atelectasis is similar on the right and improved on the left. <unk> was successfully paged to discuss these findings at <time> p.m. On <unk> at the time of discovery.
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Single frontal view of the chest was obtained. Patchy right basilar opacity may represent vascular structures, however, suggest dedicated pa and lateral views when patient able. The left lung is clear. There is no pleural effusion or evidence of pneumothorax. The cardiac and mediastinal silhouettes are unremarkable.
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As compared to the previous radiograph, there is no relevant change in appearance of the bilateral pleural effusions, the retrocardiac atelectasis as well as the area of mild right upper lobe opacity. Unchanged appearance of the cardiac silhouette. Unchanged bilateral lymph node calcifications at the hila.
pneumonia, evaluation for interval change.
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A single portable ap supine view of the chest was obtained. Endotracheal tube projects <num> cm above the carina. A right internal jugular central venous catheter is present with the tip in the mid svc. Nasogastric tube is subdiaphragmatic. There is diffuse opacification of bilateral lungs with a perihilar predominance but also extensively extending into the upper and lower lung zones. Scattered air bronchograms are also noted. Accounting for changes related to technique and positioning, heart is mildly enlarged. Mediastinal contour is notable for venous engorgement and extensive aortic calcifications. Small to moderate bilateral pleural effusions. No pneumothorax.
<unk>-year-old woman, intubated after cardiac arrest.
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Left-sided dual-chamber pacemaker/aicd with leads terminating in the right atrium and right ventricle is unchanged. Mild to moderate cardiomegaly is re- demonstrated. The mediastinal and hilar contours are unchanged. There is mild pulmonary vascular congestion. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities.
history: <unk>m with likely congestive heart failure exacerbation
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The lungs are clear without consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. Hypertrophic changes are noted in the spine.
<unk>m with cough // r/o pna
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Cardiac silhouette is enlarged and appears increased from the prior radiograph, but accentuation by portable ap technique may contribute to this apparent change. Pulmonary vascular congestion is accompanied by mild interstitial edema and a possible small right pleural effusion.
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Pa and lateral views of the chest. The lungs are clear of consolidation, effusion, or pulmonary vascular congestion. There is no pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities detected.
<unk>-year-old female with chest pain.
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As compared to the previous radiograph, there is no relevant change. The pre-existing changes suggestive of minimal fluid overload are still present. No pleural effusions. No evidence of pneumonia. Borderline size of the cardiac silhouette.
leukocytosis, questionable pneumonia.
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Two frontal images of the chest demonstrate interval development of pulmonary vascular congestion and interstitial markings consistent with moderate pulmonary edema. There has also been interval improvement in the bilateral pleural effusions. Cardiomediastinal silhouette is partially obscured by pulmonary edema. There is no pneumothorax. A hemodialysis catheter is again seen terminating in the right atrium. There has been interval removal of the nasogastric tube. A left-sided picc line is again seen with the tip at the cavoatrial junction.
<unk>-year-old male with tracheomalacia status post tracheobronchoplasty, recently capped, now requiring increased suctioning.
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Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. There has a been interval decrease in size of the right-sided pleural effusion. There is atelectasis at the right base. Persistent retrocardiac opacity is present. Patient is status post tracheostomy, which ends <num> cm from the carina. Cardiomediastinal and hilar contours are unchanged.
<unk>m with fever // acute process?
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Portable supine frontal radiograph of the chest demonstrates bilateral pleural pigtails, <num> in each base and <num> in the left mid hemithorax. The pleural catheter at the left lung base has a kink in it. <num> left pneumothorax has slightly increased in size seen at the base and tracking along the mediastinum. The right pleural effusion has largely cleared compared to the prior study. Pulmonary edema has largely cleared; however, there is persistent opacification in the left upper lung which likely reflects a superimposed pneumonia although asymmetric edema is possible. The right picc is in unchanged position ending at the cavoatrial junction. Dual pacer leads are also in unchanged position.
chest tubes, effusion followup.
