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As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. The right subclavian catheter is in unchanged position. There is unchanged cardiomegaly. However, there is a substantial increase in severity of the pulmonary edema, and mild bilateral pleural effusions are now visible. Unchanged retrocardiac atelectasis. Unchanged massive enlargement of the left atrium.
afib, evaluation for tubes and lines.
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Heart size is normal. Mediastinal and hilar contours are within normal limits. Lungs are clear without focal consolidation. No pleural effusion, pulmonary vascular congestion, or pneumothorax is identified. No acute osseous abnormalities are demonstrated.
chest pain.
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The lung volumes are normal. Moderate cardiomegaly without pulmonary edema. No pneumothorax. No pleural effusions. No evidence of pneumonia. Mild tortuosity of the thoracic aorta. Sternal wires in situ. Moderate scoliosis, but no visible bony changes.
hypotension, chest pain.
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Pa and lateral views of the chest. There is elevation of the right hemidiaphragm. No focal consolidations are seen. There is no pleural effusion or pneumothorax. Aortic calcifications are seen. The heart size is top normal. The mediastinal and hilar contours are normal. Multiple old right rib fractures are seen.
<unk>-year-old male with hemoptysis, question of effusion.
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Minimal right apical pneumothorax. Mediastinal structure and trachea are shift to the right. A right chest tube was positioned and its tip is positioned in the posterior-inferior right lung field. There is an incomplete atelectasis of the lingula with bilateral pleural effusion more evident on the left lung field.
<unk> year old woman with pulmonary nodules, s/p rul wedge biopsy. pneumothorax?
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The lungs are well expanded. There is increasing opacity in the right lateral mid lung field at the site of the prior chest tube, which likely represents fluid loculated within the major fissure. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax or pleural effusion. Patient is status post gastric pull through with clips noted in the mediastinum.
dyspnea.
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The endotracheal tube terminates in the distal trachea. An enteric tube is also unchanged in position. Since the study of <num> day prior, there is increased retrocardiac opacification which is most likely due to atelectasis. The heart and mediastinum are magnified by the projection. There is no pneumothorax.
<unk>-year-old female with history of aca aneurysm complicated by subarachnoid hemorrhage status post coiling of vp shunt placement with recurrent c diff colitis. hypercarbic respiratory failure.
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Pa and lateral views of the chest provided. A calcified granuloma is again seen in the right mid-zone, of no active concern. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk> year old woman with incidental finding of <num> mm right lower lung opacity, possibly a pulmonary nodule or alternatively a vessel on end. recommend dedicated pa and lateral chest radiographs // eval ? <num>mm rll lung opacity
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There are new small left upper, left lower and right middle lobe opacities which may represent multifocal consolidation. Cardiac and mediastinal silhouettes are unchanged. Dr. <unk> <unk> these findings with dr. <unk> at <time> p.m. On <unk>. Given this atypical appearance, clinical correlation and followup are recommended.
alcoholic hepatitis. question pneumonia.
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There has been interval placement of a dobbhoff nasogastric tube with the tip seen coiled in the distal esophagus. As compared to prior examination, there has been interval development of a vague opacity within the right lower lobe, concerning for aspiration pneumonia. Redemonstrated are biapical scars, mild pulmonary edema, and moderate cardiomegaly. No pleural effusion or pneumothorax is identified. Mediastinal contours are normal.
dysphagia, new dobbhoff tube placement.
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Ap upright and lateral views of the chest were obtained. The heart is normal size and cardiomediastinal contour is stable. The lungs are hyperinflated. There is no focal consolidation, pleural effusion or pneumothorax. Pulmonary vasculature is within normal limits.
<unk>-year-old woman with elevated white count, status post fall, evaluate for infection.
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The heart size remains moderately enlarged. There is mild pulmonary edema with small bilateral pleural effusions. Left basilar opacity may reflect pneumonia or atelectasis. No pneumothorax is detected. The mediastinal contours appear relatively unchanged. A wedge compression deformity within the mid thoracic spine is unchanged compared to the prior ct.
dyspnea.
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Dobhoff tube now ends in the proximal stomach. Stable, mild cardiomegaly. Unchanged moderate right pleural effusion and moderate to large left pleural effusion. Substantial bibasilar atelectasis. Normal mediastinal and hilar contours.
<unk>-year-old man with a history of chf, now status post repositioning of dobhoff tube.
