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Ap upright and lateral views of the chest provided. Lung volumes are low limiting assessment. Allowing for this, there is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. A compression deformity involving t<num> vertebra spine is unchanged from prior. No free air below the right hemidiaphragm is seen.
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<unk>f with pmh of cva with residual rue and rle weakness and lumbar fx, now with <num> days progressive bilateral <unk> weakness, confusion, and weight loss
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A left-sided chest tube is unchanged in position with the tip oriented towards the left lung apex. The amount of subcutaneous emphysema along the left lateral chest wall and the left supraclavicular region is unchanged. A very tiny left apical pneumothorax may be present. There is persistent left basilar atelectasis. A small right pleural effusion is noted on the lateral view. The left hemidiaphragm remains elevated compatible with left-sided volume loss. An epidural catheter remains in place. The cardiomediastinal silhouette is stable.
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left hilar mass status post sleeve resection.
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Compared to the prior study there is slight interval increase in the vascular plethora, cardiomegaly, and small bilateral effusions.
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<unk> year old woman with tissue avr, chb sob // chb sob
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Since most recent radiograph, there is no significant interval change. Again seen is bilateral pleural effusion and atelectasis, not significantly changed from prior. The et tube now terminates approximately <num> cm from the carina, which may be due to patient positioning. Otherwise, there is no appreciable change in support lines. Sternotomy wires and surgical clips are in place.
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<unk>m cad, afib here with nstemi and occlusion of svg-om which was deemed not intervenable now with pea arrest after respiratory distress and intubation.
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Patient is status post median sternotomy and cabg. Cardiac silhouette size remains mildly enlarged but unchanged. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Chain sutures are noted along the right hilum and right suprahilar region compatible with prior lobectomy with evidence of prior partial right fifth rib resection. Linear scarring is noted within the right lung base along with unchanged right-sided lateral pleural thickening. No focal consolidation, pleural effusion or pneumothorax is seen. No pleural effusion or pneumothorax is present. No acute osseous abnormality is identified.
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history: <unk>m with syncopal episode status post cabg
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Lines and tubes: tracheostomy tube in unchanged position. Ekg leads overlie the chest wall. Lungs: lower lung volumes. Persistent, unchanged left lower lobe opacity comprising of atelectasis and/or consolidation. Stable mild haziness in the right lower lobe. Pleura: unchanged moderate left pleural effusion. Left-sided chest tube is not clearly visualized owing to underpenetration. Mediastinum: stable cardiomediastinal silhouette with unchanged cardiomegaly. Bony thorax: unchanged
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<unk> year old man with history of bacteremia and empyema s/p chest tube with fever, hypoxia // interval change
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The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The mediastinal and hilar contours are unremarkable. The cardiac silhouette is not enlarged.
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fever and drenching night sweats.
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The lungs are clear and the heart mediastinal contours are within normal limits in size and shape. No pneumothorax or pleural effusion is seen. No fracture is visible, however if there is concern for nondisplaced vertebral body or rib fracture, specific bone films should be obtained.
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history: <unk>f with six days ago // ? fracture,? pneumothorax
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Mild to moderate cardiomegaly is stable. The mediastinal and hilar contours are unchanged. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. There is stable appearance of a linear opacity at the left lung base since <unk>, which may reflect atelectasis or scarring. Paucity of vessels at the lung apices indicates emphysematous changes.
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shortness of breath and new oxygen requirement.
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Interval removal of the right-sided chest tube with suggestion of right apical line just below two overlapping ribs and difficulty determining whether vessels extend beyond it. A small right apical pneumothorax could be present. Extensive bibasilar atelectasis and small left-sided pleural effusion persist. The cardiac and mediastinal contours are stable.
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<unk> year old man s/p r vats wedge // r/o ptx post ct removal
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Compared with prior radiograph, the left-sided picc line has been partially withdrawn, and the tip of the line has moved from its prior lower svc position to the midline likely at the level of the left brachiocephalic vein. A nasojejunal tube is seen with the tip to the left of midline, following a contour compatible with placement in the fourth portion of the duodenum versus the proximal jejunum. A line tracking across the left upper quadrant which may represent a drainage catheter. Otherwise, the lungs are well expanded and clear noting right linear opacity suggesting atelectasis. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax.