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The lungs are normally expanded and clear. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. There is no pleural effusion or pneumothorax.
history: <unk>f with chest pain, shortness of breath // eval for pneumonia, pleural effusion
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Patient is status post median sternotomy and cabg. Cardiac silhouette size is top normal with the left ventricular predominance. The aorta is calcified and mildly tortuous. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is not engorged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. Hypertrophic changes are seen throughout the thoracic spine.
history: <unk>m with chest tightness now resolved
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Semi-upright portable view of the chest demonstrates et tip terminating <num> cm above the carina. Low lung volumes. No pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. The heart size is normal. There is no pulmonary edema. Multiple surgical clips and tips shunt catheter projects over right upper abdomen.
patient intubated for gi endoscopy. assess for et tube placement.
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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.
history: <unk>m s/p prostate biopsy, now with continued bleeding, cp, weakness, nausea. abd paun and back pain // ? abscess
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Ap and lateral chest radiographs. Pulmonary edema is mild. There is cardiomegaly. There is no pleural effusion or pneumothorax. Tortuosity of the aorta is unchanged.
altered mental status. evaluation for pneumonia.
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Single portable chest radiograph is provided. The patient is status post esophageal pull-through procedure, which results in the opacity adjacent to the right mediastinal border. No evidence of pneumomediastinum. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The heart size is normal.
status post esophageal conduit dilation for anastomotic stricture, rule out mediastinal air.
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In comparison with study of <unk>, there is little change in the appearance of the right ij catheter, with its tip in the mid svc. The diffuse bilateral pulmonary opacification has substantially decreased, consistent with improving pulmonary edema. Atelectatic streak is seen at the left base.
ij placement.
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The lungs are clear without focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal.
back pain when breathing, known existing dvt, rule out cardiopulmonary process.
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In comparison with study of <unk>, there is little change except for removal of the dobbhoff tube. Tracheostomy tube remains in place. The area of increased opacification at the right base is not appreciated on the current study. Left basilar opacification most likely reflects atelectatic change, probably associated with a small pleural effusion.
tracheostomy with cavitary pneumonia.
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Ap portable upright chest radiograph was provided. There is a dual-lead pacer unchanged in position with pacer leads residing in the expected location of the right atrium and right ventricle. There is a picc line seen along the right chest with its tip residing in the low svc region. Lung volumes are low, though the lungs appear clear. The heart is top normal in size. The mediastinal contour is grossly stable with an aortic atherosclerotic calcification noted. The imaged osseous structures are intact.
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Lungs are well-expanded and clear. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation.
history: <unk>m with chest pain after smoking marijuana // ?pneumothorax
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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. There is mild s-shaped scoliosis of the thoracic spine.
history: <unk>f with cp // pna?
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Ap portable semiupright chest x-ray shows interval improvement of right base opacity with residual patchy opacities compatible with reexpansion edema after right-sided thoracentesis. Small amount of pleural effusion remains. Lung is otherwise clear. There is no nodule or consolidation. Heart size is mildly enlarged but stable since <unk>. There is no pneumothorax.
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The heart is at the upper limits of normal size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable.
cough and pain.
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Heart is upper limits of normal in size. Interval decrease in distention of the neoesophagus. Previously present diffuse bilateral airspace opacities have partially improved in the interval, with residual opacities involving the right lung more than the left, and demonstrating a relative upper lung predominance, particularly in the left hemithorax. Bilateral interstitial opacities, presumably representing interstitial edema have also decreased in extent, and a right pleural effusion has decreased in size with residual small-to-moderate effusion remaining. Probable persistent small left pleural effusion, but no visible pneumothorax.
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The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. Bilateral pleural effusions are present, not significantly changed since the prior examination. No definite consolidation is identified.
history: <unk>f with ? delirium/infection // ? pneumonia
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Right lung is clear. Small retrocardiac opacity is noted. Trace left pleural effusion has decreased since prior examination. No right pleural effusion. Heart is top-normal in size. Mediastinal contour and hila are unremarkable with prominence of the right paratracheal stripe which is unchanged since <unk>. Intact median sternotomy wires are noted.