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Ap and lateral views of the chest. Left chest wall port seen with catheter tip in the lower svc. The lungs are clear of focal consolidation or effusion. The cardiomediastinal silhouette is stable, and atherosclerotic calcifications are noted at the aortic arch. No acute osseous abnormality is identified.
<unk>-year-old male with weakness and failure to thrive.
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Median sternotomy wires are intact. Lung volumes are low. The small right apical pneumothorax is smaller compared to the prior exam. There is no focal consolidation or pleural effusion. There is retrocardiac and bibasilar atelectasis. Small left pleural effusion is stable.
<unk>-year-old woman status post cabg. evaluate for pneumothorax.
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Cardiac silhouette size is normal. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is seen. Focal eventration of the right hemidiaphragm is similar. No acute osseous abnormality is visualized. Clips within the left neck are again noted.
history: <unk>m with chest pain
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The ett is unchanged and terminates <num> cm above the carina with neck flexion. There is a left subclavian, which has changed in orientation and now is at the level of the brachiocephalic confluence. There is an ng tube seen curling in the left upper quadrant, however the tip is not visualized on this image. The perihilar opacities have resolved. There is left basilar atelectasis. The lungs are otherwise clear. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
<unk> year old woman with large right iph with ivh and hydrocephalus; increased wbc cell count and worsening abgs // assess for focal consolidation
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In comparison with the study of <unk>, the left base is somewhat clear with the hemidiaphragm well defined. The pulmonary vessels are indistinct, suggesting elevated pulmonary venous pressure. Endotracheal tube tip lies approximately <num> cm above the carina and the nasogastric tube extends well into the stomach. Obliquity of the patient makes it somewhat difficult to assess the cardiac size.
polytrauma, to assess for change.
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The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. There is persistent enlargement of the cardiac silhouette. No pulmonary edema is seen.
history: <unk>f with chest pain, shortness of breath // eval for infiltrate
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Heart size is mildly enlarged. The aorta is tortuous. A moderate size hiatal hernia is re- demonstrated. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities.
history: <unk>m with fever
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Bilateral opacities are worse in right upper and right lower lobe. Et tube is in adequate position ending <num> cm above carina. Right subclavian and left jugular lines are in adequate position. Ng tube is below the carina. There is no pneumothorax. Right-sided pigtail is in unchanged position and was fissural in previous chest ct. There is no pleural effusion or pneumothorax. Mediastinal and cardiac contours are top normal.
patient with respiratory failure, rule out for pneumonia, intubation, interval change.
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Ap single view of the chest has been obtained with patient in upright position. Comparison is made with the next preceding similar study obtained two hours earlier during the same day. The previously questioned minimal right-sided pneumothorax cannot be identified anymore. Lungs appear clear from infiltrates. The right-sided chest tube has now been removed and there remains a local chest wall emphysema similar as it existed before. No new pulmonary abnormalities identified.
<unk>-year-old male patient status post chest tube removal, small right pneumothorax, assess interval change.
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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There are no pleural effusions or pneumothorax. The lungs appear clear. There is slight rightward convex curvature of the lower thoracic spine.
left-sided pain after trauma.
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Compared with prior radiographs on <unk>, there has been worsening of bilateral large pleural effusions, making evaluation of the lung parenchyma difficult and obscuring visualization of what previously was extensive consolidation. No pneumothorax.
<unk> year old man with pmhx prostate ca, chf and possible aspiration pna getting worse after initial improvement on abx // please assess for increasing infiltrates or effusions.
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The new endotracheal tube terminates <num> cm from the carina. Low lung volumes cause bronchovascular crowding and bibasilar atelectasis. Allowing for this there is likely moderate pulmonary vascular congestion. There is a trace left pleural effusion. There is no focal consolidation or pneumothorax. There is apparent discontinuity of the lateral left seventh and eighth ribs and the posterior left fifth rib suggesting acute fractures. Right sixth and seventh ribs also appear fractured in their lateral portion. There is diffuse demineralization.
<unk> year old man with gib going for egd s/p intubation, evaluate endotracheal tube placement.
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Since the previous study, there has been removal of the right-sided pigtail catheter in the pleural space. The pneumothorax on the right side has increased slightly in size since the previous study following the chest tube removal. There remains a right basilar pleural effusion as well as lower lobe atelectasis and low lung volumes. There is unchanged right mid clavicular shaft fractures and right lower rib cage fractures.
<unk>-year-old man with right-sided rib fractures status post chest tube removal. evaluate for interval change.