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<unk>-year-old male with fever. evaluate for evidence of an infiltrate.
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No previous images. The heart is normal in size and there is no vascular congestion or pleural effusion. No acute focal pneumonia.
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weight loss and anemia.
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Comparison is made to prior study from <unk>. The endotracheal tube tip has been advanced and the distal tip is now <num> cm above the carina. This could be pulled back <num> to <num> cm for more optimal placement. The tip is pointing towards the right mainstem bronchus. Heart size is enlarged but stable. There are persistent low lung volumes with crowding of the pulmonary vascular markings and atelectasis at the lung bases. No pneumothoraces or definite consolidation is present.
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The lungs are well expanded and clear. The hila and pulmonary vasculatures are normal. No pleural abnormalities. No pneumothorax. The cardiomediastinal silhouette is normal. No fractures.
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<unk> year old woman with chest pain. // please evaluate for thoracic pathology.
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The lungs are well inflated and clear. The cardiomediastinal silhouette and hilar contours are stable. There is no pleural effusion or pneumothorax.
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<unk>-year-old woman with cough. evaluate for pneumonia.
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As compared to the previous radiograph, the widespread bilateral parenchymal opacities, likely reflecting a combination of pulmonary edema and infection, are constant in appearance. They have neither increased nor decreased since the previous exam. Currently, there are no larger pleural effusions and the size of the cardiac silhouette is mildly enlarged. No pneumothorax. No new parenchymal changes.
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worsening shortness of breath and hypoxia, evaluation.
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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. Patient is known to have prominent epicardial fat pad which accounts for the subtle effacement of the heart borders inferiorly. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
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<unk>f with cp // acute process
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Cardiac silhouette size remains mildly enlarged. The mediastinal contour is similar with tortuosity of the thoracic aorta re- demonstrated. New consolidative opacities are noted within the right upper and middle lobes, as well as patchy bibasilar airspace opacities concerning for multifocal pneumonia. Small bilateral pleural effusions are also new in the interval. Pulmonary vasculature is not engorged. There is no pneumothorax. No acute osseous abnormalities seen.
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history: <unk>f with anemia, shortness of breath, cough x<num> days
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The patient is scoliotic and rotated to his left. The lung volumes are adequate on the right, but decreased on the left. The retrocardiac opacity, seen on prior chest x-ray, has improved. This opacity could represent a consolidation from infectious causes or an opacification due to atelectasis. There is a minimal left pleural effusion. The right costophrenic angle is unremarkable. The heart size and mediastinal vasculature is less apparent, likely reflecting improved congestion.
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<unk> year old man with cidp, suspicion for aspiration event, new coarse lung sounds // assess for consolidation.
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Exam is suboptimal secondary to positioning and rotation. Increased opacity seen at the lung bases confirmed on the lateral view. Superiorly the lungs are clear. Cardiomediastinal silhouette is stable. Bones are diffusely demineralized. Compression deformities in the thoracic and lumbar spine were seen on prior. High density material projects over the renal collecting systems bilaterally compatible with excreted contrast from recent ct scan.
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<unk>f with acute altered mental status with ?abd ttp.
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Since the prior exam, there is increase in the right apical pneumothorax, now moderate in size and without evidence of tension. There is increased right pleural effusion and right basal atelectasis. The previously noted right chest wall subcutaneous emphysema has resolved. Numerous right rib fractures are redemonstrated.
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<unk>m with r sided pneumo // worsening of ptx
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There is no pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is normal. Minimal opacity at right lung base is probably atelectasis and less likely an early focus of pneumonia.
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<unk>f with fever, evaluate for infection
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There is redemonstration of a left-sided port-a-cath, ending in the low svc. The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Mild sclerosis is seen within the left humeral head, nonspecific in nature.
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history of sickle cell disease presenting with right shoulder pain and left hip pain. evaluate for acute intrathoracic process.
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Cardiac, mediastinal and hilar contours are normal. Pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected.
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fevers, cough.
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Lung volumes are low. Bibasal areas of atelectasis are extensive, in particular in the right lung base heart size is within normal limits. Lung fields are clear. There is no pneumothorax.