<unk>f with ams. assess for pneumonia.
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Pa and lateral views of the chest provided. The lungs are hyperinflated though clear without 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 pmh of asthma, p/w acute onset of shortness of breath.
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Endotracheal tube tip is approximately <num> cm above the carina, just above the level of the clavicles. Right subclavian catheter courses into the high right atrium, as seen previously. Esophageal catheter courses below the diaphragm with side port likely just distal to the gastroesophageal junction, unchanged. There has been interval removal of bilateral chest tubes, with one left chest tube remaining. No pneumothorax is detected on these views. Small left pleural effusion persists. Sternal wires and left upper quadrant surgical clips are noted.
<unk>-year-old woman status post sternotomy, now status post removal of chest tubes.
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New since prior exam is a left ij central venous catheter with distal tip projecting over the low svc in grossly appropriate location. There is no pneumothorax. The enteric tube and the et tube are in unchanged, appropriate configuration. There is a stable appearance of the heart and lungs, including at least moderate enlargement of the cardiac silhouette and diffuse bilateral airspace opacities. Difficult to exclude trace pleural effusions.
<unk>-year-old man status post left central venous line placement.
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The lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiac and mediastinal silhouettes are normal. Prominent prevascular nodes noted on ct are not clearly delineated on this study. No acute fractures are identified.
history of hemochromatosis with abnormal liver function tests.
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During the latest examination interval, a new right-sided internal jugular approach central venous line has been placed, seen to terminate overlying the right-sided superior mediastinal structures at the level <num> cm above the carina. This is compatible with the upper third of the svc. On the right base, the previously existing pigtail end catheter has been removed. A chest tube has now been inserted through the right-sided lateral chest wall at the level of the sixth rib interval. The chest tube makes a sharp kink in caudal direction to terminate in the posterior pleural sinus. There is significant increase of local chest wall edema at the site of the chest tube entrance. No new increased pleural effusion can be identified. Small right-sided pneumothorax appears to be unchanged, but is rather difficult to assess because of the overlying tissue edema. <unk> was paged at <time> p.m.
<unk>-year-old male patient status post chest tube placement, evaluate for pneumothorax.
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The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable.
history: <unk>f with new afib // please evaluate for acute cp process
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There is vascular congestion without frank pulmonary edema. Heart is mildly enlarged but unchanged. No pleural effusion. No pneumothorax or focal airspace consolidation. No displaced rib fracture. Tendon anchors are seen within both shoulders.
chest pain after cpr.
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Pa and lateral radiographs of the chest demonstrate clear lungs and normal hilar and mediastinal contours. The heart is mildly enlarged but stable. There is no pneumothorax or pleural effusion. The aorta is calcified and unfolded. There are median sternotomy wires in place and multiple surgical clips likely from prior cabg. There is sclerosis of a lower thoracic vertebral body which is unchanged from <unk>.
weakness. evaluate for pneumonia.
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There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size.
history: <unk>m with body aches // eval infiltrate
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The lungs are well inflated and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Degenerative changes are seen in the thoracic spine.
<unk>f with worsening spinal stenosis add-on for or tomorrow, pre-op chest x-ray.
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Diffuse interstitial abnormality in the lungs, predominantly in the upper lobes as seen on prior ct chest, is consistent with fibrosis from known sarcoidosis. Patchy opacity at the left base may represent soft tissue, however, can also be infection superimposed on chronic lung disease. Cardiomediastinal silhouette appears unchanged given differences and technique. There is no pleural effusion or pneumothorax. The osseous structures are intact.
<unk>-year-old female with shortness of breath and cough, question pneumonia.
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Pa and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Heart size is top-normal. Imaged osseous structures are intact. No free air below the diaphragm is seen.