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The lung volumes are low. In comparison to <unk> portable chest radiograph, there is increased streaky, linear, dense opacification of the right and left lower lobes consistent with bibasilar atelectasis. The endotracheal tube previously seen on <unk> chest radiograph has been removed. There are no pleural effusions, nor pneumothorax, nor pulmonary edema. The heart size is top normal. There are no acute bony abnormalities.
<unk> y/o m pod #<unk> s/p hemicolectomy and sbr, now p/w hypoxia and increased o<num> requirement // r/o acute pulmonary process
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As compared to the previous radiograph, there is no relevant change. Borderline size of the cardiac silhouette, mild tortuosity of the thoracic aorta. No evidence of pneumonia, lung nodules or pulmonary edema. No pleural effusions.
history of breast cancer, questionable abnormalities.
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There has been interval improvement of the bibasilar atelectasis and bilateral pulmonary edema. There is a moderate right and small left pleural effusion, both of which appear stable compared to the previous exam although definite comparison is difficult given differences in technique between the radiographs. No new focal consolidations are identified. There is no pneumothorax. The mild to moderate cardiomegaly is stable compared to multiple exams dating back to <unk>. The hilar and mediastinal contours are otherwise normal. There is a stable mid thoracic wedge-shaped deformity, better evaluated on the ct from <unk>.
<unk>-year-old man with recent tavr, who presents for followup evaluation.
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Bibasilar atelectatic changes. Otherwise, the lungs are clear. The cardiomediastinal silhouette and hila are normal. There is a right port-a-cath ending at the cavoatrial junction. There is no pneumothorax. No pleural effusion.
<unk>-year-old with fever.
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The lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities.
<unk>f with chest pain // acute process?
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There has been interval removal of chest tubes with no observed pneumothorax. Right ij catheter sheath is seen in unchanged position terminating within the upper svc. There has been interval increase in the amount of bilateral pleural effusion, pulmonary edema, and basilar atelectasis with no observed change in the cardiomediastinal silhouette. There are no areas of focal consolidation concerning for infection. Pleural surfaces are unremarkable.
<unk>-year-old male status post chest tube removal.
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Pa and lateral views of the chest are compared to portable exam from earlier the same day and chest x-ray from <unk>. New from prior exam is retrocardiac opacity confirmed on the lateral view. Elsewhere, the lungs are clear. There is no effusion. Cardiac silhouette is enlarged, not significantly changed from prior exam in <unk>. There are enlarged pulmonary hila bilaterally as seen on prior portable exam. Osseous and soft tissue structures are unremarkable.
cough with mild leukocytosis. question pneumonia.
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Endotracheal tube tip terminates approximately <num> cm from the carina. Orogastric tube tip and side port are within the stomach. Heart is moderately enlarged. The mediastinal contours are unremarkable. Perihilar haziness and vascular engorgement is compatible moderate pulmonary edema. No large pleural effusion or pneumothorax is seen on this supine exam.
intubation.
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Persistent marked enlargement of the cardiac silhouette accompanied by decreased vascular distention and improved interstitial opacities in the right lung that were likely due to edema. However, worsening coalescent opacities are present in the left perihilar region with persistent peripheral septal thickening. It is uncertain whether this represents asymmetrical pulmonary edema or interstitial edema, co-existing with superimposed aspiration or developing pneumonia. Followup radiographs may be helpful in this regard.
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The patient is status post left vats. <num> left chest tubes are present. No definitive pneumothorax identified. Persisting retrocardiac opacity which may reflect post procedural changes/atelectasis. Mild atelectasis in the right lower lung zone. No right pleural effusion or pneumothorax. The size of the cardiac silhouette is enlarged but unchanged.
<unk> year old man with hemothorax s/p vats washout chest tube placement x<num> // ?interval change
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As compared to the previous image, the frontal and lateral radiographs show the pacemaker lead projecting over the right ventricle. The course of the lead is unremarkable. Sternal wires and clips are unchanged. No pulmonary edema. No pneumothorax.
icd, evaluation for lead position.
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The right ij line terminates in the right atrium. The heart is moderately enlarged. The mediastinal silhouette is unchanged. The diffuse bilateral parenchymal reticular opacities are consistent with patient's background fibrosis and severe emphysema. Rounded lucencies in the right upper lung consistent with chronic bullous emphysematous changes better evaluated on chest ct from <unk>. Lobe opacity in the right middle lung as seen on the prior study from <unk> is consistent with <num> pneumonia. There is no pulmonary edema, pleural effusion, or pneumothorax.