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<unk>m w/wheeze and cough and tactile fevers, please eval for pna // <unk>m w/wheeze and cough and tactile fevers, please eval for pna
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The cardiac, mediastinal and hilar contours are normal. The lungs are clear. Pulmonary vascularity is normal. No pleural effusions or pneumothoraces. No acute osseous abnormalities are present.
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bilateral pitting edema.
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Frontal lateral radiographs of the chest demonstrate normal heart size, mediastinal and hilar contours. The lungs are hyperinflated but clear. No pleural effusion or pneumothorax.
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left-sided chest pain and dyspnea. evaluate for pneumothorax or pneumonia.
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As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are unchanged, except for the nasogastric tube that has been removed. Unchanged low lung volumes and moderate cardiomegaly with small bilateral pleural effusions and atelectatic parenchymal opacities. No newly appeared parenchymal opacities. No pneumothorax.
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gastrointestinal bleed, evaluation for interval change.
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Moderate left pleural effusion has increased in size since the post-thoracentesis radiograph of <unk> is now similar in appearance to the pre-thoracentesis radiograph from that date. Hiatal hernia with intrathoracic stomach is again demonstrated as well as elevation of the left hemidiaphragm with adjacent atelectasis and/or consolidation. Within the right lung, a confluent ground-glass opacity has developed just above the minor fissure level, and could reflect either aspiration or early focus of pneumonia. Small right pleural effusion has decreased in size.
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The lung volumes are low. Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vascularity is normal. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormalities are seen.
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chest pain, shortness of breath.
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The lines and tubes are in unchanged standard position. The cardiac silhouette is obscured by pleural parenchymal abnormalities. Large bilateral pleural effusions associated with adjacent atelectasis are unchanged. Mild pulmonary edema is stable.
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Again seen is a severe convex right thoracic scoliosis and increased retrocardiac opacity due in part to the hiatal hernia. There is increased pulmonary vascular redistribution and a new infiltrate in the right lower lobe. It is unclear if this infiltrate is infectious or due to asymmetric pulmonary edema. The overall impression is that of chf with or without associated infection in the right lower lobe.
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desaturation to <num>s.
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There is retrocardiac opacity silhouetting the left hemidiaphragm similar to prior. Elsewhere, the lungs are clear noting that the left lung apex is obscured by patient's chin. There is no overt edema. There is no large right-sided pleural effusion. The cardiomediastinal silhouette is grossly within normal limits.
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<unk>m with ?<num>rd degree heart block // eval for infiltrate
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As compared to the previous radiograph, patient has received a new dobbhoff catheter. The course of the catheter is unremarkable, the catheter is coiled in the stomach, the tip currently projects over the mid portions of the stomach. There is no evidence of complications, notably no pneumothorax. The patient has also received a tracheostomy tube that replaces the previous endotracheal tube. The position of the tracheostomy tube is unremarkable. There is no evidence of complications, notably no pneumomediastinum. Otherwise, the radiograph is unchanged.
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dobbhoff placement.
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Ap portable upright view of the chest. A new orogastric tube extends into the stomach, with the tip beyond the scope of this examination. The endotracheal tube and right ij central venous catheter are unchanged in position. The remainder of the examination is unchanged since the <time> pm radiograph.
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<unk> year old man with sepsis, etoh hep // et tube/ogt placement okay?
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As compared to the previous radiograph, the pleural drain is in unchanged position. The distribution and appearance of the left pleural effusion is constant. This is true for both the frontal and the lateral radiographs. Sternal wires in constant alignment. The size of the cardiac silhouette is unchanged. Normal appearance of the right lung.
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pleural effusion, evaluation.
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Compared to the prior study from <unk>, there has been slight interval increase in right pleural effusion, with stable cardiomegaly. Underlying consolidation is likely present. Prosthetic cardiac valve and median sternotomy wires are unchanged in position. The left lung is grossly clear.
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<unk>m with shortness of breath, tachypnea, rlq pain while at dialysis
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Since <unk>, the opacity in the medial right upper hemithorax has improved, most consistent with improving right middle lobe collapse. Otherwise, no significant interval change. Stable elevation of the right hemidiaphragm status post right upper lobectomy. Stable cardiomediastinal silhouette. The left lung is clear. No pneumothorax, focal consolidation to suggest pneumonia, pulmonary edema, or pleural effusion. The bilateral calcified pleural plaques are unchanged.