<unk>f with <num> days incr doe, now <num> hrs sscp // eval ? pulmonary edema, infiltrate
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The heart and mediastinal contours appear normal. There is tracheobronchial tree calcification. The lungs are well expanded and clear. There are no pleural effusions or pneumothorax. The visualized osseous structures are unremarkable.
<unk>-year-old female patient with seizure activity and new fevers.
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There is a moderate right pleural effusion with overlying atelectasis. Trace left pleural effusion may also be present. No pneumothorax is seen. Cardiac silhouette is top-normal. Mediastinal contours are unremarkable. No pulmonary edema is seen.
history: <unk>m with on dialysis, p/w clotted fistula // eval for pulmonary edema or other process
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The lungs are well inflated. The right pleural effusion has diminished. There is still minimal blunting of the right costophrenic sulcus. There has been partial resolution of the bilateral nodular densities said to be septic emboli. The mediastinum is not remarkable. Mediastinum is normal. The heart size is normal. The osseous structures are normal for age. The right picc line is unchanged in position.
<unk> year old man with pleural effusion // eval
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Ap upright and lateral views of the chest provided. Two clips are seen projecting over the right upper lung, though these appear to be external to the patient as they are not seen on the lateral view. There is severe emphysema with areas of scarring in the lower lungs as well as hyperinflation and flattened diaphragms. Evaluation for subtle nodularity is limited due to severe underlying chronic lung disease. Allowing for this, no large consolidation is seen. The heart and mediastinal contour appears stable. No definite bony abnormalities are seen.
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Ap and lateral chest radiograph is compared to radiograph dated <unk>. There is a small left-sided pleural effusion and probably small right pleural effusion. Heart size is top-normal. No overt pulmonary edema. No focal opacity convincing for pneumonia is identified. There is no pneumothorax. Osseous structures demonstrates multilevel degenerative changes with mild anterior compression deformities throughout the thoracic spine, stable when compared to ct chest dated <unk>. Widespread bone metastasis involving the ribs and sternum are better appreciated on aforementioned chest ct.
<unk>-year-old female with altered mental status.
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Focal <num> mm calcified/sclerotic focus projecting over the left upper hemithorax, projecting over the medial left clavicle as well as the posterior medial left fifth rib, may represent a bone island at osseous or a calcified granuloma. No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.
history: <unk>f with coough // pna
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Compared with <unk> and allowing for considerable differences in positioning, i doubt significant interval change. Suspect background hyperinflation/copd. Again seen is marked cardiomegaly, vascular plethora and mild vascular blurring, consistent with chf. Obscuration of both costophrenic angles is again present, suggestive of small bilateral effusions. Increased retrocardiac density and opacity at the right lung base likely represents a combination of collapse and/or consolidation and pleural effusions. Both hemidiaphragms are obscured. Right paratracheal/paramediastinal opacity is again seen, not fully characterized. Curvilinear opacity extending across the upper chest into both axillae is thought to represent artifact due to overlying soft tissues.
<unk> year old woman with dchf, copd, afib, new sob and hypoxemia // cause of sob
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In comparison with the study of <unk>, there is little overall change. Some flattening of the hemidiaphragms with hyperexpansion suggests chronic pulmonary disease. However, no acute pneumonia, vascular congestion, or pleural effusion.
smoking history with wheezing.
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Cardiac silhouette size appears mildly enlarged but similar compared to the prior study. Prominence of the right mediastinal border and azygos region appears unchanged compared to the previous radiograph. Hilar contours are unremarkable. Pulmonary vasculature is not engorged. Bibasilar linear opacities are compatible with areas of subsegmental atelectasis, along with small bilateral pleural effusions which are new in the interval. No pneumothorax is detected. There are no acute osseous abnormalities visualized.
history: <unk>f with shortness of breath and hypoxia // please assess for pleural effusions/pneumonia
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There is a large, somewhat rounded, area of focal opacity in the lateral portion of the right upper lobe, abutting the minor fissure, with equivocal associated air bronchograms. Possible minimal atelectasis at the right base. Otherwise, no focal infiltrates or consolidations are identified. No chf or effusion. No pneumothorax detected. There is mild cardiomegaly. Within the limits of plain film radiography, no hilar or mediastinal lymphadenopathy is detected. The current radiograph suggests mild right convex curvature of the thoracic spine centered at t<num>/<num> --<unk> thoracic spine curvature was probably subtly present on <unk>.
history: <unk>m with sepsis, ruq abdominal pain // r/o pna
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The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal.