<unk> year old woman with copd, pneumonia, and sepsis // pneumonia, interval change, pulmonary edema
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When compared to remote priors, the nodular opacity in the lingula with adjacent scarring is unchanged. Elsewhere, the lungs are clear. There is no effusion, consolidation, or edema. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormalities.
<unk>f with cough // acute process
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Since earlier same day chest radiograph, near-complete opacification of the left lung is improved following bronchoscopy with partial reopening of the left upper lobe, unchanged appearance of multifocal opacities in the left lung from <unk>, possibly representing pneumonia, and moderate left pleural effusion. Lung volumes are low. Moderate to severe cardiomegaly is unchanged. The tip of the endotracheal tube terminates <num> cm above the carina. A feeding tube is seen in the stomach and continues out of view.
<unk> year old man with s/p bronch with secretion suctioning // <unk> year old man with s/p bronch with secretion suctioning
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In comparison with study of <unk>, the dobbhoff tube extends at least to the lower body of the stomach where it crosses the lower margin of the image. Tracheostomy tube is in good position without evidence of complication. Bibasilar opacifications most likely reflect atelectasis, with possible small effusion on the left. There may be mild elevation of pulmonary venous pressure.
cancer resection for nasogastric tube placement.
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The lateral view is slight suboptimal due the patient's overlying arm.the lungs are hyperinflated, but without focal consolidation. . No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Surgical hardware is seen at the right shoulder, not optimally evaluated.
history: <unk>f with weight loss // r/o acute process
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Pa and lateral views of the chest are compared to previous exam from <unk>. The lungs are clear of consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable.
<unk>-year-old female with chest pain.
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An enteric tube is seen coiling within the expected location of the cervical esophagus. The tip is not visualized. An endotracheal tube terminates <num> cm above the carina, likely due to chin positioning. A right ij central venous catheter terminates in the mid svc, unchanged in position. There has been interval improvement of pulmonary vascular congestion. The cardiac silhouette remains enlarged. Retrocardiac opacity and mild right base atelectasis have slightly improved.
<unk>-year-old man, dobbhoff placed, difficult placement, partially coiled in the pharynx. evaluate tip of tube.
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As compared to the previous radiograph, the monitoring and support devices, including the endotracheal tube, a venous introduction sheath on the right, a right swan-ganz catheter, a nasogastric tube and drainage devices over the liver are all unchanged. The lung volumes have minimally increased, likely reflecting improved ventilation or increased ventilatory pressure. However, atelectatic areas are still seen at the lung bases, both on the left and on the right. Normal size of the cardiac silhouette. Mild fluid overload. No evidence of pneumothorax.
status post liver transplant, evaluation for interval change.
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Right lower lobe opacity persists, although may be minimally less dense compared to the prior study. Please note that radiographic resolution is not yet expected as the prior radiograph was performed only <num> days earlier. No new consolidation. There is no pulmonary edema, pleural effusion or pneumothorax. Cardiomediastinal contours are normal. No acute osseous abnormalities.
history: <unk>m with persistent cough after previous pneumonia // rule out progression of pneumonia
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Portable ap view of the chest. The endotracheal tube is again seen. Right picc tip is in the mid svc. There is blunting of the bilateral costophrenic angles potentially due to effusions or scarring, unchanged. The lungs are hyperinflated. Linear bibasilar opacities have not significantly changed. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected.
<unk>-year-old female with a prior hospitalization with question pneumonia now with green secretions. abdominal pain.
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As compared to the previous radiograph, there is mild progression of the preexisting and already very severe parenchymal opacities. Opacities are relatively diffuse and bilateral. No evidence of pleural effusions is noted, despite the gravity of the parenchymal changes. The lung volumes remain low. Moderate cardiomegaly. The patient has been extubated, nasogastric tube has been removed.
aaa repair.
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Pa and lateral views of the chest were provided. There is no focal consolidation, effusion, or pneumothorax. No signs of chf. The cardiomediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm is seen.
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Left perihilar and retrocardiac opacities persist. The right lung remains clear. The patient is status post median sternotomy. The heart and mediastinal structures are otherwise unremarkable and unchanged. There are no concerning bone findings.
interval change
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The lung volumes are low, with bibasilar hazy opacities, right greater than left, possibly due to the atelectasis, however underlying pneumonia cannot be excluded. The heart size is unchanged, and the pulmonary arteries remain prominent. There is no pneumothorax or overt pulmonary edema. No large pleural effusion is identified. There is a healed left clavicle fracture.
history: <unk>m with cp // eval for infiltrate
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Pa and lateral views of the chest provided demonstrate aicd device in the left chest wall with lead tips extending into the expected location of the right atrium and right ventricle. Lungs appear clear aside from mild opacity in the posterior costophrenic recess which could represent small effusion. The cardiomediastinal silhouette appears grossly unremarkable. There is mild hilar congestion which could indicate mild edema. Bony structures intact.