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<unk> year old man with enlarging rul nodule now s/p rul wedge with completion lobectomy on <unk>; evaluate for interval change.
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Compared with prior radiographs on <unk>, there is improvement in both the right and left lung interstitial markings. There is no pleural effusion or pneumothorax. There is no vascular congestion or edema. There is no evidence to suggest or exclude pulmonary embolism. Again seen is chronic elevation of the right hemidiaphragm with a loop of large bowel beneath the diaphragm.
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<unk> year old man with ipf presents with <num> weeks of worsening dyspnea and fatigue. // ? acute process, pneumonia
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There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Pulmonary nodules as described on prior chest ct are not discretely visualized on today's examination. Mild scoliosis is again noted in the thoracic spine.
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history: <unk>m with sob // r/o infection
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The heart is normal in 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.
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cough, fever and myalgia.
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The cardiomediastinal and hilar contours are within normal limits. The lungs are well expanded. There is a <num> mm focal density overlying the right <num>th rib, likely a calcified granuloma. Otherwise, there is no focal consolidation, pleural effusion or pneumothorax.
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palpitations. evaluate for mass and/or other explanation for palpitations.
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Endotracheal tube terminates in the mid trachea. Nasogastric tube courses into the stomach and out of view. Lungs are reasonably well expanded without focal consolidation or pleural effusion. Mild vascular congestion is noted. No pneumothorax is seen. Heart and mediastinum are exaggerated with supine technique, but appear otherwise, normal.
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<unk>-year-old woman with intraparenchymal hemorrhage, status post intubation.
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Cardiomediastinal contours are stable in appearance. Lung volumes are low. Patchy opacity in right infrahilar region probably represents a combination of patchy atelectasis and adjacent small pleural effusion. Aspiration or an early focus of pneumonia are additional considerations, and followup radiographs may be helpful in this regard. Within the left hemithorax, a small left pleural effusion is unchanged.
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Minimal linear left mid lung atelectasis is seen. Otherwise, lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.
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Ap single view of the chest has been obtained with patient in sitting semi-upright position. Analysis is performed in direct comparison with the next preceding similar study of <unk>. There is no significant interval change between these two studies obtained with a <unk>-hour interval. The left-sided basal density with obscuration of the left-sided diaphragmatic contour persists. This is explained by patient's pancreatitis. No increased pulmonary vascular congestion and no evidence of new parenchymal infiltrates. Right-sided picc line in place. High contrast image clearly identifies its termination in the lower third of the svc. A gas-distended stomach can be identified and overlying drainage tubes are seen in the upper abdominal area, however, more detailed analysis of the abdomen can be performed.
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<unk>-year-old male patient with history of necrotizing hemorrhagic pancreatitis complicated with abdominal compartment syndrome with persistent fluid collections and new <unk>-<unk> fistula. presented on <unk> for drain upsizing, now with worsening mental status, respiratory acidosis, arrived in icu, evaluate for interval change.
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Midline tracheostomy tube is seen. The patient is status post interval placementof a left sided picc, which has a sharp kink at its distal portion. The left-sided picc appears to course towards the proximal svc and take a sharp kink and then head in a relative superior direction <num>-mm. Picc should be repositioned. This finding was discussed with dr. <unk> on <unk> at <time> p.m. Via telephone two minutes after discovery. The patient is status post median sternotomy and cabg. The aorta is quite unfolded. The aortic knob is prominent, probably due to underlying aneurysm. No priors studies for comparison. The patchy opacity projecting over the right lung could be due to sites of aspiration or infection. No large pleural effusion or pneumothorax is seen. The cardiac silhouette is top normal to mildly enlarged.
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Mediastinal contour is enlarged. Heart size is top-normal. There is no large pleural effusion. There is no pneumothorax. Lung volumes are low without focal consolidation. No displaced rib fracture is seen.
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<unk>-year-old man with fall evaluate for pneumonia
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As compared to the previous radiograph, the endotracheal tube has been slightly pulled back. The tip of the tube now projects <num> cm above the carina. There is no evidence of complications, notably no pneumothorax. The bilateral areas of atelectasis have minimally increased in severity and are now better visible on the left than on the right. There is unchanged evidence of minimal fluid overload. No pleural effusions. No pneumothorax. Borderline size of the cardiac silhouette.
