Incidental finding of congenital pericardial and mediastinal pleural defect by pneumothorax in an adult Y. Sugiura, Y. Matsusaka, E. Nemoto, T. Hashizume,

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Incidental finding of congenital pericardial and mediastinal pleural defect by pneumothorax in an adult Y. Sugiura, Y. Matsusaka, E. Nemoto, T. Hashizume, S. Kaseda Radiography Volume 21, Issue 2, Pages e81-e84 (May 2015) DOI: 10.1016/j.radi.2014.12.010 Copyright © 2014 The College of Radiographers Terms and Conditions

Figure 1 Postero-anterior chest X-ray showed a left pneumothorax (black arrowheads), and lucency between the silhouette of the right side of heart and the right lung (black arrows). Radiography 2015 21, e81-e84DOI: (10.1016/j.radi.2014.12.010) Copyright © 2014 The College of Radiographers Terms and Conditions

Figure 2 (a–c) Axial slices of computed tomography using lung window settings. (a) Free air in the transverse sinus and the space between the right lung and the right side of aorta (Ao). PA indicates main trunk of pulmonary artery and the asterisk shows the transverse sinus. (b) The anterior mediastinal pleura on the left side was obviously deficient (white arrow head). (c) The cardiac position shifted into the left thorax. (d) The coronal slice demonstrated free air trapped at the superior margin of pericardial space just above the aortic root (white arrow). The black dotted line indicates part of the left residual mediastinal pleura. Radiography 2015 21, e81-e84DOI: (10.1016/j.radi.2014.12.010) Copyright © 2014 The College of Radiographers Terms and Conditions

Figure 3 The cardiac position was elevated by the inflated lung after the chest tube was inserted. Radiography 2015 21, e81-e84DOI: (10.1016/j.radi.2014.12.010) Copyright © 2014 The College of Radiographers Terms and Conditions