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| Patient: 55 year old female |
| History: The patient was admitted with a right tibial plateau fracture after falling in the bathtub. Following surgery, she was found "down" on the orthopaedics floor in PEA. She was successfully resuscitated and intubated, however she continued to have persistent hypoxia. Due to an elevated creatinine, a V/Q scan, rather than a PE protocol CT was ordered. |
Image Size:[small][as-submitted]
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| Findings: The aerosol ventilation images demonstrate no ventilation of the left lung. There is deposition in the tracheobronchial tree in the right lung, which has grossly normal ventilation. Perfusion images demonstrate a slight generalized decrease in perfusion to the left lung, although it does remain perfused. There is also relatively less perfusion to both lung bases compared with the upper lobes. No large or segmental perfusion defects are noted. |
| DDx: Selective intrinsic occlusion of the right main bronchus, such as with a mucous plug. Extrinsic compression of the right main bronchus, by a mass. Intrinsic compression by an intraluminal mass such as carcinoid. Iatrogenic lack of ventillation of the left lung because of a right mainstem bronchial intubation. |
| Diagnosis: A chest radiograph performed prior to the V/Q scan demonstrated a right mainstem bronchial intubation. According to the ICU fellow managing the patient's care, this right mainstem broncial intubation was confirmed and corrected prior to the V/Q scan. |
| Comments: No comments posted. |
| Additional Details:
Case Number: 97810 The reader is fully responsible for confirming the accuracy of this content. |