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The tip of the nasogastric tube is not included on the image. It likely projects over the distal parts of the stomach. The side hole of the nasogastric tube projects approximately <num> cm below the gastroesophageal junction. There is no visible evidence of complications. Moderate cardiomegaly with bilateral areas of atelectasis and mild pulmonary edema. Left pectoral pacemaker in situ.
nasogastric tube placement. evaluation.
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Pa and lateral views of the chest were obtained. Midline sternotomy wires, aortic valve replacement and upper to mid thoracic spinal hardware is again noted. The lungs are clear bilaterally without focal consolidation, effusion, or signs of chf. Cardiomediastinal silhouette is stable. Bony structures appear intact.
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The cardiomediastinal silhouettes are unchanged and normal in appearance. There is interval increase in bilateral hilar prominence, which probably represents hilar lymphadenopathy given prior ct exam findings from <unk>. The previously seen right parahilar opacification has resolved. In comparison to prior radiograph from <unk>, there is stable appearance of increased bilateral interstitial prominence. There is also now seen a right infrahilar opacification which could reflect an area of consolidation of new lung nodule. It is recommended to obtain repeat chest ct for further evaluation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or effusion.
<unk> year old man with nk cell deficiency, ebv viremia who has had cough with some sputum for last <num> months // etiology of cough
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Again, there is elevation and tenting of the left hemidiaphragm suggesting persistent atelectasis. There is new lace-like interstitial abnormality in the right upper lung and new opacities in the right middle lobe and perihilar region. Mild cardiomegaly is unchanged. The mediastinal and hilar contours are normal. There is no large pleural effusion or pneumothorax.
shortness of breath. evaluate for pneumonia.
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The cardiac, mediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. The lungs appear clear. The bones appear demineralized. Post-traumatic deformity appears unchanged along the proximal left humerus. As noted previously, there is a recent left distal clavicle fracture. In addition, on this study, irregular nondisplaced lucency in the medial left clavicular head are consistent with a fracture, although these are similar and retrospect to a recent prior ct of the cervical spine from <unk>, although hard to visualize on recent prior dedicated left shoulder radiographs.
status post fall with chest wall pain.
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Heart size remains mildly enlarged. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is demonstrated. No acute osseous abnormality seen.
history: <unk>f with weakness and nausea
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Ap and lateral views of the chest provided. The lungs are essentially clear besides as minimal right basilar atelectasis. There is no effusion or edema. Cardiomediastinal silhouette is within normal limits. Mid thoracic dextroscoliosis is noted. Surgical clips in the right upper quadrant suggest prior cholecystectomy.
<unk>f with hypoxia. evaluate for infiltrate.
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As compared to the previous radiograph, the patient has received a new pacemaker. The pacemaker leads are in expected position. The pacemaker generator is located in the left pectoral region. Borderline size of the cardiac silhouette without pulmonary edema. No pneumothorax. No pleural effusions.
dual-chamber pacemaker. evaluation for pneumothorax.
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The patient is status post sternotomy. Sternotomy wires are well aligned. Surgical clips overlie the mediastinum and right upper lung field. Allowing for ap projection and rotation, the heart is upper limits of normal. Lung volumes are mildly decreased. Patchy and linear opacities are present at the left lung base. . There is no lobar consolidation, pneumothorax, or pulmonary edema. Mild blunting of the left costophrenic angle may be secondary to pleural thickening or trace pleural effusion.
history: <unk>m with cough, hypotension // eval for pna
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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.
transient left upper quadrant pain.
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Lungs are clear. Heart size normal. Mediastinal contours are within normal limits. No pleural effusion or pneumothorax.
<unk> year old woman with above, former smoker // r/o pna: cough/bibasilar <unk>/dullness
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Patient has underlying chronic interstitial lung disease. However, compared to chest radiograph from <unk>, there has been significant interval increase in bilateral pulmonary opacities as well as obscuration of the bilateral hemidiaphragms. Findings raise concern for bilateral pleural effusions with overlying atelectasis, subtle suggestion of bibasilar air bronchograms raises concern for bilateral consolidations which may be due to infection and/ or aspiration. Underlying pulmonary edema may also be present.
history: <unk>m with pulmonary fibrosis, chf, on bipap, prior film from osh // evaluate for pulmonary edema, pneumonia, acute change
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Ap view of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal. No displaced fractures are identified.
fall and trauma.
