1. SURGICAL RADIOLOGY (CHEST ) BY DR IBRAHIM GALAL PROFESSOR OF GENERAL SURGERY

2. PA VIEW

3. × NORMAL AP

4. × NORMAL AP √ NORMAL PA

5. STRUCTURES FORMING THE MEDIASTINAL MARGINS

6. CHEST EXAM = ABCDEF
AIRWAY. BONE. CARDIOMEDIASTINAL SILHOUETTE. DIAPHRAGM. EXPANDED LUNGS/EVERYTHING ELSE. FOREIGN OBJECTS

7. FOCAL SHADOWS NEOPLASIA: -PRIMARY: -BRONCHOGENIC. -PLUERAL. -LYMPHOMA.
-SECONDARY: BREAST,HYPERNEPHROMA,MELANOMA, THYROID, STOMACH,
PROSTATE, OSTEOSARCOMA.
CYST:
-SIMPLE.
-HYDATID.
-ABSCESS.
-EMPHYSEMATOUS.
CONSOLIDATION:
-COLLAPSE.
-PNEUMONIA.

8. SINGLE FOCAL LESION
RT.APICAL LT. MID ZONAL

9. RT. FOCAL LESION Q.BREAST METS

10. PERIPHERAL LESION

11. PERIPHERAL LESION

12. CENTRAL FOCAL LESION BLUE ARROW: FOCAL LESION (Q.BRONCHIAL CA)
RED ARROWS:
HILAR SHADOWS
(Q.NODAL METS)

13. RT. MULTIPLE FOCAL SHADOWS + RT DIAPHRAGMATIC PARALYSIS

14. BILATERAL MULTIPLE FOCAL SHADOWS

15. MEDIASTINUM

16. SUPERIOR MEDIASTINAL SHADOW RETROSTERNAL GOITER

17. SUPERIOR MEDIASTINAL SHADOW AORTIC ANEURYSM

18. WIDE MEDIASTINUM Q.HEMATOMA(AORTIC INJURY)

19. ANT. MEDIASTINAL SHADOW THYMUS

20. POSTERIOR MEDIASTINAL SHADOW LYMPHADENOPATHY

21. LOWER POSTERIOR MEDIASTINALSHADOW (SLIPPED FUNDOPLIACTION)

22. PNUEMOTHORAX

23. PATHOGENESIS OF PNUEMOTHORAX
PRESENCE OF AIR INSIDE THE PLEURA .
AIR MAY ENTER THE PLEURA VIA A TEAR FROM EITHER:
1- OUTSIDE (PLEURO-CUTANEOUS COMMUNICATION).
2- INSIDE (PLEURAO-BRONCHIALCOMMUNICATION).

24. CAUSES OF PLEURAL TEAR 1- TRAUMA.
2- SPONTANEOUS (RUTURE PATHOLOGICAL LESION): EMPHYS. BULLA,TB CVITY,CYST).
3- IATROGENIC:
- BAROTRAUMA(VENTILATOR) .
- CVP INSERTION.

25. TYPES
1- CLOSED (SIMPLE). 2- OPEN (SUCKING). 3- VALVULAR (TENSION).

26. RADIOLOGICAL PICTURE
PNUEMOTHORAX :
- PLEURA : CONTAINS JET BLACK AIR IN THE PERIPHERY.
- LUNG : COLLAPSED MEDIALLY WITH VISIBLE EDGE.
- MEDIASTINUM: - CENTRAL SIMPLE .
- SHIFTED  FLUTTER  OPEN.
 FIXED  TENSION.

27. CLINICAL PICTURE RESPIRATORY DISTRESS. HYPER-RESONANCE.
DIMINISHED AIR ENTERY.
IN ADDETION:
1- OPEN : SUCKING CHEST WOUND (HISSING SOUND).
MEDIASTINAL FLUTTER.
2- TENSION : CONTRALATERAL FIXED MEDIASTINAL SHIFT.
CONGESTED NECK VEINS.

28. TENSION PNEUMOTHORAX

29. TENSION PNEUMOTHORAX

30. PLEURAL EFFUSION
PRESENCE OF FLUID INSIDE THE PLEURA .

31. RT. PLUERAL EFFUSION

32. HYDRO/PNEUMOTHORAX

33. RIGHT JET BLACK PLEURAL SPACE. COLLAPSED LUNG. AIR/FLUID LEVEL.
OBLITERATED C/PH ANGLE.
CENTRAL MEDIASTINUM

34. LEFT

35. LEFT

36. LEFT

37. BILATERAL

38. CARDIOMEGALY
CARDIOTHORACIC RATIO SHOULD BE LESS THAN 55%. IN THIS CASE IT IS GREATER THAN 70%.
AN ECHOCARDIOGRAM EXCLUDED A PERICARDIAL EFFUSION.
THE CENTRAL PULMONARY VESSELS ARE DILATED (BLACK ARROWS).
AN INFUSION PORT CATHETER IS NOTED OVERLYING THE RIGHT CHEST (YELLOW ARROW)

39. CYISTIC LESIONS SIMPLE. PARASITIC. INFLAMATORY. EMPHYSEMATOUS.
BRONCHIECTASIS.
NEOPLASTIC.

40. RT.SINGLE CYST

41. BRONCHOGRAPHY
BRONCHIECTASIS

42. BRONCHIECTASIS

43. BRONCHIECTASIS

44. TB CAVITY

45. DIAPHRAGMATIC HERNIA

46. DIAPHRAGMATIC HERNIA

47. AIR UNDER DIAPHRAGM

48. CARDIAC AIR EMBOLISM

49. LUNG FIBROSIS

50. DIFFUSE LUNG INFILTRATES ESINOPHILIC PNEUMONIA

51. LYMPHANGITIS CARCINOMATOSIS

52. CVP

53. CVP COMPLICATION LEFT PNEUMOTHORAX (DOUBLE-HEADED YELLOW ARROW).
LEFT LUNG MARGIN (BLACK
ARROWS).
THE DISTAL TIP OF THE CENTRAL VENOUS LINE IN THE SUPERIOR VENA CAVA (RED ARROW).
TIP OF THE ENDOTRACHEAL TUBE (WHITE ARROW).

54. PACEMAKER
THE WIRES CONNECTING THE PACEMAKER TO THE INTRACARDIAC ELECTRODES MUST BE INTACT.
(YELLOW ARROW IN THE SVC
& RED ARROW IN THE RT.
VENTRICLE).

55. LT LOWER LOBE COLLAPSE WITH EFFUSION

56. LOBAR COLLAPSE RT UPPER LOBE

57. PNUEMONIA RT UPPER LOBE LT MIDDLE ZONE

58. SARCOIDOSIS

59. COPD

60. TRACHEAL SHIFT(GOITER)