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intubation for gastrointestinal bleeding, evaluation for interval change.
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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 study obtained four hours earlier during the same day. Evidence of bilateral pleural effusion and thickening of the pleural spaces along the lateral chest walls as before. Pulmonary congestive pattern with perivascular haze in pulmonary circulation. No evidence of new discrete parenchymal infiltrates. Inspirational effort somewhat less than on next preceding portable study. Quantification of pleural density and translate into amount of free pleural effusion is impossible on single view portable chest examination.
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<unk>-year-old male patient with cancer and pleural effusion. now with worsening oxygen requirement, evaluate for worsening.
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The tip of the endotracheal tube projects over the mid thoracic trachea. The gastric tube extends below the level of the diaphragms but beyond the field of view of this radiograph. The right internal jugular central venous catheter tip projects over the mid svc. There has been further increase in the bilateral predominantly perihilar and lower lobe patchy and confluent airspace opacities, possibly reflective of pulmonary edema and/or multifocal pneumonia in the correct clinical context. The small layering left pleural effusion. The size of the cardiac silhouette is unchanged.
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<unk> year old woman with etoh cirrhosis and gib intubated for egd // et tube placement evaluation
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No focal consolidation, pleural effusion, or pneumothorax is seen. Heart and mediastinal contours are within normal limits.
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<unk>-year-old male status post fall with intracranial hemorrhage.
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The cardiac, mediastinal and hilar contours appear within normal limits. Blunting of the left costophrenic angle suggests the possibility of very small effusion. There is no pleural effusion on the right. The lungs appear clear. Several old right-sided rib fractures appear unchanged. Mild degenerative changes are similar along mid to lower thoracic levels. A lower thoracic interspace shows new moderate narrowing over the long interval suggesting degenerative change. The vertebral body heights appear preserved.
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acute cognitive decline, gait changes, and severe mid back pain.
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The patient is status post median sternotomy. The aorta appears dilated and tortuous. Clips are seen projecting over the right lung apex. Heart size is normal. Hilar contours and pulmonary vascularity are normal. No focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormalities are detected.
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new onset atrial fibrillation status post aortic dissection repair.
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Frontal and lateral views of the chest were obtained. Projecting over the right upper lung, there is a <num> mm nodular opacity which is more apparent as compared to the prior studies. No additional focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable.
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Pa and lateral views of the chest provided. There is a right chest wall port-a-cath with its tip in the low svc at the region of the cavoatrial junction. 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.
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<unk>f with fevers.
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Again seen is a peripherally calcified right lower lung lesion. When compared to prior, it does not appear increased in size. There is no new consolidation. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Metallic surgical clips project over the supraclavicular regions bilaterally.
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<unk>f with weakness // pna?
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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable.
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chest pain.
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Cardiomediastinal silhouette and hilar contours are normal. The previously noted subtle retrocardiac density has no clear lateral correlate and is likely vascular shadowing. Lungs are otherwise clear. There is no pleural effusion or pneumothorax. A right central venous catheter is unchanged in position with the tip terminating in the low svc.
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new diagnosis of aml with increased sputum production and cough.
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Pa and lateral views of the chest provided. Clips in the right upper quadrant are noted. A calcified granuloma projects over the right mid lung. 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.
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<unk>f with anterior chest pain, dyspnea, cough //
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The heart size is top normal. The central pulmonary vasculature is engorged, without overt edema. Bibasilar linear type opacities, worse at the left, are most compatible with atelectasis, though small underlying consolidation cannot be entirely excluded. There is no pneumothorax or pleural effusion. Mild degenerate changes throughout the thoracic spine are unchanged since <unk>.
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weakness.
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Pa and lateral views of the chest were provided. The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. The imaged bony structures are intact. No free air is seen below the right hemidiaphragm.
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<unk>-year-old man with history of hiv and brain lesions, with near syncopal episode, assess for pneumonia.
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Pa and lateral views of the chest provided. Airspace opacity within the right upper lobe and to a lesser extent right lower lobe remains concerning for pneumonia. Relative prominence of the right pulmonary hilum could reflect the presence of reactive lymph nodes, though underlying mass is difficult to exclude. The left lung is clear. Patient is known to have emphysema. The heart size is stable. Bony structures are intact.