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The patient is rotated somewhat to the left. The pac is noted overlying the left lateral upper hemithorax. There is a relative opacity projecting over the left mid-to-lower lung, possibly in the lingula which could relate to patient positioning, underlying consolidation due to an infection or contusion given not excluded. No pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. Thoracic scoliosis is noted.
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There has been interval removal of previously seen left-sided central venous catheter. Last below the aortic endograft appears to be in stable position, there is increased opacity between the superior edge of the endograft and the superior wall of the aorta at the aortic arch, which may be due to increasing size of aortic aneurysm and/or dissection. Ct scan is pending. The cardiac silhouette is stable and top normal in size. No focal consolidation, pleural effusion, evidence of pneumothorax is seen. Right mid lung linear scarring is noted.
syncope
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The cardiac silhouette is mildly enlarged. The mediastinal contour is normal. Low lung volumes. No overt edema or pneumonia. There is no pleural effusion or pneumothorax.
<unk>m with weakness, evaluate for pneumonia..
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Frontal and lateral views of the chest demonstrate well expanded clear lungs. There is a small right-sided pleural effusion. The cardiomediastinal and hilar contours are unremarkable. No consolidation or pneumothorax.
<unk> year old man with cirrhosis, p/w diffuse myalgias and leukocytosis to <unk>. no clear source. // assess for infiltrate
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A right-sided swan-ganz catheter ends in the main pulmonary artery. There is a large bore left internal jugular central venous catheter ending in the mid svc. A dobbhoff tube ends in the lower stomach. There is a pleural pigtail catheter projecting over the left lower lung. There is also a right-sided pleural catheter terminating in the right juxtahilar region. A right-sided midline versus peripherally positioned picc is unchanged in location. Mild to moderate interstitial pulmonary edema is not significantly changed. Superimposed patchy right lung opacities are also unchanged. The cardiomediastinal silhouette is unchanged. There is a tiny right hydropneumothorax, as seen on the ct from <unk>.
<unk> year old man s/p pericardiectomy // eval for hemothorax/swan placement
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Pa and lateral views of the chest were obtained. Multiple small clips are noted in the low neck/superior mediastinum as seen previously compatible with a prior thyroidectomy. The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. The heart and mediastinal contour appear normal. The imaged osseous structures are intact. There is no free air below the right hemidiaphragm.
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The patient is status post median sternotomy and cabg. The heart size remains mildly enlarged but stable. Aortic valvular calcifications are severe. There is no pulmonary vascular congestion. Elevation of the right hemidiaphragm is chronic. Mild bibasilar atelectasis is seen, but no focal consolidation is present. There is diffuse calcification of the thoracic aorta. Mediastinal and hilar contours are unremarkable. No pleural effusion or pneumothorax is present. There are mild degenerative changes in the thoracic spine.
end-stage renal disease, orthostasis, fatigue.
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The cardiomediastinal and hilar contours are stable with mild tortuosity of the descending aorta. There is no pleural effusion or pneumothorax. Hyperinflation and flattened hemidiaphragms may be indicative of a chronic pulmonary process. A <num> mm density is seen in the left lower lung, stable since the prior study and probably a calcified granuloma, is likely of no clinical significance. Note is made of an old right clavicular fracture.
cough for two weeks.
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The lungs are relatively well expanded. Heart size is stable. There is a new focal consolidation in the left lower lobe posteriorly. No pleural effusion or pneumothorax is noted. There is no pulmonary edema.
<unk>f with left flank pain, bibasilar crackles // pneumonia or consolidation?
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The lungs are clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk> year old man with severe pancreatitis, now febrile to <num> // please assess for infiltrate
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Frontal and lateral chest radiograph demonstrates hyperinflated lungs with flattening of the diaphragms and basilar predominance.persistent left upper lobe opacity may represent a component of overlapping shadows however cannot exclude pulmonary nodule. Areas of bronchial wall thickening and bronchiectasis are similar to previous examination. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits.
copd, multiple myeloma and shortness of breath, cough. assess for pneumonia.
