PMC7896536_01
anteroposterior and lateral chest radiographs showing thinned out and markedly elevated left hemidiaphragm (diaphragmatic eventration) with mass effect of the sub-phrenic abdominal contents causing ipsilateral left lung collapse and contralateral trachea-mediastinal shift (tension viscero-thorax)
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F1
Figure 1 below was the last in the series of these chest radiographs. These were not visible on the chest radiograph done earlier on the same day (Figure 1). The appearance was also not consistent with early features of diffuse lymphogenous pulmonary metastasis attributable to the recently operated pelvic tumour.
anteroposterior chest radiograph showing dextrocardia and features of bilateral pneumonic consolidations with peripheral disposition and an age-related aortic atherosclerotic calcification
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F2
Tomographic (CT) scan was performed (Figure 2, Figure 3) on the same day while awaiting the pre-operative laboratory test results, which showed the previously known left diaphragmatic eventration and its mass effect as well as multiple ground-glass densities with surrounding pneumonic consolidations diffusely aligned within both lung fields but worse in the right lower lobe.
scanogram and axial views of the chest CT scan showing diffuse bilateral peribronchovascular ground glass densities and focal lung consolidation (red arrows) and a mild left pleural effusion (blue arrow)
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F3
Tomographic (CT) scan was performed (Figure 2, Figure 3) on the same day while awaiting the pre-operative laboratory test results, which showed the previously known left diaphragmatic eventration and its mass effect as well as multiple ground-glass densities with surrounding pneumonic consolidations diffusely aligned within both lung fields but worse in the right lower lobe.
axial and coronal views of the same chest CT scan showing the eventrated left hemidiaphragm (red arrow) and tension viscero-thorax from gastric and colonic subphrenic abdominal components (blue arrow)
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F4
Post-operative chest radiograph (Figure 4) showed correct positioning of the left hemidiaphragm, return of the mediastinum and trachea to the centre and re-expansion of the left lung.
PMC7896536_02
post-operative chest radiograph shows normal position of the left hemidiaphragm (red arrow) and normal position of the trachea and mediastinum (blue arrow) with right lung infiltrates
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F5
There was no evidence of pleural or pericardial effusion (Figure 5).
axial CT scan (lung window) showing dextrocardia, bovine pattern of aorta and diffuse peripherally and basally distributed ground-glass densities with consolidations in both lungs
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F6
The liver was located on the left and the spleen on the right, in keeping with a situs inversus (Figure 6).
PMC7896536_03
axial CT scan (lung window) showing diffuse peripherally and basally-distributed ground-glass densities with consolidations in both lungs
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F7
He had a chest computed tomographic (CT scan) done on the 2nd day of admission (Figure 7), which revealed diffuse peripherally-oriented ground glass densities in both lungs, which were more marked in the lower lobes.