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<unk>m with decreased right breath sounds // pna?
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Mild pulmonary vascular congestion is new. Right middle and right lower lobe atelectasis has slightly worsened, with persistent adjacent elevation of right hemidiaphragm. Slight improvement in left retrocardiac opacity, likely due to atelectasis. Small left pleural effusion is unchanged. No visible pneumothorax.
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Lordotic positioning. Compared to the prior film, an et tube is now in place, tip approximately <num> cm above the carina. Again seen is hyperinflation, consistent with copd, an elevated right hemidiaphragm, moderate to moderately severe cardiomegaly, and changes related to old healed rib fractures in both upper zones. There is upper zone redistribution, without other evidence of chf. No obvious focal infiltrate. No pleural effusion.
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<unk> year old man s/p ablation. // evaluate for pulmonary edema
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The patient is status post median sternotomy cabg. Moderate cardiomegaly is unchanged. Dual lumen right-sided central venous catheter tip terminates in the proximal right atrium, unchanged. Loculated small right pleural effusion is unchanged compared the prior study induced chronic. Curvilinear opacities are noted bilaterally which are unchanged, compatible with rounded atelectasis. Small left pleural effusion is also stable. There is no pneumothorax. No pulmonary vascular congestion is present. There are no acute osseous abnormalities. Clips are noted within the right upper quadrant the abdomen compatible with prior cholecystectomy.
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shortness of breath.
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In comparison with study of <unk>, there is continued and possibly increasing bilateral opacification at the bases, consistent with pleural effusion and compressive atelectasis, more prominent on the right. Continued enlargement of the cardiac silhouette with evidence of elevated pulmonary venous pressure in this patient with a pacer device in place.
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chest pressure with desaturation.
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There are bibasilar opacities, right greater the left. There is also bilateral effusions. The heart is mildly enlarged with mild pulmonary edema. No pneumothorax is seen. Prior rib fractures are noted.
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<unk>-year-old male with altered mental status and, purposes. please evaluate for pneumothorax, consolidation, effusion or mass.
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Study is limited by patient rotation and low lung volumes. Cardiac silhouette size remains moderately enlarged. Dense atherosclerotic calcifications are noted at the aortic knob. Mediastinal contours appear grossly unchanged. There is new mild to moderate pulmonary edema with perihilar haziness and vascular indistinctness. Retrocardiac opacification could reflect atelectasis combined with a small left pleural effusion, though pneumonia is not excluded in the correct clinical setting. Patchy opacity within the right lung base may also reflect an additional area of atelectasis.
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history: <unk>m with lethargy, fever
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Lung volumes remain low. Cardiomediastinal contours are within normal limits. Persistent linear bibasilar atelectasis. Slightly more confluent opacity projects posteriorly over the spine on the lateral view, obscuring the posterior hemidiaphragms bilaterally, likely corresponding to patchy areas of increased opacity in the retrocardiac area on the frontal view. There are no pleural effusions. Rounded opacity in the right upper quadrant of the abdomen corresponds to post-tace changes.
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Portable frontal radiograph of the chest demonstrates a small left apical pneumothorax which is likely stable allowing for differences in technique. Opacification in the left upper lung likely relates to recent rfa. Stable appearance of the cardiomediastinal silhouette. No pleural effusion or right pneumothorax.
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left upper lobe lesion status post rfa, assess pneumothorax.
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There are relatively low lung volumes. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen.
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history: <unk>f with mvc yesterday // eval for traumatic process
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In comparison with the study of <unk>, there is little overall change. Again there is opacification in the left retrocardiac region with obscuration of the hemidiaphragm, consistent with substantial volume loss in the left lower lobe. Blunting of the costophrenic angle could reflect a small pleural effusion. The patient has taken a much better inspiration when compared to the prior study. There is no evidence of acute vascular congestion or pneumonia. Supraclavicular catheter remains in place with its tip in the upper portion of the right atrium.
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postoperative fever.
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Pa and lateral views of the chest were obtained. The lungs are clear bilaterally with no evidence of focal consolidation or pulmonary edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. There are no acute bony abnormalities, an old <unk> posterior right rib fracture is noted. There is no free air below the right hemidiaphragm.
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weakness.