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Since the prior exam, there is slight increasing density at the right base, which could be due to a slight increase in the small right pleural effusion or increasing atelectasis. A small left pleural effusion is unchanged. Mild pulmonary edema is stable. There is no new consolidation. There is no pneumothorax. The cardiomediastinal silhouette is stable. A left picc terminates at the atriocaval junction.
status post valvuloplasty complicated by stroke with increasing white count.
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A left chest tube is present. There is a left apical opacity with a small adjacent pneumothorax, reflective of postsurgical change. The lungs are hyperexpanded. No focal consolidation, pleural effusion or pneumothorax in the right lung. The size of the cardiac silhouette is enlarged. Subcutaneous emphysema is noted over the left lateral chest wall.
<unk> year old woman s/p vats // eval for post-op changes
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Frontal and lateral radiographs of the chest show persistently low inspiratory lung volumes. Mild biapical pleural thickening is unchanged. No focal consolidation, pleural effusion, or pneumothorax is present. Mild mediastinal and pulmonary vascular engorgement is noted. Mildly increased interstitial lung markings are equivocal for mild pulmonary edema in the setting of low lung volumes. The cardiac silhouette is mildly enlarged with ring shadowing at the cardiac apex suggestive of myocardial calcification which could be related to aneurysm formation or prior myocardial infarction. The thoracic aorta is slightly unfolded and heavily calcified, particularly along the descending portion. The mediastinal and hilar contours are stable with prominence of the azygos vein. The patient is status post median sternotomy with wires intact and multiple surgical clips projecting along the left cardiac border consistent with prior cardiac surgery. A left supraclavicular dual-channel dialysis catheter is unchanged in position with the tip terminating in the right atrium. Surgical clips are noted in the right upper quadrant of the abdomen consistent with prior cholecystectomy.
<unk>-year-old female with leukocytosis and fever, here to evaluate for pneumonia.
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All lines and tubes are unchanged in positioning. There are persistent multifocal opacities on the right, and at the left base, which may have slightly increased compared to the previous examination. The pulmonary vasculature is normal. The cardiomediastinal silhouette is stable. Small pleural effusions are difficult to exclude. There is no pneumothorax.
<unk> year old man with s/p bronch // infiltrate
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Interval placement of endotracheal tube, terminating approximately <num> cm above the carina. Enteric tube courses below the diaphragm, finally terminating in the left upper quadrant in the expected location of the stomach. Extensive bilateral pulmonary opacities, right significantly greater than the left, are re- demonstrated, as seen on the prior study. No large pleural effusion is seen although small pleural effusion would be difficult to exclude on the left.
history: <unk>m with s/p intubation // ett placement
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The tracheostomy tube appears in relatively horizontal orientation, unchanged from prior examination. However, complete assessment is difficult in this single view. A right picc line terminates in the region of the right subclavian vein. Feeding tube projects below the contours of the diaphragm, the tip is not included in this examination. There is diffuse mediastinal widening, consistent with known thyroid mass, unchanged from prior examinations. Cardiac silhouette is stable. Widespread pulmonary metastases are again demonstrated. Right lower lung opacity is slightly increased, likely related to a combination of atelectasis and pleural fluid. The left lung is clear.
<unk>-year-old woman with thyroid cancer. study requested for evaluation of trach and infiltrate/changes.
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The lungs are essentially clear. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are normal. Pulmonary vascularity is normal.
<unk>-year-old male with stroke and leukocytosis. evaluate for pneumonia.
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No significant changes compared to prior exam. The patient is status post right lung biopsy. Postsurgical changes are seen at the right lung base. Stable calcified granuloma in the left lung base. Small bilateral pleural effusions can't be excluded. Enlarged heart size is unchanged. There is no pneumothorax.
<unk> year old man with recent biopsy now with lower <unk> sat. // concern for pneumothorax (had no ptx @ <num> cxr today)
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Single lead left-sided aicd is in place and unchanged. Mild lateral left base atelectasis/scarring is again seen. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are stable.
shortness of breath.
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Heart size is borderline enlarged, unchanged. Aortic knob calcifications are again noted. The mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes noted in the thoracic spine.
history: <unk>m with general weakness
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Small biapical pneumothoraces have slightly decreased in size, and remain larger on the left than the right side. Exam otherwise appears relatively similar to the recent study except for slight worsening of bibasilar opacities, left greater than right, and increase of a moderate left pleural effusion, aspiration or infectious pneumonia. Small-to-moderate left pleural effusion has slightly increased in size, and a small right pleural effusion is unchanged.