<unk>-year-old female with chest pain.
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The lungs are hyperinflated and clear of focal consolidation, pleural effusion or pulmonary edema. There is atelectasis in the right lung base. The heart is normal in size, and mediastinal contours are stable.
<unk> year old man with chest pain.
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Low lung volumes and technical factors limit the interpretation of this film. Increased mediastinal pedicle as well as vascular engorgements and may be mild cardiomegaly are related to failure. No focal consolidations concerning for pneumonia are present. No pleural effusion is present. No pneumothorax.
fever.
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Ap upright portable chest radiograph obtained. The ng tube descends into the left upper quadrant. The tip resides in the expected location of the stomach. The lungs are clear. No pneumothorax or effusion. Cardiomediastinal silhouette is normal. Bony structures are intact. Residual contrast is noted within the kidneys related to ct performed earlier today.
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Pa and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. A mild dextroscoliosis of the spine noted.
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Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. There is mild scoliosis
<unk> year old man with hcv cirrhosis // new evaluation for liver transplant assess for cardiopulmonary abnormalities
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Single semi-erect frontal view of the chest demonstrates persistent prominent cardiomediastinal silhouette, likely accentuated by low lung volumes and ap technique. There is persistent vascular engorgement, and bilateral pleural effusions with atelectasis. Allowing for slight technical differences, upper lung aeration does not appear substantially changed, certainly not significantly improved. A left-sided picc has tip terminating approximately <num> cm below the carina, unchanged.
<unk>-year-old female with tracheobronchomalacia status post tracheoplasty with fluid overload and respiratory distress. question pulmonary edema.
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In comparison with study of <unk>, the tip of the endotracheal tube measures approximately <num> cm. Nasogastric tube extends well into the stomach. Continued retrocardiac opacification consistent with collapse of a substantial portion of the left lower lobe. Otherwise, little change in the appearance of the heart and lungs.
respiratory distress, for et tube placement.
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A frontal semi upright view of the chest was obtained portably. Heterogeneous opacity in the left lower lung is concerning for aspiration or pneumonia. The right lung is clear. Heart size is normal. Mediastinal silhouette and hilar contours are normal. The right porta cath ends in the proximal right atrium. Fullness in the left neck soft tissues is noted.
nasopharyngeal cancer, likely aspirated with fever.
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Mild to moderate cardiomegaly is re- demonstrated. Mild atherosclerotic calcifications are seen involving the aortic arch. Mild pulmonary edema is worse compared to the prior exam with perhaps trace bilateral pleural effusions. No pneumothorax is identified. There are no acute osseous abnormalities.
history: <unk>f with paroxysmal atrial fibrillation , chf, cad, cva, anxiety with panic attacks who presents with dyspnea, palpitations for <num> day.
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Pa and lateral chest radiograph demonstrates clear lungs bilaterally. Cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion or pneumothorax. Osseous structures demonstrates no acute abnormality.
