Wk 2, Case 11 - Review

EXAM: CT Chest w/ Contrast
CLINICAL INDICATION: PE Protocol; Acute shortness of breath.

TECHNIQUE: Non-gated spiral axial images of the chest were obtained with nonionic intravenous contrast according to a pulmonary embolism protocol. If applicable, point-of-care testing was approved following departmental protocol. There were no immediate complications reported.

COMPARISON: None

FINDINGS:

PULMONARY ARTERIES:
No pulmonary embolism. Main pulmonary artery is normal in size.

MEDIASTINUM/HEART/VESSELS:
The heart is normal in size with the massively enlarged pericardial effusion.

The contours of the cardiac chambers are preserved. The thoracic aorta is normal in size. There is an enteric tube extending beyond the GE junction. There is no lymphadenopathy.

AIRWAY/LUNGS/PLEURA:
There are trace pleural effusions. There is patchy consolidation bilaterally. ETT terminates in the midtrachea.

VISIBLE ABDOMEN:
There is reflux of contrast in the IVC and hepatic veins. Please refer to the CT of the abdomen and pelvis from the same date for findings below the diaphragm.

SOFT TISSUES/BONES:
No concerning findings

IMPRESSION:
No pulmonary embolism.
Massively large pericardial effusion. Consider echocardiogram to evaluate for tamponade.
Patchy consolidation bilaterally likely from pulmonary edema. Underlying infectious process is difficult to exclude.