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Left-sided pacemaker device with leads terminating in the right atrium and right ventricle is again noted. Heart size is normal. Aortic knob is mildly calcified. Mediastinal and hilar contours are unchanged. Upper lobe predominant emphysema is again noted. Streaky bibasilar airspace opacities likely reflect atelectasis. No pleural effusion, pulmonary vascular congestion, or pneumothorax is identified. There are mild degenerative changes in the thoracic spine.
cough and fever.
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Frontal and lateral chest radiograph demonstrates cardiomegaly. When compared to chest radiograph <unk>, there is decreased but persistent pulmonary edema with right pleural effusion. There is no focal consolidation. There is no pneumothorax. A right-sided pacer is identified with its single lead terminating in the standard position within the right ventricle.
<unk>-year-old male with moderate to severe mitral regurgitation undergoing mitral valve surgical intervention. preop evaluation.
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Portable upright view of the chest demonstrates normal lung volumes. There is no pleural effusion, focal consolidation, or pneumothorax. Hilar and mediastinal silhouettes are unchanged. Heart size is normal.
chest pain.
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Left picc tip terminates in the lower svc, unchanged. Heart size is normal. 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.
<unk> year old man status post right arm surgery, with picc in place for iv antibiotics
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Pa and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>f with cp // evidence of effusion, pneumonia
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The lungs are well-expanded and clear. No focal consolidations. Normal appearance of the cardiomediastinal silhouette. No pleural effusion. No pneumothorax. No acute osseous abnormalities detected.
history: <unk>m with chest pain s/p mvc. // rib fx, pneumo?
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Lung volumes are low. There is a retrocardiac opacity, likely reflecting atelectasis. No right pleural effusion. There is mild cardiomegaly. An et tube terminates approximately <num> cm above the carina. An enteric tube terminates in the stomach.
<unk> year old woman with post op. gastric access for meds // og tube placement
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As compared to the previous radiograph, a <num> to <num> cm apical lateral pneumothorax has newly occurred. The right chest tube is in unchanged position. Unchanged appearance of the pre-described post-surgical air collections in the soft tissues and the mediastinum. Minimal increase of the left pleural effusion. No evidence of tension or other changes. At the time of dictation and observation, <time> p.m., on <unk>, the referring physician <unk>. <unk> was notified by dr. <unk> <unk> the telephone.
right upper lobectomy, evaluation for interval change.
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Since <unk>, bilateral pneumothoraces, right greater than left, are appreciated. The right pneumothorax is seen <num> cm from the apex and extends laterally. The left pneumothorax is seen <num> cm from the apex. Lung volumes remain low with continued bibasilar atelectasis. Known right chest tube positioning is slightly changed. The cardiomediastinal silhouette is normal. Worsening marked subcutaneous emphysema along the right chest wall, may be due to positioning of the chest tube.
<unk> year old man with myasthenia <unk>, s/p r vats thymectomy. eval for lung reexpansion. // <unk> year old man with myasthenia <unk>, s/p r vats thymectomy. eval for lung reexpansion.
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Interval placement of right-sided chest tube terminating at the level of the right sixth posterior rib, with a persistent small right apical pneumothorax at the level of the right third posterior rib level. Multiple contiguous rib fractures are present from the second to the seventh rib level, including at least one segmental fracture, concerning for flail chest. Widespread consolidation in the right lung has slightly worsened, and persistent subcutaneous emphysema is also demonstrated. Circular lucencies in the right mid and lower lung are consistent with pulmonary laceration injury. Cardiomediastinal contours are within normal limits for technique. Left lung and pleural surfaces are clear. Additional traumatic injuries are demonstrated with the right clavicular and scapular fractures, shown to better detail on ct.
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Lung volumes are low. No focal consolidation, pleural effusion, or pneumothorax is detected. There may be mild central pulmonary vascular engorgement, which may be exaggerated by low lung volumes. Evaluation of heart size is suboptimal in the setting of low lung volumes. Mediastinal contours are within normal limits. Post-surgical changes are again noted. Osteopenia is seen.
<unk>-year-old male with altered mental status.
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Cardiac, mediastinal and hilar contours are unchanged with the heart size within normal limits. Moderate size hiatal hernia is re- demonstrated. Lungs are clear. Pulmonary vasculature normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
chest pain and dyspnea.
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Ap upright and lateral views of the chest provided. Diffuse ground-glass opacities are noted within both lungs which may reflect pulmonary edema versus atypical infection. No large effusion or pneumothorax is seen. The cardiomediastinal silhouette is grossly unremarkable. Bony structures are intact.
<unk>f with cough.