<unk>f with fever of unknown origin for <num> days // ? infiltrate
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Heart size remains borderline enlarged. Mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized.
history: <unk>f with lupus, febrile, on multiple immunosuppressants, with pleuritic chest pain, productive cough
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Cardiac and mediastinal contours are normal with the heart size within normal limits. Volume loss within the right upper lobe with slight elevation of the minor fissure and persistent but somewhat improved linear appearing opacification in the right upper lobe are noted, suggestive of improving infection. Left lung is clear. Pulmonary vasculature is not engorged and the hilar contours are unremarkable. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities.
history: <unk>m with shortness of breath
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A nasogastric tube enters the stomach, tip not visualized. An endotracheal tube terminates at the level of the clavicles. The chin and associated soft tissues partially obscure the lung apices. Marked cardiomegaly despite the projection has increased. Lung volumes are relatively low, and retrocardiac and right basilar subsegmental atelectasis is unchanged. The lungs are grossly clear.
<unk> year old woman with new ng placement // ng placement
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Lung volumes are low. On the lateral view, there is a focal opacity overlying the minor fissure, as well as a spine sign likely from a vague retrocardiac opacity seen on the pa view. Otherwise, cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax.
<unk>-year-old male with iv drug abuse and leukocytosis. evaluate for evidence of pneumonia.
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Allowing for differences in technique and projection, there has been minimal interval change in the appearance of the chest. Right picc has apparently been advanced at the proximal svc. Bilateral pulmonary edema has a slightly more asymmetrical distribution, now worse on the right than the left side, and a moderate right pleural effusion has apparently slightly increased. Small left pleural effusion is again demonstrated as well as improving atelectasis in the left retrocardiac area.
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The cardiac silhouette is enlarged. There are increased interstitial markings. Bibasilar opacities could reflect aspiration. There are probable small bilateral pleural effusions. Left-sided pacemaker wires terminate in the right atrium and right ventricle.
history: <unk>f with ? aspiration on ct // eval ? pna eval ? pna
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Ap portable upright view of the chest. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Surgical clips in the right upper quadrant noted. No free air below the right hemidiaphragm is seen.
<unk>f with altered mental status, vomiting, diarrhea, chest pain.
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Frontal and lateral views of the chest are unchanged. There is no pleural effusion, pneumothorax or focal airspace consolidation. The lungs are somewhat hyperinflated but unchanged. Minimal bibasilar atelectasis is appreciated. The hilar and mediastinal contours are normal. There is no pleural effusion or pneumothorax. The pulmonary vascularity is normal.
cough and shortness of breath.
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As compared to the previous radiograph, there is no relevant change. Normal lung volumes. No evidence of pneumonia or other parenchymal lung disease. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures.
cough, immunosuppressive therapy, rule out pneumonia.
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The right pigtail catheter has been removed in the interim. Complete opacification of the right lower and mid hemithorax with silhouetting of the right heart border and right hemidiaphragm is new. There is associated rightward shift of the cardiomediastinal silhouette. These findings suggest volume loss. However, superimposed pneumonia cannot be excluded given the clinical history. The heart appears enlarged, overall similar to the prior exam. Streaky retrocardiac opacities are most likely reflective of atelectasis. No pneumothorax. There is a small effusion extending in the minor fissure seen on both the frontal and lateral views.
history: <unk>m with ams. evaluate for pneumonia.
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Ap portable supine view of the chest. There has been interval intubation with the endotracheal tube tip residing <num> cm above the carina. The endogastric tube descends into the mid upper abdomen. Lung volumes are markedly low limiting assessment. Increased opacities in the left lung may reflect atelectasis or aspiration. There is partial collapse of the right upper lobe. No supine evidence for large effusion or pneumothorax. Cardiomediastinal silhouette is difficult to assess given suboptimal technique.
<unk>f s/p intubation // et tube, og tube placement
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Pa and lateral chest radiographs were provided. A right picc terminates in the upper svc. Lung volumes are low. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The bones are intact. The imaged upper abdomen is unremarkable.
<unk>-year-old female with right upper extremity picc, concern about placement. evaluate for picc placement.
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As compared to the previous radiograph, no relevant change is seen. The monitoring and support devices, including the left-sided chest tube are unchanged. Minimal atelectasis in the retrocardiac lung regions is developing. The opacities on the left are constant. On the right, the lung parenchyma is normal. Unchanged appearance of the cardiac silhouette.
stab wound, evaluation for interval change.