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Pulmonary nodules are re- demonstrated although better assessed on prior ct. Confluent lateral right mid lung opacity and bibasilar opacities are worrisome for multifocal pneumonia. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable.
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history: <unk>m with sob and lll rales // infiltrate?
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In comparison with the study of <unk>, there has been placement of a right chest tube with removal of substantial amount of fluid from the right pleural space. No definite pneumothorax. Residual opacification is consistent with fluid and atelectasis and probably some post-expansion edema in the previously collapsed portion of the right lung.
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chest tube for effusion.
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The lungs are well-expanded without focal consolidation. Moderate cardiomegaly and pulmonary vascular congestion are slightly increased from <unk>. No pulmonary edema or pleural effusions. Unchanged right chest dual lumen pacemaker.
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<unk> year old man with worsening cough, decreased bs lll, history of chf // ? effusion ? pna
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The lungs are clear. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are normal. Pulmonary vascularity and heart size are normal.
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<unk>-year-old male with chest pain.
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A nasogastric tube courses below the diaphragm, with tip below the borders of the radiograph, but likely located within the distal stomach. A right-sided picc has been repositioned and now terminates in lower svc. Mild left basilar atelectasis is persistent but slightly improved. Otherwise, no significant interval change.
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painless jaundice, confirm ng tube placement.
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As compared to the previous examinations, there is stable opacification of the right upper lobe, consistent with aspiration versus pneumonia. The lung volumes are decreased, which leads to crowding of the bronchovascular structures. The remainder of the lungs are essentially clear without additional focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. The cardiomediastinal silhouette is stable. An endotracheal tube is noted to be in place terminating <num> cm above the level of the carina. A nasogastric tube is seen passing into the stomach.
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status post ingestion, now with fever. evaluate for aspiration or pneumonia.
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The tip of the hickman catheter is in the lower portion of the svc. The lungs are essentially clear without vascular congestion.
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catheter placement.
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Et tube is in appropriate position. The right picc line ends in the lower svc. The ng tube extends below the diaphragm. There is no significant change in the bibasilar atelectasis and pleural effusions. There is no pneumothorax. The cardiomediastinal contours are normal.
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multiple strokes found down with ards. evaluate ards/ventilatory associated pneumonia.
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Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs without focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable.
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preoperative evaluation in a patient with mandibular fracture.
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Lordotic positioning. Allowing for this, the heart is not enlarged and the cardiomediastinal silhouette is unchanged. No chf, focal infiltrate, effusion, or pneumothorax is detected. No free air seen beneath the diaphragms.
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history: <unk>m with worst ha of life, cp, sob //
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The lung volumes lead to crowding of the bronchovascular structures. Moderate to severe cardiomegaly is unchanged, as is moderate central pulmonary vascular congestion and interstitial edema. Small bilateral pleural effusions with adjacent atelectasis is noted. The upper lungs are grossly clear. There is no pneumothorax. There is wedging of a few thoracic vertebral bodies.
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history: <unk>f with chf, liver cirrhosis. // history: <unk>f with chf, liver cirrhosis. ? pulm edema, pna
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Ap portable supine view of the chest. There has been interval intubation with the endotracheal tube tip positioned <num> cm above the carina. The endogastric tube extends into the upper abdomen. There is significant interval worsening in pulmonary opacities concerning for worsening pneumonia. There is partial collapse of the right lower lobe. There may be a small right pleural effusion. Overall cardiomediastinal silhouette is unchanged. Bony structures are intact.
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<unk>f with s/p intubation // tube placement correct
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Pa and lateral views of the chest provided. Hilar congestion persists without significant pulmonary edema. No convincing evidence of pneumonia or large effusion. No pneumothorax. Cardiomegaly is again noted. Mediastinal contour is stable with aortic calcification. Bony structures are intact.
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<unk>f with increasing sob // pneumonia?
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A frontal supine view of the chest was obtained portably. The endotracheal tube ends <num> cm above the carina. Bibasilar opacities are atelectasis on subsequent chest ct. Widening of the mediastinum is due to mediastinal lipomatosis on subsequent ct. The nasogastric tube within the esophagus is displaced to the right, ending in the stomach, with the side port at the gastroesophageal junction. There is no effusion or large pneumothorax.
