Free Air Beneath the Hemidiaphragm
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0177-Free Air Beneath the Hemidiaphragm
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CA0177-Free Air Beneath the Hemidiaphragm
Case ReportHistory
Exam
Prior Study
Findings
Technique
The AP supine exam is expiratory and slightly rotated to the left.
The exam is somewhat limited by overlying external leads.
Support Devices
There is an ETT present in the mid trachea.
There is a PAC in place with the tip in the main pulmonary outflow tract.
There is an NG tube extending below the GE junction though the tip is not included.
There are two left chest tubes in place.
Cardiomediastinum
The mediastinum is not abnormally widened considering the technique.
There is no enlargement of the cardiac silhouette.
Vasculature
The aorta is mildly dilated with ill-defined borders from recent aneurysm repair.
The central pulmonary vessels and hila are not enlarged.
Lungs
The lungs are mildly underinflated.
There is left basilar subsegmental atelectasis or airspace disease.
The right lung is clear for the expiratory technique.
Pleura
There is no pneumothorax and the pleural space is clear.
Bones, Soft Tissues, Upper Abdomen
There is free air beneath the right hemidiaphragm indicating pneumoperitoneum which could be from a perforated viscus or related to the recent aneurysm repair.
The bones and soft tissues are normal.
Impression
Left lower lobe opacity is likely from subsegmental atelectasis.