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Ap and lateral views of the chest were reviewed. The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well expanded with no focal consolidation concerning for pneumonia. A rounded opacity in the left mid lung zone is new since <unk> but similar to the study in <unk>.
cough and weakness
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The lungs are clear.the cardiac, hilar and mediastinal contours are normal.no pleural abnormality is seen.
history: <unk>f with cough, immunosuppresion // pna?
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Lungs are fully expanded and clear without focal consolidation or clearly identifiable pulmonary nodules. There are no pleural effusions. Heart size is normal. Cardiomediastinal hilar silhouettes are normal. Pleural surfaces are normal.
<unk> yo man with bladder cancer, ? recurrence // <unk> yo man with bladder cancer, ? recurrence
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As compared to the previous radiograph, there is no relevant change. The endotracheal tube has been pulled back. The nasogastric tube is in unchanged position. The volumes have slightly decreased. There is unchanged evidence of mild areas of atelectasis at the lung bases. Moderate cardiomegaly without overt pulmonary edema. No evidence of pneumonia. No pneumothorax.
ruptured aneurysm, evaluation for interval change.
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Pa and lateral views of the chest were provided. A right ij central venous catheter is seen with its tip residing at the level of the low svc. No pneumothorax, effusion, or signs of pneumonia. Cardiomediastinal silhouette is normal. Bony structures are intact.
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Single supine ap portable view of the chest was obtained. Endotracheal tube is seen, terminating approximately <num> cm above the level of the carina. Underlying trauma board partially obscures the view. Given this, lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. There is mild thoracolumbar scoliosis.
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Assessment is somewhat limited by patient positioning. Cardiac and mediastinal contours are unchanged. The heart size appears borderline enlarged. Mild pulmonary vascular congestion is present. Streaky opacities in the lung bases likely reflect areas of atelectasis, with no focal consolidation. Blunting of the right costophrenic angle may suggest a trace pleural effusion. No pneumothorax is identified.
history: <unk>m with lethargy, low oxygen saturation// eval for pneumonia
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Two views were obtained of the chest. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours.
wheezing and shortness of breath.
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Due to an error in pacs, this study is being interpreted on <unk>. Lung volumes are low. Heart size is normal. Aorta is tortuous and calcified. There is crowding of the bronchovascular structures. Patchy right basilar opacity could reflect atelectasis. No pleural effusion or pneumothorax is seen. Unusual lucency is seen within the mid mediastinum which does not persist on subsequent exam, of uncertain etiology.
hypoglycemia.
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Linear right basilar opacities are similar compared to the prior study but opacities at the left base have substantially improved in the interval. Calcified scarring at the right apex appears unchanged, and cardiomediastinal contours are stable compared to prior study as well.
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Pa and lateral views of the chest provided. Right port-a-cath terminates at the low svc. The lungs are well-inflated and grossly clear. There is no pleural effusion, or pneumothorax. Possible right pleural thickening at the right costophrenic angle is unchanged. The hilar and cardiomediastinal contours are normal. Mild mid thoracic vertebral body compression fractures are of indeterminate age.
<unk> year old woman with metastatic pancreatic cancer, now s/p ercp with stent placement, new fever // r/o infiltrate
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Ap portable supine view of the chest. Midline sternotomy wires and left chest wall pacer device is noted with pacer lead extending into the region the right ventricle. The heart is mildly enlarged. The aorta is calcified and unfolded. There is hilar congestion and mild to moderate interstitial edema. No supine evidence for effusion or pneumothorax. No definite fracture is seen.
status post fall assess for injury to the chest.
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Because today's exam is erect pa and lateral the exact comparison of the pneumothorax is hard to assess. It has not changed significantly and is still small at apex measuring <num> mm. There is now air-fluid level seen inferiorly. Prior sternotomy was done for cabg in this patient with moderate cardiomegaly, left lung is unremarkable.
bilateral pleural effusion, thoracocentesis, pneumothorax.