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Right-sided dual lumen central venous catheter tip terminates in the right atrium, unchanged. Mild to moderate enlargement of the cardiac silhouette is re- demonstrated. The mediastinal contour is unchanged. Moderate pulmonary edema is present, similar to that seen on the prior exam, with a new small left pleural effusion. Patchy opacities in the lung bases likely reflect areas of atelectasis. No pneumothorax is present. Clips project over the left axilla. There are no acute osseous abnormalities.
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<unk> year old woman with presyncope, congestive heart failure, end-stage renal disease.
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In comparison with the study of <unk>, the right apical pneumothorax on the right is again seen, though it may be slightly smaller. Monitoring and support devices are unchanged. Bibasilar opacifications persist.
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apical pneumothorax.
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Interval placement of pigtail pleural catheter in the lower right hemithorax, with associated decrease in size of right pleural effusion, now moderate in size. Adjacent lung parenchymal opacity in right lung base is likely due to atelectasis. Mild pulmonary vascular congestion is accompanied by minimal interstitial edema.
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Pa and lateral chest radiographs demonstrate low lung volumes and bibasilar atelectasis. However, there is no focal consolidation, pleural effusion or pneumothorax.
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substernal chest pain.
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Heart size is mildly enlarged but unchanged. The mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Minimal patchy bibasilar airspace opacities likely reflect areas of atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. Widening of the right acromioclavicular joint appears unchanged compared to <unk> chest radiograph, likely reflective of prior trauma.
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history: <unk>m with breakthrough seizures
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Pa and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding ap portable single view chest examination of <unk>. The previously described right-sided chest tube remains in place seen to terminate in apical area of the right hemithorax. Right-sided paravertebral structures are also air-containing most likely represent moderately air-distended esophageal reconstruction. Attenuated appearance of hyperexpanded right lower lobe lung tissue status post right upper and middle lobectomies. No remaining pneumothorax can be identified. The on previous examination persistent rather prominent chest wall emphysema has been reduced to minute remnants. Elevation of right hemidiaphragm as before, but no evidence of any significant pleural effusion in the lateral or posterior pleural sinus. Left-sided hemithorax remains unremarkable as before. The heart size is within normal limits and there is no evidence of any pulmonary vascular congestion.
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<unk>-year-old male patient status post esophagectomy, evaluate interval change.
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As compared to the previous radiograph, the patient was intubated. The course of the nasogastric tube is unremarkable, the tip of the tube projects over the middle to distal parts of the stomach. There is no evidence of complications, notably no pneumothorax. Lung volumes remain low. There is moderate cardiomegaly and tortuosity of the thoracic aorta. Mild atelectasis at the right lung bases. No pulmonary edema. No pleural effusions.
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melena, hematocrit drop, suspected upper gastrointestinal bleed. evaluation of orogastric tube position.
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Pa and lateral views of the chest provided. There are subtle ground-glass opacities within the upper lungs, more in the periphery of the lungs which could represent pneumonia. No effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact.
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Frontal and lateral views of the chest were obtained. Subtle basilar opacity seen posteriorly over the spine on the lateral view inferiorly may be due to atelectasis, although an early infectious process is not excluded in the appropriate clinical setting. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable.
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As compared to a previous radiograph, the tip of the endotracheal tube is not substantially changed, the tip projects <num> cm above the carina. The right internal jugular vein catheter and the nasogastric tube are also unchanged. Moderate cardiomegaly persists. Bilateral areas of atelectasis are seen in unchanged manner. Minimal blunting of the costophrenic sinuses caused by pleural effusions. No pneumonia, signs indicative of fluid overload have minimally improved as compared to the previous image.
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altered mental status, shock, intubation, evaluation for tube placement.
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Ap portable upright view of the chest. Midline sternotomy closure device again noted. The heart is stably enlarged and the mediastinal contour is markedly unfolded and widened in this patient with known history of aortic dissection. There is no focal consolidation, large effusion or pneumothorax. No evidence of pulmonary edema. Bony structures are intact.
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<unk>f with weakness, history of aortic dissection status post repair.
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Comparison is made to previous study from <unk>. There is right-sided chest tube at the base. This is unchanged in position. There is some pleural fluid at the right base extending into the right minor fissure, unchanged. There are no pneumothoraces identified. Again seen is borderline cardiomegaly. There is no overt pulmonary edema.
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