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In comparison with the study of <unk>, there is little change. Monitoring and support devices are again seen. Large bilateral pleural effusions with compressive atelectasis at the bases persist. There is probably some underlying pulmonary vascular congestion.
large amount of blood suctioned from the tracheostomy tube, to assess for change.
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Ap frontal view of the chest demonstrates hyperinflated lungs. There is no consolidation, pleural effusion, or pneumothorax. The cardiomediastinal contours are normal. Right ribcage deformity noted.
altered mental status.
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Pa and lateral chest views were obtained with patient in upright position. Analysis is compared with the next preceding portable chest examination obtained five hours earlier during the same day. Mild cardiac enlargement as before. Thoracic aorta of normal dimension but calcium deposits are seen in the wall, mostly at the level of the arch. Pulmonary vasculature is not congested. Similar as suspected on the preceding portable chest examination, there are bilateral scattered patchy, sometimes confluenting infiltrates in the lung bases. The lateral view discloses the predominant postero-inferior location in the posterior dependent portion of the lower lobes. Minor pleural effusion cannot be excluded but major effusions are not present.
<unk>-year-old female patient with questionable pneumonia versus pleural effusion, lateral and pa chest examination advised by interpreter of previous portable chest examination obtained <num> hours earlier.
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The patient is status post tracheoplasty. Lung volumes are low. Moderate bibasilar atelectasis and small bilateral pleural effusions, left greater than right, are new since <unk>, likely postsurgical. Widening of the mediastinum is expected in the postoperative period. The heart size is likely normal. There is a new pleural drain in the right lung.
<unk> year old woman s/p tracheoplasty // ? ptx
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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 cough after inhaling bleach // evaluate for pneumonia
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The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.
<unk>f with sob and cp // r/o infiltrate
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Again seen is the single lead left-sided pacemaker, lead tip over right ventricle. Inspiratory volumes are low. The cardiomediastinal silhouette is unchanged. There may be minimal upper zone redistribution and slight vascular plethora, but i doubt other evidence of chf. Minimal bibasilar atelectasis is also again noted. A small right effusion is likely present.
<unk> year old woman with leukocytosis, recent ppm placement // interval changes
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The lungs are noted to be hyperexpanded and the hemidiaphragms are somewhat flattened. There is blunting of the bilateral costophrenic angles, which may be secondary either to bilateral pleural effusions or pleural thickening. There is no focal consolidation, pneumothorax, or pulmonary edema identified. The heart size is normal. Mediastinal contours are normal. Multiple, old, healed bilateral rib fractures are seen, unchanged from prior examinations. Redemonstrated is a cluster of small metallic coils are noted within the right upper quadrant.
status post fall <num> week prior, now with chest pain and cough.
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The inspiratory lung volumes are appropriate. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits although note is made of slightly increased heart size from the prior study, possibly related to the phase of the cardiac cycle. No acute osseous abnormality is detected.
history: <unk>f with cough and dyspnea // r/o acute process
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The cardiac, mediastinal and hilar contours appear unchanged. The heart is mildly enlarged. The aortic arch is partly calcified. The lung volumes are again low. There is widespread peripheral coarse reticulation of each lung, most consistent with pulmonary fibrosis, most confluent in the mid to lower than upper lungs. Best seen on the lateral view is a new patchy opacity obscuring the left hemidiaphragm on the lateral view with slight upward tenting. There is no pleural effusion or pneumothorax.
dyspnea on exertion. patient with known idiopathic pulmonary fibrosis, on home oxygen.
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There is a slightly increased density overlying the left lung base, which may represent an early pneumonia or may be related to overlying soft tissue. Followup radiographs are recommended in <num> week to evaluate for interval change. The heart size is top-normal. A metallic fiducial is noted in the right upper lung zone. There is no pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits.
<unk> year old woman with copd, worsening cough and rhonhi at the left base // please evaluate for pneumonia